The Tailored Adherence Incentives for Childhood Asthma Medications Randomized Trial: A Research Protocol for Children with High-Risk Asthma.

Year of Publication


Date Published

2020 Apr 07

ISSN Number



<p><strong>BACKGROUND: </strong>Poor adherence to inhaled corticosteroid (ICS) medications for children with high-risk asthma is a well-documented and poorly understood problem with a disproportionate prevalence and impact on urban minority children. Financial incentives have been shown as a compelling method to engage a high-risk asthma population, but whether and how adherence can be maintained and lead to sustained high adherence trajectories is unknown.</p>

<p><strong>OBJECTIVE: </strong>To determine the marginal effects of a financial incentive-based ICS adherence intervention on adherence, healthcare system use, and costs in a prospective cohort of child-caregiver dyads.</p>

<p><strong>METHODS: </strong>Participants include 125 children aged 5-12 years who have had at least two hospitalizations or one hospitalization and one emergency room visit for asthma in the prior year and their caregivers. All participants have an electronic inhaler sensor that is linked to a smartphone app to track medication use for 7 months. After one month of observation, participants are randomized to one of three possible arms for a 3-month experiment. Participants in arm 1 receive daily text message reminders, feedback, and nominal gain-framed financial incentives; those in arm 2 receive daily text message reminders and feedback only and those in arm 3 receive no reminders, feedback, or incentives. All participants are then observed for an additional 3 months with no reminders, feedback, or incentives to assess for sustained effects.</p>

<p><strong>RESULTS: </strong>Study enrollment began in September 2019. Estimated primary completion date is June of 2022 and analyses will be completed by June of 2023.</p>

<p><strong>CONCLUSIONS: </strong>The present study will provide data on whether a financial incentive-based mobile-health intervention for promoting ICS use is efficacious in high-risk asthma patients over time.</p>

<p><strong>CLINICALTRIAL: </strong>Clinicaltrial.gov NCT03907410; https://clinicaltrials.gov/ct2/show/NCT03907410.</p&gt;



Alternate Title

JMIR Res Protoc




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