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CompletedNCT03265665ACTIONUpdated Feb 23, 2022Results posted

physicAl aCtiviTy In minOrity womeN With Asthma Intervention

An interventional study of ACTION Intervention and Enhanced usual care in Asthma, sponsored by University of Illinois at Chicago. Completed at 1 site in United States. Open to female participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2022-02-23.

Sponsored by University of Illinois at Chicago · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
53
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
Female
01

Study summary

The ACTION intervention: physicAl aCtiviTy In minOrity womeN with asthma is a 3lifestyle physical activity intervention refined to be applicable for sedentary African American (AA) women with asthma. The main outcome of this study is to test the feasibility, acceptability and estimate the efficacy of the ACTION intervention in a randomized controlled pilot of 80 AA women with asthma within a pragmatic community setting at 24-weeks.

Read the detailed description

Asthma is a highly prevalent chronic disease that disproportionately impacts African American (AA) women. AA women have poorer asthma-related quality of life and higher rates of asthma exacerbations, healthcare utilization and mortality compared to Caucasian women. Further, AA women are less physically active than any other subgroup of adults, which may help explain the asthma health disparities, found between AA and Caucasian women. Physical inactivity among individuals with asthma is associated with poor asthma control and respiratory function, greater health care utilization, and poorer quality of life. Given the connection between poor asthma outcomes and physical inactivity, addressing physical activity (PA) among sedentary AA women with asthma is imperative. Physical activity demonstrated improvement in asthma outcomes specifically asthma control, quality of life and healthcare utilization. Despite these benefits, fewer than 25% of AA women with asthma engage in regular physical activity. The ACTION intervention: physicAl aCtiviTy In minOrity womeN with asthma is a lifestyle PA intervention refined to be applicable for sedentary AA women with asthma.

02

Conditions studied

  • Asthma

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Keywords

  • walking
  • African American women
  • lifestyle
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • Self-identify as female and black or AA
  • Age 18-70
  • Sub-optimally controlled persistent asthma based on Asthma Control Test (ACT \<20)
  • Wiling to enroll and provide written-informed consent
  • Willing to be randomly assigned to treatment or control group

Exclusion Criteria: • Plans to relocate outside of the Chicagoland area during the study period.

  • Unable to ambulate without human assistance (ie. use of a wheelchair, scooter)
  • History of significant mental illness (e.g. uncontrolled bipolar disorder, psychoses)
  • Currently pregnant, planning to become pregnant over the next 3 months
  • Diagnosis of COPD (emphysema or chronic bronchitis) suggested by patient report of doctor diagnosis or smoking history (>20 pack years)
  • Poorly controlled high blood pressure (BP >180/100 at baseline visit)
  • Family/household member of another study participant or staff member
  • Inability to speak, read or understand English;
  • Investigator discretion for safety or protocol adherence reasons
  • Participation in ACTION focus groups (Aim 1) or pre-pilot (Aim 2) of the study
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
53 participants (actual)

Study arms

  • Experimental
    ACTION Intervention

    Women in the ACTION intervention will attend 1 asthma education/physical activity session and 5 group sessions in community location convenient to participants during the adoptive phase (24-weeks) and 1 group session during the maintenance phase (12-weeks). Each session will last approximately 2 hours. Participants will be given Fitbit Charge HR to monitor their daily steps and will be sent motivational, educational and reminder text messages up to 3 times per week.

    Behavioral: ACTION Intervention

  • Other
    Enhanced usual care

    Women in the Enhanced usual care arm will attend 1 asthma education/physical activity session and be given a Fitbit Charge HR to monitor their daily steps. They will be given a static step goal to achieve. Only reminder text messages for data collection visits will be sent.

