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Uganda experiences high morbidity and costs due to uncontrolled asthma. Poor asthma control in adolescents is partly attributed to inadequate asthma education; indicating that education and self-management programs are essential components of asthma control. Adolescents with poorly controlled asthma are reported to have improved asthma control after using a smart phone application in outpatient setting studies. However, there is paucity of data on the effectiveness, feasibility and acceptability of smart phone applications in the control of asthma among adolescent secondary school students in low resource settings.
Uganda experiences high morbidity and costs due to uncontrolled asthma. Poor asthma control in adolescents is partly attributed to inadequate asthma education; indicating that education and self-management programs are essential components of asthma control. Adolescents with poorly controlled asthma are reported to have improved asthma control after using a smart phone application in outpatient setting studies. However, there is paucity of data on the effectiveness, feasibility and acceptability of smart phone applications in the control of asthma among adolescent secondary school students in low resource settings. This study will evaluate the effectiveness, acceptability and feasibility of the "KmAsthma" self-management app in improving the control of asthma among day scholar secondary school adolescents in Kampala City Uganda.
This study is a 6-month cluster randomized, controlled, single-centre, single-blinded, pragmatic parallel trial, with two arms and a primary endpoint of improving the control of uncontrolled asthma measured as change in individual mean scores on the Asthma control questionnaire during a self-management intervention delivered by the "KmAsthma" smartphone app. The study will compare students with uncontrolled asthma in the intervention group using the "KmAsthma" smartphone app (T) with the students in the control arm (C) who will receive no intervention. Data will be analysed by summarizing descriptive statistics; determining odds ratios for asthma control using logistic regression models, using repeated measures ANCOVA for repeated continuous measurements. Permission from CEU and approval from SOMREC and UNCST will be sought. Informed and written consent and assent will sought. Dissemination will be through publications and presentations in local and international conferences. The findings may contribute to filling the gap leading to overall unsatisfactory asthma control in adolescents.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| KmAsthma self-management smart phone app intervention | Experimental | Participants assigned to the intervention arm will be given a link to download the self-management app on their Android smartphone or iPhone |
|
| Control arm | No Intervention | Will emulate standard access to asthma self-management information |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The KmAsthma self-management smart phone app intervention | Device | KmAsthma is a free app which enables users to track their symptoms, access their action plan, learn about asthma and set goals to make change |
| Measure | Description | Time Frame |
|---|---|---|
| Change in mean Asthma Control Test (ACT) scores | The ACT questionnaire is composed of five questions, each scored on a scale from 1 to 5, with a total score range of 5 to 25. A score of 19 or above is considered indicative of well-controlled asthma | Baseline, 3 and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Adolescent Asthma Self-Efficacy Questionnaire (AASEQ) | Change in AASEQ scores | Baseline, 3 and 6 months |
| Feasibility based on proportion of participants that will drop out of the study | Deemed feasible if the percentage of participants who drop out of the study (i.e., fail to complete any of the tools) is less than 15% |
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Inclusion Criteria for Schools:
Exclusion criteria for schools:
Inclusion criteria for students:
Exclusion criteria for students:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| James Davis Katumba, MSc | Contact | +256783109311 | jamesdaviskatumba@gmail.com, james.katumba@students.mak.ac.ug |
| Name | Affiliation | Role |
|---|---|---|
| James Davis Katumba, MSc | Makerere University, College of Health Sciences, Clinical Epidemiology Unit | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 14713908 | Background | Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, Murray JJ, Pendergraft TB. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004 Jan;113(1):59-65. doi: 10.1016/j.jaci.2003.09.008. | |
| 31048348 | Background | Holley S, Knibb R, Latter S, Liossi C, Mitchell F, Radley R, Roberts G. Development and validation of the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ). Eur Respir J. 2019 Jul 4;54(1):1801375. doi: 10.1183/13993003.01375-2018. Print 2019 Jul. |
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All the individual participant data collected after de-identification.
Immediately following publication
Data available indefinitely at the link that will be added
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| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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The participants and the assessors will be masked to the study arm
| Baseline, 3 and 6 months |
| 29064746 | Result | Davis SR, Peters D, Calvo RA, Sawyer SM, Foster JM, Smith L. "Kiss myAsthma": Using a participatory design approach to develop a self-management app with young people with asthma. J Asthma. 2018 Sep;55(9):1018-1027. doi: 10.1080/02770903.2017.1388391. Epub 2017 Nov 28. |
| 38053534 | Derived | Katumba JD, Kirenga B, Muwagga Mugagga A, Kalyango JN, Nantanda R, Karamagi C. MICROS: Asthma Control App for School Adolescents in a Low Resource Setting - A Cluster Randomized Controlled Trial Protocol. Patient Prefer Adherence. 2023 Nov 30;17:3125-3133. doi: 10.2147/PPA.S438549. eCollection 2023. |
| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |