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Kemble H, Foster M, Blamires J, Mowat R. Children and young people's self-reported experiences of asthma and self-management nursing strategies: An integrative review. J Pediatr Nurs 2024; 77:212-235. [PMID: 38598994 DOI: 10.1016/j.pedn.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/16/2024] [Accepted: 03/17/2024] [Indexed: 04/12/2024]
Abstract
AIM To explore children and young people's (CYP) (5-24 years of age) self-reported experiences of asthma self-management strategies (ASMS) with nursing involvement across various settings. BACKGROUND Childhood asthma is an increasingly significant health issue, highlighting the importance of acquiring self-management skills to optimise future health outcomes. Registered nurses play a pivotal role in delivering appropriate, personalized self-management support. METHODS This integrative review searched four electronic databases: Cumulated Index to Nursing and Allied Health Literature via Elton B. Stephens Company, Medical Literature Analysis and Retrieval System Online (MEDLINE), Object, View and Interactive Design (OVID), and PubMed, that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis flowchart. Included studies were critically appraised using the Joanna Briggs Institute critical appraisal tools. Braun and Clarks thematic analysis was used to generate themes, and sub-themes. FINDINGS Fifteen studies were included for review. Thematic analysis generated three themes being healthy literacy; health and wellbeing; and tools and working together. CONCLUSIONS Asthma continues to have negative physical, psychological, and social implications among CYP. CYP are both willing and capable of engaging in ASMS and learning self-management skills, however, continue to have unmet self-management needs. IMPLICATIONS TO PRACTICE Strategies must bolster health literacy, improve physical and psychological health, and harness interactive, youth-centric, and informative tools to facilitate communication and decrease the burden of self-management. Applications pose a promising avenue for self-management support. This age group remains under-explored and future research should enable meaningful engagement with CYP to better understand their perspectives and improve strategy success.
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Affiliation(s)
- H Kemble
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| | - M Foster
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Edith Cowan University, School of Nursing and Midwifery, Perth, Western Australia, Australia; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - J Blamires
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
| | - R Mowat
- Auckland University of Technology, School of Clinical Sciences, Auckland, New Zealand; Auckland University of Technology, School of Clinical Sciences (Nursing), 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand.
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Deslippe AL, González ODJ, Buckler EJ, Ball GDC, Ho J, Bucholz A, Morrison KM, Mâsse LC. Do Individual Characteristics and Social Support Increase Children's Use of an MHealth Intervention? Findings from the Evaluation of a Behavior Change MHealth App, Aim2Be. Child Obes 2023; 19:435-442. [PMID: 36576875 DOI: 10.1089/chi.2022.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose: Mobile health (mHealth) apps may support improved health behavior practice among youth living in larger bodies. However, long-term use is low, limiting effectiveness. This study evaluated whether youths' motivation, satisfaction, engagement with social features, or parent co-participation supported long-term use of an app named Aim2Be. Methods: A secondary analysis of two versions of Aim2Be (preteen and teen versions) using covariate-adjusted multivariable regression was conducted. We evaluated associations between social support features (a virtual coach, a social poll, or a social wall), parent co-participation (time spent in the parent app), and app satisfaction on use (time spent in Aim2Be). Models were stratified by age and satisfaction was explored as a moderator. Results: Preteens (n = 83) engagement with the social poll (β = 0.26, p < 0.001), virtual health coach (β = 0.24, p = 0.01), app satisfaction (β = 0.31, p = 0.01), and parent co-participation (β = 0.24, p = 0.01) predicted use. In teens (n = 90), engagement with the virtual coach (β = 0.31, p < 0.001) and full utilization of social wall features (β = 0.41, p < 0.001) predicted use. Furthermore, satisfaction moderated the effects of partial utilization of the social wall among teens (β = 0.32 p = 0.02). Conclusion: Social support in mHealth apps may impact users differently depending on age. Features that include health professionals or peers may be more advantageous across ages. App developers should consider age when designing interventions. Clinical Trial Registration NCT03651284.
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Affiliation(s)
- Alysha L Deslippe
- Human Nutrition, Land and Food Systems, University of British Columbia, Vancouver, British Columbia, Canada
- Healthy Starts, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Olivia De-Jongh González
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Evidence to Innovation (Behaviour Change Group), BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - E Jean Buckler
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Josephine Ho
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Annick Bucholz
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Evidence to Innovation (Behaviour Change Group), BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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3
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Easton S, Ainsworth B, Thomas M, Latter S, Knibb R, Cook A, Wilding S, Bahrami‐Hessari M, Kennington E, Gibson D, Wilkins H, Yardley L, Roberts G. Planning a digital intervention for adolescents with asthma (BREATHE4T): A theory-, evidence- and Person-Based Approach to identify key behavioural issues. Pediatr Pulmonol 2022; 57:2589-2602. [PMID: 35932183 PMCID: PMC9826240 DOI: 10.1002/ppul.26099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/05/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To describe a transparent approach to planning a digital intervention for adolescents to self-manage their asthma using breathing retraining (BRT), based on an existing, effective adult intervention (BREATHE). METHODS A theory-, evidence-, and Person-Based Approach was used to maximise the effectiveness and persuasiveness of the intervention. A scoping review and semistructured interviews with target intervention users (N = 18, adolescents aged 12-17 years with asthma and parents) were carried out to explore user perspectives, barriers, and facilitators towards the intended behaviours and potential intervention features. The combined evidence was used alongside and to inform theory-based activities and enabled iterative planning of the intervention. RESULTS The scoping review identified themes relating to user-specific self-management issues, content, education, training needs, and features for a digital intervention. Interviews elicited potential barriers to intended behaviours such as the anticipated embarrassment of using BRT and concerns around remaining calm. Facilitators included BRT delivered by adolescents who share experiences of asthma and information for performing exercises discreetly. Relevant theoretical frameworks ensured that appropriate psychological constructs were targeted. A behavioural analysis identified six intervention functions and thirty behaviour change techniques. Logic modelling mapped the programme theory and mechanisms, which aims to improve adolescent asthma-related quality of life. CONCLUSIONS This study gives a transparent insight into the approach followed to plan a self-guided BRT intervention for adolescents and has led to identification of key behavioural issues, enabling relevant intervention content to be chosen. Insight has been given into adolescent perceptions of BRT, which facilitated development of the prototype intervention.
