Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study

Lorie L Geryk, Courtney A Roberts, Adam J Sage, Tamera Coyne-Beasley, Betsy L Sleath, Delesha M Carpenter, Lorie L Geryk, Courtney A Roberts, Adam J Sage, Tamera Coyne-Beasley, Betsy L Sleath, Delesha M Carpenter

Abstract

Background: Most youth asthma apps are not designed with parent and clinician use in mind, and rarely is the app development process informed by parent or clinician input.

Objective: This study was conducted to generate formative data on the use, attitudes, and preferences for asthma mHealth app features among parents and clinicians, the important stakeholders who support adolescents with asthma and promote adolescent self-management skills.

Methods: We conducted a mixed-methods study from 2013 to 2014 employing a user-centered design philosophy to acquire feedback from a convenience sample of 20 parents and 6 clinicians. Participants were given an iPod Touch and asked to evaluate 10 features on 2 existing asthma apps. Participant experiences using the apps were collected from questionnaires and a thematic analysis of audio-recorded and transcribed (verbatim) interviews using MAXQDA. Descriptive statistics were calculated to characterize the study sample and app feature feedback. Independent samples t tests were performed to compare parent and clinician ratings of app feature usefulness (ratings: 1=not at all useful to 5=very useful).

Results: All parents were female (n=20), 45% were black, 20% had an income ≥US $50,000, and 45% had a bachelor's degree or higher education. The clinician sample included 2 nurses and 4 physicians with a mean practice time of 13 years. Three main themes provided an understanding of how participants perceived their roles and use of asthma app features to support adolescent asthma self-management: monitoring and supervision, education, and communication/information sharing. Parents rated the doctor report feature highest, and clinicians rated the doctor appointment reminder highest of all evaluated app features on usefulness. The peak flow monitoring feature was the lowest ranked feature by both parents and clinicians. Parents reported higher usefulness for the doctor report (t(10)=2.7, P<.02), diary (t(10)=2.7, P<.03), and self-check quiz (t(14)=2.5, P<.02) features than clinicians. Specific participant suggestions for app enhancements (eg, a tutorial showing correct inhaler use, refill reminders, pop-up messages tied to a medication log, evidence-based management steps) were also provided.

Conclusions: Parent and clinician evaluations and recommendations can play an important role in the development of an asthma app designed to help support youth asthma management. Two-way asthma care communication between families and clinicians and components involving families and clinicians that support adolescent self-management should be incorporated into adolescent asthma apps.

Keywords: adolescents; asthma; clinicians; mHealth; mobile apps; parents; self-management; social support.

Conflict of interest statement

Conflicts of Interest: None declared.

©Lorie L Geryk, Courtney A Roberts, Adam J Sage, Tamera Coyne-Beasley, Betsy L Sleath, Delesha M Carpenter. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 06.12.2016.

Figures

Figure 1
Figure 1
Parent and clinician app feature usefulness rankings (note: mean feature usefulness ratings on a scale of one to five; 1=not at all useful to 5=very useful).

