Walking a path to better asthma control

The common image of asthma control is the inhaler, providing a spray of medicine whenever a person feels short of breath or can’t stop coughing. But a new trial co-led by Lisa Sharp, professor and associate dean for research at the University of Illinois Chicago College of Nursing, will assess whether a daily walking program can help Black women with asthma better control their symptoms before they start. 

Sharp and collaborator Sharmilee Nyenhuis, a former UIC researcher who now is associate professor of pediatrics and medicine at the University of Chicago, have launched a trial with funding from the National Institute on Minority Health and Health Disparities to test a walking intervention in women with poorly controlled asthma. The intervention uses a combination of mobile health technology, group education sessions and individualized goal setting to encourage more daily walking. 

Each study participant in the treatment group receives asthma education, a Fitbit to measure their steps and text messages to help set step goals and provide motivation. Through a platform called iCardia — developed at UIC by Spyros Kitsiou, associate professor of biomedical and health information sciences — research assistants can monitor participants’ daily activity and customize the text messages they send. 

“We’re really trying to keep walking in the forefront of women’s minds in between group sessions and help them to set manageable goals,” Sharp said.  

Previous research has shown that regular, moderate physical activity can improve asthma control and symptoms and reduce use of urgent health care services. The new trial follows a pilot study that found that women were satisfied with the intervention and showed improvements in asthma control and quality of life.  

Starting from their baseline, the women are challenged to walk 150 additional steps each week, with the aim of increasing daily walking by 3,000 steps at the end of the six-month program. But the coordinators also work with each person on customized goals. 

“It really provides behavioral techniques to support goal setting and achievement,” Nyenhuis said. “Some people have medical illnesses or even just got out of the hospital, and they might say, ‘I’m not going to be able to increase walking by this much.’ So, we say to do what you can, but then we may ramp up other times during the six-month period.” 

After the study, the researchers will measure changes in lung function and self-reported asthma control in participants given the full intervention compared to women given only asthma education through text messages. They also will measure how well walking habits and asthma control persist six months after the intervention ends and will collect data on environmental and societal barriers to increasing physical activity.  

“A good portion of the participants are living in neighborhoods where there has really been a lot of community disinvestment, and safety is a very serious thing,” Sharp said. “We’re also very interested in climate change, because asthma is such a climate-sensitive disease. We want to explore those avenues to see how we might be able to increase climate resiliency in the neighborhoods, partnering with different community-based organizations that are trying to address this issue.”