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Affiliation(s)
- Stephanie Easton
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Ben Ainsworth
- Department of Psychology, Faculty of Humanities and Social SciencesUniversity of BathBathUK
| | - Mike Thomas
- Primary Care and Population Sciences, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Sue Latter
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Rebecca Knibb
- School of Psychology, College of Health and Life SciencesUniversity of AstonBirminghamUK
| | - Amber Cook
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Sam Wilding
- Clinical Trials Unit, University Hospital SouthamptonSouthamptonUK
| | - Michael Bahrami‐Hessari
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | | | - Denise Gibson
- Physiotherapy DepartmentUniversity Hospital SouthamptonSouthamptonUK
| | - Hannah Wilkins
- Physiotherapy DepartmentUniversity Hospital SouthamptonSouthamptonUK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health PsychologyUniversity of SouthamptonSouthamptonUK
| | - Graham Roberts
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustSouthamptonUK
- Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
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Iio M, Sato M, Narita M, Yamamoto-Hanada K, Oishi T, Kishino A, Kawaguchi T, Nishi R, Nagata M, Ohya Y. Development and Feasibility of a Mobile Asthma App for Children and Their Caregivers: Mixed Methods Study. JMIR Form Res 2022; 6:e34509. [PMID: 35594073 PMCID: PMC9166665 DOI: 10.2196/34509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/18/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Mobile health apps can support the self-management of pediatric asthma. Previous studies on mobile apps for children aged >7 years with asthma are limited, and most reports on asthma apps do not consider interactions between the children and their caregivers. Therefore, we developed an asthma app for children aged 0-12 years and their caregivers based on the results of our previous study regarding user needs. Objective The aim of this study was to evaluate the feasibility of a developed mobile app for children with asthma and their caregivers and to modify and complete the app according to the feasibility results. Methods We recruited children diagnosed with persistent asthma by an allergy specialist at 2 children’s hospitals, 1 university hospital, 2 general hospitals, and 1 pediatric clinic. Thereafter, the app usage was assessed, and questionnaires were administered. This study used convergent mixed methods, including providing user feedback about the pediatric asthma app, completing questionnaire surveys regarding preferences, and obtaining quantitative data about app usage. Quantitative data were analyzed based on the ratings provided for the app features used by the participants, and the usage of the app features was analyzed using descriptive statistics. Qualitative data were analyzed via a descriptive qualitative research analysis and were used to identify codes from the content-characteristic words. Results In total, 30 pairs of children aged 2-12 years and their caregivers responded to the 3-month survey, and 20 pairs of children aged 4-12 years and their caregivers responded to the 6-month survey. In the 3- and 6-month surveys, “record” was the most commonly used feature by both caregivers and children. The average access logs per month among the 20 pairs ranged from 50 to 79 in the 6-month survey. The number of access logs decreased over time. In the qualitative results, app utilization difficulties were identified for 6 categories: record, preparing, alert settings, change settings, mobile phone owner, and display and motivation. Regarding app feasibility, 60% (12/20) of the caregivers strongly agreed or agreed for all evaluation items, while 63% (7/11) of the children strongly agreed or agreed for 6 items, excluding satisfaction. In the qualitative results, feasibility evaluation of the app was classified into 3 categories: high feasibility of the app, improvement points for the app, and personal factors preventing app utilization. Based on the results of the feasibility analysis, the final version of the app was modified and completed. Conclusions The app feasibility among children with asthma and their caregivers was generally good. Children aged 7-12 years used elements such as record, quiz, and manga. This app can support the continuous self-management of pediatric asthma. However, efforts must be taken to maintain and improve the app quality. Trial Registration UMIN Clinical Trials Registry UMIN000039058; https://tinyurl.com/3na9zyf8
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Affiliation(s)
- Misa Iio
- College of Nursing, Kanto Gakuin University, Yokohama, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Setagaya, Japan
| | - Masami Narita
- Department of Pediatrics, Kyorin University School of Medicine, Kyorin University, Mitaka, Japan
| | | | - Taku Oishi
- Department of Pediatrics, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Ai Kishino
- Division of Pediatrics, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | | | - Rin Nishi
- Division of Pediatrics, Yutenji Family Clinic, Meguro, Japan
| | - Mayumi Nagata
- College of Nursing, Kanto Gakuin University, Yokohama, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Setagaya, Japan
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Wu J, Yu Y, Yao X, Zhang Q, Zhou Q, Tang W, Huang X, Ye C. Visualizing the knowledge domains and research trends of childhood asthma: A scientometric analysis with CiteSpace. Front Pediatr 2022; 10:1019371. [PMID: 36245730 PMCID: PMC9562269 DOI: 10.3389/fped.2022.1019371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Asthma is one of the most common chronic diseases in children globally. In recent decades, advances have been made in understanding the mechanism, diagnosis, treatment and management for childhood asthma, but few studies have explored its knowledge structure and future interests comprehensively. OBJECTIVE This scientometric study aims to understand the research status and emerging trends of childhood asthma. METHODS CiteSpace (version 5.8.R3) was used to demonstrate national and institutional collaborations in childhood asthma, analyze research subjects and journal distribution, review research keywords and their clusters, as well as detect research bursts. RESULTS A total of 14,340 publications related to childhood asthma were extracted from Web of Science (core database) during January 2011 to December 2021. The results showed that academic activities of childhood asthma had increased steadily in the last decade. Most of the research was conducted by developed countries while China, as a developing country, was also actively engaged in this field. In addition to subjects of allergy and immunology, both public health aspects and ecological environmental impacts on the disease were emphasized recently in this research field. Keywords clustering analysis indicated that research on asthma management and atopy was constantly updated and became the two major research focuses recently, as a significant shift in research hotspots from etiology and diagnosis to atopic march and asthma management was identified. Subgroup analysis for childhood asthma management and atopy suggested that caregiver- or physician-based education and interventions were emerging directions for asthma management, and that asthma should be carefully studied in the context of atopy, together with other allergic diseases. CONCLUSIONS This study presented a comprehensive and systematic overview of the research status of childhood asthma, provided clues to future research directions, and highlighted two significant research trends of asthma management and atopy in this field.
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Affiliation(s)
- Jinghua Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yi Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xinmeng Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Qinzhun Zhang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Qin Zhou
- Department of Pediatrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Weihong Tang
- Department of Gastroenterology, Hangzhou Children's Hospital, Hangzhou, China
| | - Xianglong Huang
- Department of Pediatrics, Xihu District Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China
| | - Chengyin Ye
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
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6
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Liu Y, Huang W, Luo D. The reception of support in peer-to-peer online networks: Network position, support solicitation, and support provision in an online asthma caregivers group. Health Informatics J 2021; 27:14604582211066020. [PMID: 34910594 DOI: 10.1177/14604582211066020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study applies social network analysis and quantitative content analysis to messages exchanged within an online support forum of caregivers of children with chronic asthma to examine how peer-to-peer network positions and personal communication styles (seeking and providing support) impact the reception of social support. Content analysis is used to determine rates of giving and receiving informational and emotional support. Network analysis assesses levels of individual betweenness and closeness centrality in the online network. Relationships between network positions, solicitation strategies, and the provision and reception of informational and emotional support are examined. Betweenness and closeness centrality are associated with improved informational and emotional support. The provision of informational support is also improved by providing descriptions of personal experience. Practical implications for the design and use of online support platforms are discussed.
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Affiliation(s)
- Yan Liu
- School of Journalism and Communication, 34747Shanghai University, Shanghai, China
| | - Wensen Huang
- School of Media and Communication, 47890Shenzhen University, Shenzhen, China
| | - Dan Luo
- School of Nursing, 12390Wuhan University, Wuhan, China
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7
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Lin PJ, Fanjiang YY, Wang JK, Lu CW, Lin KC, Cheong IM, Pan KY, Chen CW. Long-term effectiveness of an mHealth-tailored physical activity intervention in youth with congenital heart disease: A randomized controlled trial. J Adv Nurs 2021; 77:3494-3506. [PMID: 34151444 DOI: 10.1111/jan.14924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/25/2021] [Accepted: 05/24/2021] [Indexed: 12/29/2022]
Abstract
AIMS To evaluate the long-term effectiveness of the Care & Organize Our Lifestyle (COOL) programme, a self-regulation theory-based mHealth programme, on improving disease knowledge and physical activity in youth with congenital heart disease (CHD). DESIGN A three-arm parallel-group randomized controlled trial. METHODS A total 143 participants with simple and moderate CHD aged 15-24 years were recruited from June 2016 to February 2018. The 12-month programme compared two active intervention groups to a standard-care control group (n = 47). Participants in one active intervention group (n = 49) were provided with COOL Passport, a mobile healthcare application. Those in the other group (n = 47) were provided with access to the Health Promotion Cloud system and use of game-based interactive platforms along with COOL Passport. Outcomes were the Leuven Knowledge Questionnaire for Congenital Heart Disease and the International Physical Activity Questionnaire-Taiwan Show-Card Version. RESULTS After 12 months, 103 participants remained; the overall attrition rate was 28%. No significant differences were observed between the groups in any domain of disease knowledge after 6 months or 1 year. Neither active group exhibited significantly greater physical activity intensity than the standard-care control group in any month during the 1 year. CONCLUSION The mHealth-tailored intervention of the COOL programme did not improve disease knowledge or physical activity in young adults with CHD. IMPACT The application of the COOL Passport and Health Promotion Cloud system and use of game-based interactive platforms must be modified and verified in future studies and may have clinical potential. TRIAL REGISTRATION The registry of clinical trials was ClinicalTrials.gov: NCT04264650.
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Affiliation(s)
- Pei-Jung Lin
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yong-Yi Fanjiang
- Department of Computer Science and Information Engineering, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Wei Lu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - In-Mei Cheong
- Department of Dietetics, Macau Yin Kui Hospital, Macau, Macao
| | - Kuan-You Pan
- Taiwanese Society of Suicidology, Taipei, Taiwan
| | - Chi-Wen Chen
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Mosnaim G, Safioti G, Brown R, DePietro M, Szefler SJ, Lang DM, Portnoy JM, Bukstein DA, Bacharier LB, Merchant RK. Digital Health Technology in Asthma: A Comprehensive Scoping Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2377-2398. [PMID: 33652136 DOI: 10.1016/j.jaip.2021.02.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND A variety of digital intervention approaches have been investigated for asthma therapy during the past decade, with different levels of interactivity and personalization and a range of impacts on different outcome measurements. OBJECTIVE To assess the effectiveness of digital interventions in asthma with regard to acceptability and outcomes and evaluate the potential of digital initiatives for monitoring or treating patients with asthma. METHODS We evaluated digital interventions using a scoping review methodology through a literature search and review. Of 871 articles identified, 121 were evaluated to explore intervention characteristics, the perception and acceptability of digital interventions to patients and physicians, and effects on asthma outcomes. Interventions were categorized by their level of interactivity with the patient. RESULTS Interventions featuring non-individualized content sent to patients appeared capable of promoting improved adherence to inhaled corticosteroids, but with no identified improvement in asthma burden; and data-gathering interventions appeared to have little effect on adherence or asthma burden. Evidence of improvement in both adherence and patients' impairment due to asthma were seen only with interactive interventions involving two-way responsive patient communication. Digital interventions were generally positively perceived by patients and physicians. Implementation was considered feasible, with certain preferences for design and features important to drive use. CONCLUSIONS Digital health interventions show substantial promise for asthma disease monitoring and personalization of treatment. To be successful, future interventions will need to include both inhaler device and software elements, combining accurate measurement of clinical parameters with careful consideration of ease of use, personalization, and patient engagement aspects.
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Affiliation(s)
- Giselle Mosnaim
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, North Shore University Health System, Evanston, Ill
| | | | - Randall Brown
- Teva Branded Pharmaceutical Products R&D, Inc, West Chester, Pa
| | - Michael DePietro
- Teva Branded Pharmaceutical Products R&D, Inc, West Chester, Pa.
| | - Stanley J Szefler
- The Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - David M Lang
- Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jay M Portnoy
- Pediatric Allergy and Immunology, Children's Mercy Hospital, Kansas City School of Medicine, Kansas City, Mo
| | - Don A Bukstein
- Allergy, Asthma and Sinus Center, Milwaukee, Greenfield, Wis
| | - Leonard B Bacharier
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville, Tenn
| | - Rajan K Merchant
- Woodland Clinic Medical Group, Allergy Department, Dignity Health, Woodland, Calif
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9
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Mayoral K, Garin O, Caballero-Rabasco MA, Praena-Crespo M, Bercedo A, Hernandez G, Castillo J, Lizano Barrantes C, Pardo Y, Ferrer M. Smartphone App for monitoring Asthma in children and adolescents. Qual Life Res 2021; 30:3127-3144. [PMID: 33387290 DOI: 10.1007/s11136-020-02706-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE The asthma stepwise treatment approach recommended is based on monitoring patients' symptoms. The Asthma Research in Children and Adolescents (ARCA) cohort was created to provide evidence about the evolution of persistent asthma. This manuscript describes the development of an electronic health tool, comprising a mobile health application for patients with asthma and its associated online platform for pediatricians to monitor them. METHODS The development process followed 7 phases: the first 5 (Conceptualization, Preparation, Assessment scheduling, Image and user interface, and Technical development) defined and designed the tool, followed by a testing phase (functionality assessment and pilot test with ARCA patients), and a last phase which evaluated usability. Since the target population was aged 6-16 years, three versions were designed within the same smartphone application: parents/proxy, children, and adolescents. The online platform for pediatricians provides real-time information from the application: patients' responses over time with color-coded charts (red/amber/green, as in traffic lights). RESULTS The pilot test through semi-structured phone interviews of the first 50 participants included in the ARCA study (n = 53) detected their misunderstandings. Pediatricians were trained to emphasize that the application is free of charge and requires monthly answers. Median of the System Usability Scale scores (n = 85), ranging 0 (negative)-100 (positive), was > 93 in the three age versions of the application. CONCLUSIONS Technology has the capability of transforming the use of patient-reported outcomes. Describing all the development phases of a mobile health application for monitoring children and adolescents with asthma may increase the knowledge on how to design applications for young patients.
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Affiliation(s)
- K Mayoral
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain
| | - O Garin
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain. .,Pompeu Fabra University UPF, Barcelona, Spain.
| | - M A Caballero-Rabasco
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Pediatric Allergy and Pulmonology Unit, Pediatric Service, Hospital del Mar, Barcelona, Spain
| | - M Praena-Crespo
- Centro de Salud la Candelaria, Servicio Andaluz de Salud, Seville, Spain.,Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain
| | - A Bercedo
- Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain.,Centro de Salud Dobra, Servicio Cántabro de Salud, Cantabria, Spain
| | - G Hernandez
- Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain.,CAP Vila Olimpica, Parc Sanitari Pere Virgili, Barcelona, Spain
| | - J Castillo
- Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain.,Pediatric Pneumology Unit, Pediatric Service, Hospital Infantil Universitario Miguel Servet, Zaragoza, Spain
| | - C Lizano Barrantes
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Pompeu Fabra University UPF, Barcelona, Spain.,University of Costa Rica, San José, Costa Rica
| | - Y Pardo
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Ferrer
- Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. .,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain.
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10
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Blower S, Swallow V, Maturana C, Stones S, Phillips R, Dimitri P, Marshman Z, Knapp P, Dean A, Higgins S, Kellar I, Curtis P, Mills N, Martin-Kerry J. Children and young people's concerns and needs relating to their use of health technology to self-manage long-term conditions: a scoping review. Arch Dis Child 2020; 105:1093-1104. [PMID: 32444448 PMCID: PMC7588410 DOI: 10.1136/archdischild-2020-319103] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of patient-facing health technologies to manage long-term conditions is increasing; however, children and young people may have particular concerns or needs before deciding to use different health technologies. AIMS To identify children and young people's reported concerns or needs in relation to using health technologies to self-manage long-term conditions. METHODS A scoping review was conducted. We searched MEDLINE, PsycINFO and CINAHL in February 2019. Searches were limited to papers published between January 2008 and February 2019. We included any health technology used to manage long-term conditions. A thematic synthesis of the data from the included studies was undertaken. We engaged children with long-term conditions (and parents) to support review design, interpretation of findings and development of recommendations. RESULTS Thirty-eight journal articles were included, describing concerns or needs expressed by n=970 children and/or young people aged 5-18 years. Most included studies were undertaken in high-income countries with children aged 11 years and older. Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people's main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information. DISCUSSION This review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.
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Affiliation(s)
- Sarah Blower
- Department of Health Sciences, University of York, York, UK
| | - Veronica Swallow
- College of Health, Wellbeing & Life Sciences, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Camila Maturana
- York Trials Unit, University of York, York, North Yorkshire, UK
| | - Simon Stones
- School of Healthcare, University of Leeds, Leeds, West Yorkshire, UK
| | - Robert Phillips
- Centre for Reviews and Dissemination, University of York, York, North Yorkshire, UK
| | - Paul Dimitri
- NIHR Children and Young People MedTech Cooperative, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, Sheffield, UK
| | - Zoe Marshman
- School of Clinical Dentistry, The University of Sheffield, Sheffield, Sheffield, UK
| | - Peter Knapp
- Department of Health Sciences and Hull York Medical School, University of York, York, North Yorkshire, UK
| | - Alexandra Dean
- York Trials Unit, University of York, York, North Yorkshire, UK
| | | | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
| | - Penny Curtis
- School of Nursing and Midwifery, The University of Sheffield, Sheffield, Sheffield, UK
| | - Nathaniel Mills
- NIHR Children and Young People MedTech Co-operative and NIHR Devices for Dignity MedTech Co-operative, Sheffield Children's NHS Trust, Sheffield, UK
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11
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Iio M, Miyaji Y, Yamamoto-Hanada K, Narita M, Nagata M, Ohya Y. Beneficial Features of a mHealth Asthma App for Children and Caregivers: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e18506. [PMID: 32831181 PMCID: PMC7477670 DOI: 10.2196/18506] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/12/2020] [Accepted: 08/10/2020] [Indexed: 12/26/2022] Open
Abstract
Background mHealth and uHealth apps are available for children with asthma and their caregivers. However, previous studies on mHealth apps for children older than 7 years old with asthma are limited, and most studies on asthma apps do not consider interactions involving communication between children and caregivers. Therefore, a prototype mHealth child asthma app was developed for children and their caregivers, with features of tailored feedback messages in continuing self-management and interactions between children and caregivers. Objective The aim of this study was to identify the beneficial features of a prototype mHealth app developed for children with asthma and their caregivers. Methods Children diagnosed with persistent asthma by allergy specialists at the National Center for Child Health and Development were recruited. The features of a prototype mHealth app for children with asthma and their caregivers were investigated using semistructured interviews after they tried the app. Data were analyzed using thematic analysis. Content-characteristic words were named and grouped together as categories to explore themes. Results We recruited 27 children with asthma aged 2 to 12 years and 26 their caregivers. Findings on the good aspects of the app for children older than 7 years old and caregivers suggested 4 themes (confirmation of asthma knowledge, child-caregiver interaction, design of the app, and child’s interest), and 6 categories were identified. Findings on the good aspects of app for children 7 to 12 years old and caregivers suggested 5 themes (new knowledge, manga as a Japanese-style comic, child’s interest, trigger of self-management, and design and operability), and 11 categories were identified. Findings on the beneficial features of app suggested 6 themes (asthma knowledge, elements for continuous, universal design, notification, monitoring, and functions), and 12 categories were identified. Conclusions Children with asthma and their caregivers perceived that the good aspects of the app were learning asthma knowledge with fun, including manga; interaction between child and caregiver; and easy-to-read design, such as colors. They wanted not only the asthma knowledge but also the universal design and enhanced elements, monitoring, and notification functions of the app.
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Affiliation(s)
- Misa Iio
- College of Nursing, Kanto Gakuin University, Yokohama, Japan
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development, Setagaya, Japan
| | | | - Masami Narita
- Division of Allergy, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
| | - Mayumi Nagata
- College of Nursing, Kanto Gakuin University, Yokohama, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Setagaya, Japan
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12
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Zhang Y, Cao B, Wang Y, Peng TQ, Wang X. When Public Health Research Meets Social Media: Knowledge Mapping From 2000 to 2018. J Med Internet Res 2020; 22:e17582. [PMID: 32788156 PMCID: PMC7453331 DOI: 10.2196/17582] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/12/2020] [Accepted: 07/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media has substantially changed how people confront health issues. However, a comprehensive understanding of how social media has altered the foci and methods in public health research remains lacking. OBJECTIVE This study aims to examine research themes, the role of social media, and research methods in social media-based public health research published from 2000 to 2018. METHODS A dataset of 3419 valid studies was developed by searching a list of relevant keywords in the Web of Science and PubMed databases. In addition, this study employs an unsupervised text-mining technique and topic modeling to extract research themes of the published studies. Moreover, the role of social media and research methods adopted in those studies were analyzed. RESULTS This study identifies 25 research themes, covering different diseases, various population groups, physical and mental health, and other significant issues. Social media assumes two major roles in public health research: produce substantial research interest for public health research and furnish a research context for public health research. Social media provides substantial research interest for public health research when used for health intervention, human-computer interaction, as a platform of social influence, and for disease surveillance, risk assessment, or prevention. Social media acts as a research context for public health research when it is mere reference, used as a platform to recruit participants, and as a platform for data collection. While both qualitative and quantitative methods are frequently used in this emerging area, cutting edge computational methods play a marginal role. CONCLUSIONS Social media enables scholars to study new phenomena and propose new research questions in public health research. Meanwhile, the methodological potential of social media in public health research needs to be further explored.
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Affiliation(s)
- Yan Zhang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Yifan Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Tai-Quan Peng
- Department of Communication, Michigan State University, East Lansing, MI, United States
| | - Xiaohua Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
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13
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Foronda CL, Kelley CN, Nadeau C, Prather SL, Lewis-Pierre L, Sarik DA, Muheriwa SR. Psychological and Socioeconomic Burdens Faced by Family Caregivers of Children With Asthma: An Integrative Review. J Pediatr Health Care 2020; 34:366-376. [PMID: 32299726 DOI: 10.1016/j.pedhc.2020.02.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Asthma affects nearly 1 in every 12 children in the United States. Caring for a child with asthma poses significant challenges for the parent or caregiver. The purpose of this integrative review was to identify the psychological and socioeconomic burdens faced by family caregivers of children with asthma. METHOD An integrative review was conducted to review and appraise 80 studies. RESULTS Psychosocial burdens included decreased mental health, quality of life, sleep, family stress, educational deficits, cultural and health disparities, and health care communication challenges. Socioeconomic burdens included poor access to care, as well as work and financial challenges. Studies demonstrated a link between family caregiver health and child health outcomes. Facilitators included education and empowerment, social support, and use of technology. DISCUSSION As the family caregiver's health directly affects the asthmatic child's health, addressing the burdens of family caregivers should be a key consideration in pediatric asthma care.
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14
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Foronda CL, Jawid MY, Alhusen J, Muheriwa SR, Ramunas MM, Hooshmand M. Healthcare Providers' Experiences with Gaps, Barriers, and Facilitators Faced by Family Caregivers of Children with Respiratory Diseases. J Pediatr Nurs 2020; 52:49-53. [PMID: 32179377 DOI: 10.1016/j.pedn.2020.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to identify healthcare providers' experiences of the gaps in the healthcare system, barriers to obtaining care, and facilitators that promoted safe, quality care for family caregivers of children with respiratory diseases. DESIGN AND METHODS A qualitative, descriptive design was used with 13 pediatric healthcare providers. FINDINGS Gaps included themes of 1) fragmented healthcare system and 2) lack of asthma management knowledge. Barriers included themes of 1) poor access to healthcare and medications, 2) non-adherence, and 3) linguistic diversity and poor health literacy. Facilitators of optimal respiratory management included themes of 1) education, 2) improved communication, and 3) peer support. CONCLUSIONS Through better understanding the gaps, barriers, and facilitators, pediatric nurses will be able to more effectively anticipate and address the needs of the caregivers. PRACTICE IMPLICATIONS The nurse is in a pivotal role to empower caregivers with the skills and resources to address challenges and connect them with providers for optimal respiratory management.
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Affiliation(s)
- Cynthia L Foronda
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, United States of America.
| | - Maryam Yasmeen Jawid
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, United States of America.
| | - Jeanne Alhusen
- University of Virginia, School of Nursing, Charlottesville, VA, United States of America.
| | - Sadandaula Rose Muheriwa
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, United States of America.
| | - Marisa M Ramunas
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, United States of America.
| | - Mary Hooshmand
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, United States of America.
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15
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Al-Otaibi HM, Ansari KA, Hamad O, Alanzi TM. Opinions of healthcare providers on the design of a smartphone application for asthma treatment in the Kingdom of Saudi Arabia. Multidiscip Respir Med 2020; 15:508. [PMID: 32269774 PMCID: PMC7137761 DOI: 10.4081/mrm.2020.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/28/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction In several countries of the world, smartphone applications have been designed to contribute to the treatment of asthma. However, none of these applications has been developed in Saudi Arabia. Therefore, the objective of this article is to design a smartphone application for the treatment of asthma based on the opinions of healthcare providers from the Kingdom of Saudi Arabia. Methods In order to know the opinion of the healthcare providers from Saudi Arabia about the design of an asthma App, we used a purposive sampling method and conducted a cross sectional survey employing a questionnaire which was distributed through the QuestionPro.com website to all healthcare providers working in this country. The questionnaire was sent to 376 healthcare providers and the response rate was 25%. Results The data indicated that the majority of the respondents opined that the following features were important or very important in the design of a smartphone application for asthma treatment in Saudi Arabia: information about patient diagnosis (98%), primary physician access information(83%), patient satisfaction with the therapeutic process (91%), push notifications about reminder for drugs (95%), push notification for treatment of inhaler and other drugs (92%), push notifications about reminders of clinic visits and therapy sections (81%), push notifications to ask for help sending SMS to primary physician about patients’ attacks (89%), pathophysiology of asthma (82%), asthma triggers (98%), drug guidelines (94%), drug side effects (93%), number of asthma attacks (98%), medication statistics (88%), visual inputs such as peak flow (91%), data to link patients to healthcare providers and to healthcare centers (82%), and Global Initiative for Asthma (GINA) references (72%). Conclusions According to the opinion of the majority of healthcare providers (92%), the proposed smartphone application designed based on medical guidelines will contribute to improve the treatment of patients with asthma in the Kingdom of Saudi Arabia, and will help to reduce the number of asthma cases that need hospitalization, and the number of asthma cases in the emergency departments of the hospitals of the Kingdom.
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Affiliation(s)
- Hajed M Al-Otaibi
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid A Ansari
- Department of Health Sciences, University of the West of England (UWE), Bristol, UK
| | - Osama Hamad
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Turki M Alanzi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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16
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eHealth only interventions and blended interventions to support self-management in adolescents with asthma: A systematic review. CLINICAL EHEALTH 2020. [DOI: 10.1016/j.ceh.2020.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Morton RW, Elphick HE, Craven V, Shields MD, Kennedy L. Aerosol Therapy in Asthma-Why We Are Failing Our Patients and How We Can Do Better. Front Pediatr 2020; 8:305. [PMID: 32656165 PMCID: PMC7325940 DOI: 10.3389/fped.2020.00305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022] Open
Abstract
In order for inhaled corticosteroids to be delivered adequately to the airways they require patients to take them regularly using an effective technique. Patients often have a poor inhaler technique, and this has been shown to result in sub-optimal asthma control. It is important for all clinicians prescribing inhaled medication to be experienced in the correct technique, and take time to train children so that they have mastered corrected inhaler technique. Using Teach to Goal or teach back methodology is a simple and effective way to provide this in the clinic setting. More than one training session is typically needed before children can master correct inhaler technique. Adherence to inhaled therapy has been shown to be sub-optimal in pediatric populations, with studies showing an average rate of around 50%. Subjective methods of measuring adherence have been shown to be inaccurate and overestimate rates. The advent of new technology has allowed adherence rates to be measured electronically, and it has been shown that regular feedback of these data can be effective at improving asthma control. New mobile apps and smart technology aim to engage patients and families with their asthma care. Effective use of these apps in collaboration with health care professionals has a vast potential to improve adherence rates and inhaler technique, resulting in improved asthma control.
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Affiliation(s)
| | | | - Vanessa Craven
- Sheffield Children's Hospital, Sheffield, United Kingdom
| | - Michael D Shields
- Queen's University Belfast, Belfast, United Kingdom.,Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
| | - Lesley Kennedy
- Royal Belfast Hospital for Sick Children, Belfast, United Kingdom
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18
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Emami H, Asadi F, Garavand A. The Features of Mobile-Based Software in Self-Management of Patients with Asthma: A Review Article. TANAFFOS 2020; 19:10-19. [PMID: 33101427 PMCID: PMC7569493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND The use of mobile-based software for the self-management of patients with asthma improves the quality of life, reduces healthcare costs, provides effective health care interventions in asthma, and supports the patients in self-management. The current study was performed to identify the features of mobile-based self-management software for patients with asthma (MSSPA). MATERIALS AND METHODS The present review study was performed in 2018. Four databases including PubMed, Scopus, Emerald, and Google Scholar were screened by the combination of selected keywords. Data were collected using a data extraction form. Data were analyzed using the content analysis method. Results were abstracted and reported based on the study objectives. RESULTS Of the 297 articles retrieved during the first round of search, 24 were selected; 15 of which were the original articles (62.5%). As the most important applications of MSSPA, it could be used as a tool to support patients in self-management, provide them with educational information, and self-observation. Also, 75% of the studies (n=18) emphasized the effectiveness of MSSPA. Identification of the required field of the software was the most important requirement in using MSSPA. Nevertheless, some of the studies reported the low quality and compatibility of some designed apps compared with those of the available information systems. CONCLUSION Identification of MSSPA features and considering them in new versions can promote the quality of MSSPA. However, according to the results of the study, in addition to identifying the software features, more attention should be paid to the users' needs in software design.
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19
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Jeminiwa RN, Hohmann NS, Fox BI. Developing a Theoretical Framework for Evaluating the Quality of mHealth Apps for Adolescent Users: A Systematic Review. J Pediatr Pharmacol Ther 2019; 24:254-269. [PMID: 31337988 DOI: 10.5863/1551-6776-24.4.254] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess adolescents' preferred mobile app features and to propose a framework for evaluating health-related mobile apps for adolescents. METHODS PubMed, CINAHL, PsycINFO, ERIC, HealthIT.gov, and ClinicalTrials.gov were systematically searched in August 2017. Studies pertaining to app development, feasibility, or usability that reported preferred app features and rating criteria on mHealth (mobile health) apps intended for adolescents were included. Quality assessment was performed using the Mixed Methods Appraisal Tool. Qualitative synthesis was performed to develop themes reflecting best practices for evaluating the quality of mHealth apps for adolescents. Using a grounded theory approach, we constructed a theoretical framework of rating criteria that can be used to inform development of an evaluation tool for mHealth apps targeted to adolescents. RESULTS Thirteen articles were included. Most commonly preferred features include ability to track test results or self-management progress, connect to social media, and gain points or prizes through app gamification. Common rating criteria include degree of app customizability, ease of use, visual appeal, and interactivity. Five emerging dimensions were used in the theoretical framework: Technical Quality; Engagement; Support System; Autonomy; and Safety, Privacy, and Trust. CONCLUSIONS We found that adolescents prefer mHealth apps that are customizable, offer peer support through social media, sustain engagement via gamification, and support the ability to visualize health trends via simplified graphs. Findings may help in the development of mHealth apps that are preferred by adolescents, as well as the development of a quality evaluation tool for mHealth apps targeted to this population.