    Other: Enhanced usual care

Interventions

  • BehavioralACTION Intervention

    The intervention is based on the Women's Lifestyle Physical Activity Program, a culturally sensitive lifestyle physical activity intervention for African American (AA) women. There are 2 phases to the intervention: Adoptive (24 weeks) and Maintenance (12 weeks). 3 motivational/reminder texts will be made each week during the adoption phase. 5 Group sessions(adoptive): Participants will be given individualized step goals, watch a short DVD featuring AA women demonstrating skills and sharing experiences of engaging in walking. 1 Group session (maintenance): watch a short DVD featuring AA women demonstrating skills and sharing experiences of engaging in walking, reinforce barriers and facilitators to walking. An interventionist will lead a discussion on role-modeling and encouraging problem solving. Each intervention group will have 10 women with 1 interventionist. Data will be collected at 3 time points: baseline, 24-weeks and 36-weeks.

    Also known as: Group sessions

  • OtherEnhanced usual care

    Participants will attend 1 two hour asthma education/physical activity session at community location near them. Participants will review basic asthma topics in a didactic session and will include exercising with asthma and exercise-induced asthma. Participants will be given Fitbit and provided instructions on how to use it. Participants may receive 2 newsletters with information on asthma and reminder texts regarding data collection visits. Data will be collected at 3 time points: baseline, 24-weeks and 36-weeks.

05

What researchers measure

Primary outcomes

  1. Feasibility of Intervention-Recruitment

    The total number of participants recruited and consented in the study.

    Time frame: 24 weeks

  2. Feasibility of Intervention-Withdrawals

    Number of participants that withdrew from the study

    Time frame: 24 weeks

  3. Feasibility of Lifestyle PA Intervention

    Number of participants that completed 24-week outcomes assessment

    Time frame: 24 weeks

  4. Acceptability of Lifestyle PA Intervention

    Unabbreviated scale title: ACTION Satisfaction Scale. Acceptability was measured using a 7-point Likert scale with 1 representing not satisfied and 7 representing very satisfied. Higher scores mean more satisfied with the intervention. The range is from 1-7.

    Time frame: 24-weeks

  5. Acceptability of Lifestyle PA Intervention-Qualitative Data

    Intervention participants were asked open-ended questions about their satisfaction with the study. Responses were written down by the participant and data collector. It is not possible to summarize the data collected from the open-ended questions in tabular form as it is qualitative data.

    Time frame: 24-weeks

Secondary outcomes

  1. Light Physical Activity Levels

    as measured by accelerometer and using proprietary Actilife software

    Time frame: 24 weeks

  2. Asthma Quality of Life Questionnaire (AQLQ)

    The Asthma Quality of Life Questionnaire (AQLQ) is a 32-item questionnaire. It has 4 domains: symptoms (12 items), activity limitation (6 generic and 5 patient-specific items), emotional function (5 items), and environmental stimuli (4 items). The AQLQ items are each scored on a 7-point Likert scale, with 1 representing maximal impairment and 7 representing no impairment. Scores range 1-7, with higher scores indicating better quality of life. A total score was calculated by summing all responses for each question and then dividing by the number of items in the questionnaire (n=32). Subdomains were not reported/used.

    Time frame: 24 weeks

  3. Asthma Control Questionnaire (ACQ-6)

    Unabbreviated scale title: Asthma control questionnaire (ACQ) The ACQ score correlates with a measure of asthma control based on the GINA/NIH criteria. ACQ includes 6 questions on symptoms, activity limitation and beta2-agonist use. Each question is scored from 0 to 6 with the total score being the average of the questions. The ACQ score ranges between 0 (well controlled) and 6 (extremely poorly controlled). Recent studies show that a score of 1.5 or more on the 6-item Asthma Control Questionnaire (ACQ) indicates that a patient has inadequate asthma control.Higher scores mean poorer asthma control.

    Time frame: 24 weeks

  4. Daily Step Counts

    as measured by accelerometer

    Time frame: 24 weeks

  5. Moderate Physical Activity Levels

    as measured by accelerometer and using proprietary Actilife software

    Time frame: 24 weeks

  6. Vigorous Physical Activity Levels

    as measured by accelerometer and using proprietary Actilife software

    Time frame: 24 weeks

06

Results

Posted Feb 23, 2022

Participant flow

24-week Data Collection
Participant flow — 24-week Data Collection
MilestoneACTION InterventionEnhanced Usual Care
Started2528
Completed1921
Not completed67
Withdrew: Withdrawal by subject22
Withdrew: Lost to follow-up45
36-week Data Collection
Participant flow — 36-week Data Collection
MilestoneACTION InterventionEnhanced Usual Care
Started2326
Completed1718
Not completed68
Withdrew: Lost to follow-up68

Outcome measures

PrimaryFeasibility of Intervention-Recruitment

The total number of participants recruited and consented in the study.

Time frame:
24 weeks
Reported as:
Number · participants
Feasibility of Intervention-Recruitment
participantsScreen Participants
Feasibility of Intervention-Recruitment53
PrimaryFeasibility of Intervention-Withdrawals

Number of participants that withdrew from the study

Time frame:
24 weeks
Reported as:
Count of participants · Participants
Feasibility of Intervention-Withdrawals
ParticipantsACTION InterventionEnhanced Usual Care
Feasibility of Intervention-Withdrawals22
PrimaryFeasibility of Lifestyle PA Intervention

Number of participants that completed 24-week outcomes assessment

Time frame:
24 weeks
Reported as:
Count of participants · Participants
Feasibility of Lifestyle PA Intervention
ParticipantsACTION InterventionEnhanced Usual Care
Feasibility of Lifestyle PA Intervention1921
PrimaryAcceptability of Lifestyle PA Intervention

Unabbreviated scale title: ACTION Satisfaction Scale. Acceptability was measured using a 7-point Likert scale with 1 representing not satisfied and 7 representing very satisfied. Higher scores mean more satisfied with the intervention. The range is from 1-7.

Time frame:
24-weeks
Reported as:
Mean · units on a scale
Acceptability of Lifestyle PA Intervention
units on a scaleACTION InterventionEnhanced Usual Care
Acceptability of Lifestyle PA Intervention6.88 ± 0.33—
PrimaryAcceptability of Lifestyle PA Intervention-Qualitative Data

Intervention participants were asked open-ended questions about their satisfaction with the study. Responses were written down by the participant and data collector. It is not possible to summarize the data collected from the open-ended questions in tabular form as it is qualitative data.

Time frame:
24-weeks

No measurements were reported for this outcome.

SecondaryLight Physical Activity Levels

as measured by accelerometer and using proprietary Actilife software

Time frame:
24 weeks
Reported as:
Mean · minutes per day
Light Physical Activity Levels
minutes per dayACTION InterventionEnhanced Usual Care
Light Physical Activity Levels567.13 ± 79.99278.66 ± 89.43
SecondaryAsthma Quality of Life Questionnaire (AQLQ)

The Asthma Quality of Life Questionnaire (AQLQ) is a 32-item questionnaire. It has 4 domains: symptoms (12 items), activity limitation (6 generic and 5 patient-specific items), emotional function (5 items), and environmental stimuli (4 items). The AQLQ items are each scored on a 7-point Likert scale, with 1 representing maximal impairment and 7 representing no impairment. Scores range 1-7, with higher scores indicating better quality of life. A total score was calculated by summing all responses for each question and then dividing by the number of items in the questionnaire (n=32). Subdomains were not reported/used.

Time frame:
24 weeks
Reported as:
Mean · score on a scale
Asthma Quality of Life Questionnaire (AQLQ)
score on a scaleACTION InterventionEnhanced Usual Care
Asthma Quality of Life Questionnaire (AQLQ)5.24 ± 1.354.70 ± 1.06
SecondaryAsthma Control Questionnaire (ACQ-6)

Unabbreviated scale title: Asthma control questionnaire (ACQ) The ACQ score correlates with a measure of asthma control based on the GINA/NIH criteria. ACQ includes 6 questions on symptoms, activity limitation and beta2-agonist use. Each question is scored from 0 to 6 with the total score being the average of the questions. The ACQ score ranges between 0 (well controlled) and 6 (extremely poorly controlled). Recent studies show that a score of 1.5 or more on the 6-item Asthma Control Questionnaire (ACQ) indicates that a patient has inadequate asthma control.Higher scores mean poorer asthma control.

