Obesity Clinical Trial
Official title:
Asthma Management Support Training in Pediatrics
Self-care behaviors are decisions and actions that people can take to improve their health or cope with a health problem. It is important for people with long-term illnesses to develop and maintain effective self-care behaviors. This study will evaluate the usefulness and practicality of the Collaborative Management in Pediatrics (CMP) program, which is a training program developed to encourage pediatric resident doctors to promote self-management of illness and behavior change among children with asthma or obesity and their families.
Collaborative management health care involves strengthening and supporting self-care among
people with long-term illnesses while assuring that effective medical, preventive, and
health maintenance treatments occur. In collaborative management, it is important for
patients, family members, and health care providers to understand each other's roles and
responsibilities as they work toward a shared goal of improving the patient's health.
Examples of self-care behaviors include reading books or other materials about relevant
health care topics, exercising, following a low-fat diet, seeing a doctor on a regular
basis, and making lifestyle changes. It is crucial that doctors, case managers, nurses,
pharmacists, and other medical professionals understand the challenges that patients face
when attempting to incorporate these self-care behaviors into their lives. Currently, there
are few collaborative management programs that specifically address pediatric long-term
illness and even fewer programs that identify doctors as the primary medical professional
responsible for encouraging behavior change.
The CMP program will incorporate a collaborative management technique with a motivational
interviewing approach. Motivational interviewing is a counseling style that attempts to
increase awareness of the potential problems, causes, consequences experienced, and risks
faced as a result of the behavior in question. The goal of the CMP program is to help
pediatric resident doctors accomplish the following: assess patients' asthma and obesity
status and related health behaviors; assess the child/family aspect of self-care; motivate
parents and children to change asthma or obesity health behaviors; collaboratively set goals
for asthma management by the family; and provide tailored follow-up to patients and their
families. The purpose of this study is to evaluate the feasibility of the various components
of the CMP program. Results from this study will be used to develop a larger clinical trial
that will evaluate the effectiveness of the CMP program.
This pilot study will enroll 18 first-year pediatric resident doctors; each doctor will
select five of their pediatric patients with asthma or obesity to participate in the study.
Each resident doctor will be randomly assigned to take part in either the CMP program or a
control group. All resident doctors will complete an Objective Structured Clinical
Examination (OSCE), which will be used to assess their skills and ability in the areas of
communication, clinical examination, medical procedures, prescribing medication, and
interpretation of test results. Resident doctors participating in the CMP program will then
receive CMP training. Three weeks following the initial OSCE, all resident doctors will
perform a repeat OSCE, which will evaluate the effectiveness of the CMP training. One health
care visit will then be conducted with each participating patient. During this visit, the
resident doctor will conduct a collaborative management session emphasizing the family's
central role in managing the child's health. Study researchers will conduct a 30-minute
telephone interview with the child's parents at baseline, Week 6, following the heath care
visit, and Month 3. Parent/child behaviors, attitudes related to asthma or obesity,
management of their child's health, and satisfaction with care will be assessed during the
telephone interviews. All residents will complete a repeat OSCE at Month 6 to assess any
increase or decrease in skills.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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