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Cited by 192Asthma and respiratory diseasesMobile Health and mHealth ApplicationsOccupational exposure and asthma

Improving Asthma Outcomes and Self-management Behaviors of Inner-city Children: A Randomized Trial of the Health Buddy Interactive Device and an Asthma Diary

Guendelman, Sylvia, Meade, Kelley, Benson, Mindy, Chen, Ying Qing, Samuels, Steven·2002·Archives of Pediatrics & Adolescent Medicine
DOI 10.1001/archpedi.156.2.114
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Abstract

BACKGROUND: Asthma is an important cause of morbidity, absence from school, and use of health services among children. Computer-based educational programs can be designed to enhance children's self-management skills and to reduce adverse outcomes. OBJECTIVE: To assess the effectiveness of an interactive device programmed for the management of pediatric asthma. DESIGN: A randomized controlled trial (66 participants were in the intervention group and 68 were in the control group). SETTING: Interventions conducted at home and in an outpatient hospital clinic. PARTICIPANTS: Inner-city children aged 8 to 16 years diagnosed as having asthma by a physician. INTERVENTION: An asthma self-management and education program, the Health Buddy, designed to enable children to assess and monitor their asthma symptoms and quality of life and to transmit this information to health care providers (physicians, nurses, or other case managers) through a secure Web site. Control group participants used an asthma diary. MAIN OUTCOME MEASURES: Any limitation in activity was the primary outcome. Secondary outcomes included perceived asthma symptoms, absence from school, any peak flow reading in the yellow or red zone, and use of health services. RESULTS: After adjusting for covariates, the odds of having any limitation in activity during the 90-day trial were significantly (P =.03) lower for children randomized to the Health Buddy. The intervention group also was significantly (P =.01) less likely to report peak flow readings in the yellow or red zone or to make urgent calls to the hospital (P =.05). Self-care behaviors, which were important correlates of asthma outcomes, also improved far more for the intervention group. CONCLUSION: Compared with the asthma diary, monitoring asthma symptoms and functional status with the Health Buddy increases self-management skills and improves asthma outcomes.

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  • In the emergency department visit analysis, large heterogeneity was evident within both child and adult subgroups (child I2=62%, P=0.11; adult I2=53%, P=0.06).

    “Two child studies (Guendelman 2002; Xu 2010) and six adult studies (Donald 2008; Kokubu 2000; Liu 2011; Ryan 2012; van der Meer 2009; Willems 2008) contributed to the exacerbation requiring ED visit analysis, and a large degree of heterogeneity was evident within each subgroup (I 2 = 62%, P value = 0.11; I 2 = 53%, P value = 0.06).”

    From Home telemonitoring and remote feedback between clinic visits for asthma (2016) · cites this paper as Guendelman 2002

  • For the Guendelman 2002 trial, the risk of bias from blinding of participants and personnel for subjective outcomes was high, because subjective measures like quality of life and symptom scales may have been subject to performance bias.

    “Subjective outcomes such as quality of life and symptom scales filled in by participants or personnel may have been subject to performance bias”

    From Home telemonitoring and remote feedback between clinic visits for asthma (2016) · cites this paper as Guendelman 2002

  • For the Guendelman 2002 trial, the risk of bias from blinding of outcome assessment was high, because self-reported outcomes were assessed by the nurse co-ordinator without blinding.

    “Self reported outcomes were assessed by the nurse co-ordinator, no blinding”

    From Home telemonitoring and remote feedback between clinic visits for asthma (2016) · cites this paper as Guendelman 2002

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Authors
Guendelman, S., Meade, K., Benson, M., Chen, Y. Q., & Samuels, S.
Affiliations
University of California, Berkeley (US)
Corresponding author
Guendelman, Sylvia
ORCID
Venue
Archives of Pediatrics & Adolescent Medicine
Publisher
American Medical Association (AMA)
Published
2002-02-01
Volume
156
Issue
2
Pages
114
ISSN
1072-4710 (ISSN-L)
DOI
10.1001/archpedi.156.2.114
OpenAlex
W2050549469
Cited by
192
References
23
Citations by year
2024: 1 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 4 · 2016: 7 · 2015: 10 · 2014: 6 · 2013: 15 · 2012: 15
FWCI
6.59
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
Keywords
childhood asthma, asthma self-management, asthma diary, symptom monitoring, peak flow, activity limitation, school absenteeism, health care utilization, inner-city children, self-care behavior, telemedicine
MeSH terms
Adolescent, Asthma, California, Child, Computers, Female, Humans, Male, Patient Compliance, Patient Education as Topic, Self Care, Urban Population, Health Behavior

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