References

    1. Rosland A, Piette JD. Emerging models for mobilizing family support for chronic disease management: a structured review. Chronic Illn. 2010;6:7–21. doi: 10.1177/1742395309352254.
    1. Rosen P, Stenger E, Bochkoris M, Hannon MJ, Kwoh CK. Family-centered multidisciplinary rounds enhance the team approach in pediatrics. Pediatrics. 2009;123:e603–e608. doi: 10.1542/peds.2008-2238.
    1. National AE, Prevention Program (National Heart. LungBlood I. Second Expert Panel on the Management of Asthma. Bethesda, MD: DIANE Publishing; 1997.
    1. Ayala GX, Miller D, Zagami E, Riddle C, Willis S, King D. Asthma in middle schools: what students have to say about their asthma. J Sch Health. 2006;76:208–214. doi: 10.1111/j.1746-1561.2006.00098.x.
    1. Rhee H, Belyea MJ, Brasch J. Family support and asthma outcomes in adolescents: barriers to adherence as a mediator. J Adolesc Health. 2010;47:472–478. doi: 10.1016/j.jadohealth.2010.03.009.
    1. Duncan CL, Hogan MB, Tien KJ, Graves MM, Chorney JM, Zettler MD, Koven L, Wilson NW, Dinakar C, Portnoy J. Efficacy of a parent-youth teamwork intervention to promote adherence in pediatric asthma. J Pediatr Psychol. 2013;38:617–628. doi: 10.1093/jpepsy/jss123.
    1. Gustafson D, Wise M, Bhattacharya A, Pulvermacher A, Shanovich K, Phillips B, Lehman E, Chinchilli V, Hawkins R, Kim J. The effects of combining Web-based eHealth with telephone nurse case management for pediatric asthma control: a randomized controlled trial. J Med Internet Res. 2012;14:e101. doi: 10.2196/jmir.1964.
    1. Rasmussen LM, Phanareth K, Nolte H, Backer V. Internet-based monitoring of asthma: a long-term, randomized clinical study of 300 asthmatic subjects. J Allergy Clin Immunol. 2005;115:1137–1142. doi: 10.1016/j.jaci.2005.03.030.
    1. Morrison D, Wyke S, Agur K, Cameron EJ, Docking RI, Mackenzie AM, McConnachie A, Raghuvir V, Thomson NC, Mair FS. Digital asthma self-management interventions: a systematic review. J Med Internet Res. 2014;16:e51. doi: 10.2196/jmir.2814.
    1. Gammon D, Arsand E, Walseth OA, Andersson N, Jenssen M, Taylor T. Parent-child interaction using a mobile and wireless system for blood glucose monitoring. J Med Internet Res. 2005;7:e57. doi: 10.2196/jmir.7.5.e57.
    1. Al-Durra M, Torio M, Cafazzo JA. The use of behavior change theory in Internet-based asthma self-management interventions: a systematic review. J Med Internet Res. 2015;17:e89. doi: 10.2196/jmir.4110.
    1. Huckvale K, Morrison C, Ouyang J, Ghaghda A, Car J. The evolution of mobile apps for asthma: an updated systematic assessment of content and tools. BMC Med. 2015;13:58. doi: 10.1186/s12916-015-0303-x.
    1. Wu A, Carpenter J, Himes B. Mobile health applications for asthma. J Allergy Clin Immunol Pract. 2015;3:e16–e18.
    1. Haze KA, Lynaugh J. Building patient relationships: a smartphone application supporting communication between teenagers with asthma and the RN care coordinator. Comput Inform Nurs. 2013;31:266–271. doi: 10.1097/NXN.0b013e318295e5ba.
    1. Panzera AD, Schneider TK, Martinasek MP, Lindenberger JH, Couluris M, Bryant CA, McDermott RJ. Adolescent asthma self-management: patient and parent-caregiver perspectives on using social media to improve care. J Sch Health. 2013;83:921–930. doi: 10.1111/josh.12111.
    1. Schneider T, Panzera AD, Martinasek M, McDermott R, Couluris M, Lindenberger J, Bryant C. Physicians' perceptions of mobile technology for enhancing asthma care for youth. J Child Health Care. 2016;20:153–163. doi: 10.1177/1367493514556555.
    1. Carpenter DM, Geryk LL, Sage A, Arrindell C, Sleath BL. Exploring the theoretical pathways through which asthma app features can promote adolescent self-management [published online April 26, 2016] Transl Behav Med. 2016;DOI: 10.1007/s13142-016-0402-z doi: 10.1007/s13142-016-0402-z.
    1. Roberts C, Geryk L, Sage A, Sleath B, Tate D, Carpenter DM. Adolescent, caregiver, and friend preferences for integrating social support and communication features into an asthma self-management app. J Asthma. 2016;53:948–954. doi: 10.3109/02770903.2016.1171339.
