Application of a computer-assisted intervention and an on-line data collection method in rural adolescents with asthma

Computer-assisted approaches hold great potential for research and interventions with rural adolescents with asthma. Geographical remoteness of populations has been a barrier in conducting research with rural populations. One possible solution is through the use of online communication. Information technology is well accepted by most children and adolescents. Asthma is a leading chronic illness in children and adolescents. Adolescents, and particularly those with chronic illness, are at high risk for unhealthy behaviors. Adolescents with asthma often report positive attitudes toward smoking, and are more likely to smoke than their healthy peers despite serious health risks. This pilot study was conducted to examine the feasibility of a computer-assisted decision-making intervention to increase decision making quality and reduce risk behaviors, and an online method of collecting data from rural adolescents with asthma. A total of 41 teens, ages 14 -18 years, from 4 clinics and a high school in rural Virginia participated. The majority were females (68%) and non-Hispanic Whites (63%). The intervention included a CD-ROM program, consisting of one decision-making and three risk behavior modules, and a brief (5-10 minutes) counseling session at baseline. The decision-making CD-ROM module was repeated at 2-month follow-up, along with using a workbook to reinforce information by applying in real life situations. At 4-months, participants received another CD-ROM containing an interactive risk behavior module. Booster intervention packets (including the CD-ROM programs and workbook) were mailed to participants. Telephone follow-up was conducted to confirm compliance with the protocol. Follow-up data (at 2, 4 and 6-months post-intervention) were collected using the Internet. Sixty-two percent (n=24) of the participants transmitted follow-up data electronically using the Internet; the remainder used a mailed response. Almost all teens had online access at home, school or the public library. Adolescents with higher SES (annual income > $30,000) were more likely to transmit data online. The computer-assisted intervention was well received by the intervention group. Results of this study confirm the feasibility of conducting research with rural adolescents using computer and information technology for interventions and data collection. Lessons learned and implications for rural research using information technology will be described.