Enhancing Adolescent Asthma Control and Self-Efficacy: A Decision Tree Analysis of a Mobile Health Application in a Randomized Controlled Trial

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-09-10 DOI:10.1111/jep.70266

Nimet Karataş, Ayşegül İşler, Ayşen Bingöl

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引用次数: 0

Abstract

Aims and Objectives

To evaluate the efficacy of YoungAsthma, a nurse-led, web-based mHealth intervention on asthma control and self-efficacy among adolescents with asthma utilizing decision tree analysis.

Background

Asthma is a prevalent chronic condition in pediatric populations, necessitating sustained management for optimal disease control.

Design

A randomized controlled clinical trial.

Methods

Fifty-four eligible adolescents were randomly assigned to either the intervention group (YoungAsthma + Usual care, n = 27) or the control group (Usual care, n = 27) for 4 weeks. Primary outcomes—asthma control and self-efficacy—were assessed using the Information Form, Asthma Control Test, Self-Efficacy Scale for Children and Adolescents with Asthma. Statistical analyses included Fisher's exact test, chi-square test, Wilcoxon signed-rank test, Mann-Whitney U test, and Intention-to-Treat (ITT) analysis.

Results

Forty-eight participants completed the study (11% dropout per group). The intervention group exhibited a greater improvement in asthma control than the control group. While both groups showed increased self-efficacy, the intervention group's improvement was significantly higher. Decision tree analysis identified key predictors, indicating that lower scores were associated with a higher likelihood of remaining in the control group.

Conclusions

Nurse-led, technology-supported interventions significantly enhance asthma control and self-efficacy in adolescents. Decision tree analysis provided valuable insights into key factors influencing asthma control and self-efficacy improvements, identifying subgroups that benefited most from the intervention. Interdisciplinary collaboration facilitated a user-centered approach grounded in Bandura's Self-Efficacy Theory, offering a data-driven framework for personalized asthma management.

Relevance to Clinical Practice

Decision tree analysis aids in identifying patients who would benefit most, enabling precision-targeted interventions.

Reporting Method

This study was conducted in accordance with Consolidated Standards of Reporting Trials and with the Mobile Health Evidence Reporting and Assessment guidelines.

Clinical Trial Registration Number

Clinicaltrials. gov, ID: NCT04691557 & Date of first recruitment: December, 2020. https://register.clinicaltrials.gov/prs/beta/studies/S000AJ5B00000102/recordSummary.

查看原文本刊更多论文

增强青少年哮喘控制和自我效能：一项随机对照试验中移动健康应用程序的决策树分析

目的和目的利用决策树分析评估YoungAsthma的有效性，这是一项护士主导的基于网络的移动健康干预，对哮喘青少年的哮喘控制和自我效能感进行干预。背景：哮喘是儿科人群中一种常见的慢性疾病，需要持续的治疗以达到最佳的疾病控制。设计随机对照临床试验。方法将54名符合条件的青少年随机分为干预组（YoungAsthma +常规护理组，n = 27）和对照组（常规护理组，n = 27），为期4周。主要结局-哮喘控制和自我效能-评估使用信息表，哮喘控制测试，自我效能量表儿童和青少年哮喘。统计分析包括Fisher精确检验、卡方检验、Wilcoxon符号秩检验、Mann-Whitney U检验和意向治疗（Intention-to-Treat， ITT）分析。结果48名参与者完成了研究（每组11%的人退出）。干预组在哮喘控制方面比对照组有更大的改善。虽然两组的自我效能都有所提高，但干预组的改善程度明显更高。决策树分析确定了关键的预测因素，表明得分越低，留在对照组的可能性越大。结论护士主导、技术支持的干预措施可显著提高青少年哮喘控制和自我效能感。决策树分析为影响哮喘控制和自我效能改善的关键因素提供了有价值的见解，确定了从干预中获益最多的亚组。跨学科合作促进了基于Bandura自我效能理论的以用户为中心的方法，为个性化哮喘管理提供了数据驱动的框架。与临床实践的相关性决策树分析有助于确定哪些患者将受益最多，从而实现精确的靶向干预。报告方法本研究按照报告试验的统一标准和移动健康证据报告和评估指南进行。临床试验注册号临床试验。首次招聘日期：2020年12月。https://register.clinicaltrials.gov/prs/beta/studies/S000AJ5B00000102/recordSummary。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.