    1. National Heart Lung Blood Institute . Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Chicago, IL: American Medical Informatics Association; 2007.
    1. Cabana MD, Slish KK, Nan B, Clark NM. Limits of the HEDIS criteria in determining asthma severity for children. Pediatrics. 2004;114:1049–1055. doi: 10.1542/peds.2003-1162-L.
    1. Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23:334–340.
    1. Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117. doi: 10.1186/1471-2288-13-117.
    1. Majeed-Ariss R, Baildam E, Campbell M, Chieng A, Fallon D, Hall A, McDonagh JE, Stones SR, Thomson W, Swallow V. Apps and adolescents: a systematic review of adolescents' use of mobile phone and tablet apps that support personal management of their chronic or long-term physical conditions. J Med Internet Res. 2015;17:e287. doi: 10.2196/jmir.5043.
    1. Kyngas H, Rissanen M. Support as a crucial predictor of good compliance of adolescents with a chronic disease. J Clin Nurs. 2001;10:767–774. doi: 10.1046/j.1365-2702.2001.00538.x.
    1. Kyngäs H, Hentinen M, Barlow J. Adolescents? perceptions of physicians, nurses, parents and friends: help or hindrance in compliance with diabetes self?care? J Adv Nurs. J Adv Nurs. 1998;27:760–769. doi: 10.1046/j.1365-2648.1998.00608.x.
    1. Martínez-Pérez B, de la Torre-Díez I, López-Coronado M. Privacy and security in mobile health apps: a review and recommendations. J Med Syst. 2015;39:181. doi: 10.1007/s10916-014-0181-3.
    1. McKnight R, Franko O. HIPAA Compliance with Mobile Devices Among ACGME Programs. J Med Syst. 2016;40:129. doi: 10.1007/s10916-016-0489-2.
    1. Gillette C, Carpenter DM, Ayala GX, Williams DM, Davis S, Tudor G, Yeatts K, Sleath B. How often do providers discuss asthma action plans with children? Analysis of transcripts of medical visits. Clin Pediatr (Phila) 2013;52:1161–1167. doi: 10.1177/0009922813506256.
    1. Rhee H, Miner S, Sterling M, Halterman JS, Fairbanks E. The development of an automated device for asthma monitoring for adolescents: methodologic approach and user acceptability. JMIR Mhealth Uhealth. 2014;2:e27. doi: 10.2196/mhealth.3118.
    1. Schneider T, Panzera AD, Couluris M, Lindenberger J, McDermott R, Bryant CA. Engaging teens with asthma in designing a patient-centered mobile app to aid disease self-management. Telemed J E Health. 2015;DOI: 10.1089/tmj.2015.0041 doi: 10.1089/tmj.2015.0041.
    1. Nkoy F, Stone B, Fassl B, Koopmeiners K, Halbern S, Kim E, Poll J, Hales J, Lee D, Maloney C. Development of a novel tool for engaging children and parents in asthma self-management. AMIA Annual Symposium Proceedings: American Medical Informatics Association; November 3-7, 2012; Chicago, IL. 2012.
    1. Burbank AJ, Lewis SD, Hewes M, Schellhase DE, Rettiganti M, Hall-Barrow J, Bylander LA, Brown RH, Perry TT. Mobile-based asthma action plans for adolescents. J Asthma. 2015;52:583–586. doi: 10.3109/02770903.2014.995307.
    1. Subhi Y, Bube SH, Rolskov BS, Thomsen A, Konge L. Expert involvement and adherence to medical evidence in medical mobile phone apps: a systematic review. JMIR Mhealth Uhealth. 2015;3:e79. doi: 10.2196/mhealth.4169.
    1. Huckvale K, Car M, Morrison C, Car J. Apps for asthma self-management: a systematic assessment of content and tools. BMC Med. 2012;10:144. doi: 10.1186/1741-7015-10-144.
    1. Madden M, Lenhart A, Cortesi S, Gasser U, Duggan M, Smith A, Beaton M. Teens, social media, and privacy. Pew Research Center, The Berkman Center for Internet & Society at Harvard University. 2013 May 21;
    1. Lindsay S, Kingsnorth S, Hamdani Y. Barriers and facilitators of chronic illness self?management among adolescents: a review and future directions. J Nurs Healthc Chronic Illn. 2011;3:186–208. doi: 10.1111/j.1752-9824.2011.01090.x.

Source: PubMed

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