The Detroit Young Adult Asthma Project: Pilot of a Technology-Based Medication Adherence Intervention for African-American Emerging Adults

Abstract

Purpose To conduct a randomized controlled pilot of a multi-component, technology-based intervention promoting adherence to controller medication in African American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based in Motivational Interviewing (MI) combined with text messaged reminders between sessions. Methods Participants (N=48) were 18–29 years old, African American, with persistent asthma requiring controller medication. Participants had to report poor medication adherence and asthma control. Youth were randomized to receive the intervention or an attention control. Data were collected through computer-delivered self-report questionnaires at baseline, 1-, and 3-months. Ecological Momentary Assessment (EMA) via two-way text messaging was also used to collect "real time" data on medication use and asthma control. Results The intervention was feasible and acceptable to the target population, as evidenced by high retention rates and satisfaction scores. Changes in study outcomes from pre- to post-intervention favored the intervention, particularly for decrease in asthma symptoms, t (42) = 2.22, p < .05 (Cohen's d = .071). Conclusions Results suggest that the intervention is feasible and effective. However, findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses.

The Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma

“…A repeated measures design (baseline and 1-, 3-, 6-, 9-, and 12-months postbaseline) will be used with the primary outcome being adherence to daily controller medications and the secondary outcome as asthma control. We expand on the pilot study [ 55 ] by testing the long-term effects over 1 year, which allows us to account for seasonal variability of symptoms in a young, urban population [ 58 , 59 ], to gain understanding of the long-term impact on adherence behavior, and to allow trajectory analyses of adherence.…”

“…The MCTI was tested in a pilot randomized controlled trial [ 54 , 60 ] and is an integration of several technology-based components. The intervention group will receive 2 sessions of computer-delivered MI via CIAS software (Interva, Detroit, MI) programmed to target adherence to medications.…”

“…All elements of the proposed study protocol were piloted in NHLBI R34 (1R34HL107664 MacDonell). Results suggested feasibility and acceptability of the study protocol as well as proof of concept in a pilot randomized clinical trial [ 55 ]. We are now ready to test the intervention in a randomized clinical trial.…”

Harnessing the Potential of Emerging Digital Health and Biological Sampling Technologies for Clinical Drug Development: Promise to Reality

“…In the control arm, 29.9% of patients missed at least 20% of doses, while 27.3% and 17.0% and 13.9% missed the same amount of doses in the text reminder, smart packaging, and combined arms, respectively . However, other clinical studies and meta‐analyses have indicated that text message reminders and related digital health apps can increase medication adherence …”

A Church-Based Weight Loss Intervention in African American Adults using Text Messages (LEAN Study): Cluster Randomized Controlled Trial

“…This realization has led to the development of SMS text message-based pilot and feasibility studies targeting various behaviors such as the medication adherence, HIV prevention, healthy eating, and physical activity [ 21 - 25 ]. Although these studies demonstrate the acceptability, feasibility, and potential effectiveness of SMS text message interventions designed for African American adults, few have utilized randomized controlled designs [ 22 ], and fewer were specifically designed to promote weight loss [ 26 ]. Therefore, the purpose of the Lifestyle Changes Through Exercise and Nutrition (LEAN) study was to test the feasibility (SMS text message tolerance and satisfaction) and effectiveness (compared with a control group) of utilizing SMS text messages to promote weight loss in African American adults enrolled in a church-based weight loss program.…”