Effects of a digital motivational intervention on medication adherence and asthma control in Black emerging adults
In brief
Digital counseling improves asthma control by 1.1 points, but not adherence
In a randomized trial of 152 Black emerging adults with uncontrolled asthma, two digital motivational counseling sessions and 30 days of texts led to about a 1.1-point greater improvement on the asthma control test during the intervention than asthma education alone. The difference did not persist over follow-up, and medication adherence did not improve, leaving the clinical value of the short-term change uncertain.
- Journal
- Patient education and counseling (Q1)
- Published
- 24 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Amy Lee Hall, Bo Wang, Jean-Marie Bruzzese, Wanda Gibson-Scipio, Rhonda Dailey, Alan P Baptist, et al.
- PMID
- 42815283
- DOI
- 10.1016/j.pec.2026.110313
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (top studies of the week, 4 October 2026): Digital MI intervention modestly improved asthma control
Abstract
OBJECTIVES: To evaluate whether a technology-delivered, patient-centered motivational interviewing (MI) intervention improves medication adherence and asthma control among Black emerging adults with uncontrolled asthma. METHODS: In a randomized controlled trial, 152 Black emerging adults were randomized to two sessions of a technology-delivered MI intervention (n = 80) or an asthma education control (n = 72), with 30 days of text messaging between sessions. Assessments at baseline and 1, 3, 6, 9, and 12 months measured asthma control (Asthma Control Test [ACT]) and adherence (Ecological Momentary Assessment [EMA], the Brooks scale, and an investigator-developed percent-adherence measure). Adherence was the primary outcome and asthma control the secondary outcome. A linear latent growth curve model (LGCM) assessed EMA-based adherence (baseline, 3, 6, 12 months); piecewise LGCMs assessed asthma control and the remaining adherence measures across the one-month intervention and 11-month follow-up periods. RESULTS: Compared with the control group, the intervention group showed significantly greater improvement in asthma control during the intervention period (β=1.14, p = 0.04, 95% CI [0.03, 2.26]), with no between-group change during follow-up (β=-0.01, p = 0.86, 95% CI [-0.13, 0.11]). The intervention did not affect adherence during the intervention (Brooks: β=0.35, p = 0.37, 95% CI [-0.41, 1.10]; percent adherence: β=4.15, p = 0.39, 95% CI [-5.29, 13.59]) or follow-up (Brooks: β=-0.03, p = 0.55, 95% CI [-0.11, 0.06]; percent adherence: β=-0.67, p = 0.19, 95% CI [-1.67, 0.33]), and had no effect on EMA-based adherence (β=-0.47, p = 0.48, 95% CI [-1.78, 0.83]). CONCLUSION: A brief, technology-delivered MI intervention produced modest short-term improvements in asthma control among Black emerging adults. PRACTICE IMPLICATIONS: Patient-centered motivational counseling delivered digitally is feasible and may modestly improve asthma control even without measurable adherence change, underscoring the value of communication strategies beyond medication instruction.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.