Time frame:
24 weeks
Reported as:
Mean · score on a scale
Asthma Control Questionnaire (ACQ-6)
score on a scaleACTION InterventionEnhanced Usual Care
Asthma Control Questionnaire (ACQ-6)1.28 ± 1.031.87 ± 0.99
SecondaryDaily Step Counts

as measured by accelerometer

Time frame:
24 weeks
Reported as:
Mean · steps/day
Daily Step Counts
steps/dayACTION InterventionEnhanced Usual Care
Daily Step Counts4372.73 ± 1884.905196.32 ± 1763.58
SecondaryModerate Physical Activity Levels

as measured by accelerometer and using proprietary Actilife software

Time frame:
24 weeks
Reported as:
Mean · minutes per day
Moderate Physical Activity Levels
minutes per dayACTION InterventionEnhanced Usual Care
Moderate Physical Activity Levels16.63 ± 23.6718.07 ± 13.72
SecondaryVigorous Physical Activity Levels

as measured by accelerometer and using proprietary Actilife software

Time frame:
24 weeks
Reported as:
Mean · minutes per day
Vigorous Physical Activity Levels
minutes per dayACTION InterventionEnhanced Usual Care
Vigorous Physical Activity Levels0.37 ± 1.281.14 ± 3.03

Adverse events

Collected over 36 weeks. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
ACTION Intervention0/25 (0%)0/25 (0%)2/25 (8%)
Enhanced Usual Care0/28 (0%)0/28 (0%)1/28 (3.6%)
Most frequent other events
Most frequent other events
EventACTION InterventionEnhanced Usual Care
skin rashSkin and subcutaneous tissue disorders2/251/28

Baseline characteristics

Age, Continuous
Age, Continuous(years)ACTION InterventionEnhanced Usual CareTotal
Mean42.87 ± 1143.84 ± 1443.38 ± 12
Sex: Female, Male
Sex: Female, Male(Participants)ACTION InterventionEnhanced Usual CareTotal
Female252853
Male000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)ACTION InterventionEnhanced Usual CareTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American252853
White000
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(Participants)ACTION InterventionEnhanced Usual CareTotal
United States252853
Body Mass Index
Body Mass Index(kg/m^2)ACTION InterventionEnhanced Usual CareTotal
Mean35.97 ± 736.86 ± 1236.44 ± 10
Household Income (<$30,000/year)
Household Income (<$30,000/year)(Participants)ACTION InterventionEnhanced Usual CareTotal
Count of participants171532
Insurance status (medicare/medicaid/medical assistance)
Insurance status (medicare/medicaid/medical assistance)(Participants)ACTION InterventionEnhanced Usual CareTotal
Count of participants172037
Marital status (Single/divorced/widowed)
Marital status (Single/divorced/widowed)(Participants)ACTION InterventionEnhanced Usual CareTotal
Count of participants232447

10 further baseline measures are reported on the registry.

07

Study locations

1 site
  • University of Illinois Hospital and Health Sciences System
    Chicago, Illinois 60612, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Apr 23, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03265665
Lead sponsor
University of Illinois at Chicago
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
Responsible party
Sharmilee Nyenhuis (Associate Professor of Medicine, University of Illinois at Chicago) — Principal investigator
First posted
Aug 29, 2017
Start date
Oct 1, 2017
Primary completion
Jun 15, 2019
Completion
Sep 30, 2019
Results posted
Feb 23, 2022
Last update
Feb 23, 2022

Study contacts

Sharmilee M Nyenhuis, MD
principal investigator · University of Illinois at Chicago

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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