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20
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Qudah B, Luetsch K. The influence of mobile health applications on patient - healthcare provider relationships: A systematic, narrative review. PATIENT EDUCATION AND COUNSELING 2019; 102:1080-1089. [PMID: 30745178 DOI: 10.1016/j.pec.2019.01.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 05/21/2023]
Abstract
OBJECTIVE To explore the influence of mobile health applications on various dimensions of patient and healthcare provider relationships. METHODS A systematic, narrative review of English literature reporting experiences and outcomes of using mobile health applications was performed, evaluating communication and relationships between patients and healthcare professionals. Findings were framed thematically within the four dimensions of relationship-centred care. The methodological quality of included articles was appraised. RESULTS Thirty-seven articles were included, all of them meeting tenets of relationship-centred care. After adopting mobile health applications patients perceived an overall positive impact on their relationship with healthcare providers, indicating they are ready to transition from traditional clinical ecounters to a different modality. Use of the applications supported patients in assuming active roles in the management of their health in collaboration with health professionals. Reluctance of providers to using mobile health needs to be acknowledged and addressed when encouraging wider use of applications in clinical practice. CONCLUSION The use of mobile health applications can influence communication and relationships between patients and providers positively, facilitating relationship-centered healthcare. PRACTICE IMPLICATION Implementation of mobile health can support patients' self-efficacy, improve access to healthcare services and improve relationships between patients and providers in ambulatory and hospital settings.
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Affiliation(s)
- Bonyan Qudah
- School of Pharmacy, The University of Queensland, Woolloongabba, Qld, 4102, Australia.
| | - Karen Luetsch
- School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, Qld, 4102, Australia.
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21
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Kuipers E, Poot CC, Wensing M, Chavannes NH, de Smet PA, Teichert M. Self-Management Maintenance Inhalation Therapy With eHealth (SELFIE): Observational Study on the Use of an Electronic Monitoring Device in Respiratory Patient Care and Research. J Med Internet Res 2019; 21:e13551. [PMID: 31148542 PMCID: PMC6658221 DOI: 10.2196/13551] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/20/2019] [Accepted: 03/23/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Electronic inhalation monitoring devices (EIMDs) are available to remind patients with respiratory diseases to take their medication and register inhalations for feedback to patients and health care providers as well as for data collection in research settings. OBJECTIVE This study aimed to assess the validity as well as the patient-reported usability and acceptability of an EIMD. METHODS This observational study planned to include 21 community pharmacies in the Netherlands. Patient-reported inhalations were collected and compared to EIMD registrations to evaluate the positive predictive value of these registrations as actual patient inhalations. Patients received questionnaires on their experiences and acceptance. RESULTS A convenience sample of 32 patients was included from across 18 pharmacies, and 932 medication doses were validated. Of these, 796 registrations matched with patient-reported use (true-positive, 85.4%), and 33 inhalation registrations did not match with patient-reported use (false-positive, 3.5%). The positive predictive value was 96.0%, and 103 patient-reported inhalations were not recorded in the database (false-negative, 11.1%). Overall, patients considered the EIMD to be acceptable and easy to use, but many hesitated to continue its use. Reminders and motivational messages were not appreciated by all users, and more user-tailored features in the app were desired. CONCLUSIONS Patients' interaction with the device in real-world settings is critical for objective measurement of medication adherence. The positive predictive value of this EIMD was found to be acceptable. However, patients reported false-negative registrations and a desire to include more user-tailored features to increase the usability and acceptability of the EIMD.
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Affiliation(s)
- Esther Kuipers
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.,BENU Apotheek Zeist West, Zeist, Netherlands
| | - Charlotte C Poot
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Michel Wensing
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.,Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Peter Agm de Smet
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands.,Department of Clinical Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Martina Teichert
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Centre, Leiden, Netherlands
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22
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Smartphone Applications for Encouraging Asthma Self-Management in Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112403. [PMID: 30380692 PMCID: PMC6266660 DOI: 10.3390/ijerph15112403] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 10/24/2018] [Indexed: 12/05/2022]
Abstract
Adolescent asthma is still a major problem with poor adherence to treatment. Globally, adolescents are devoted users of smartphone technologies and app use in asthma self-management may improve adherence. The objective of this systematic review is to assess the feasibility and efficacy of mobile technology in improving asthma outcomes in adolescents. We conducted an extensive review of the peer-review literature of studies with populations consisting of children and adolescents under 18 years in seven bibliographic databases and Google Scholar. All study designs were considered. Quality assessment of included studies were independently assessed and reported. The search identified 291 articles; of the 16 eligible full-text papers, 8 met the review criteria, reporting two interventional, two qualitative and four observational studies. Samples ranged from 12 to 21 participants. Heterogeneity related to study design and the methods of the included studies prevented meta-analysis. Nevertheless, the intervention studies reported a positive effect of smartphone apps on asthma control, medication adherence and self-efficacy. Smartphone apps may be an effective asthma control tool especially among adolescents who are major users of smartphones; however, conclusions are limited by a lack of controlled trials and adequate sample sizes.
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23
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Roberts C, Sage A, Geryk L, Sleath B, Carpenter D. Adolescent Preferences and Design Recommendations for an Asthma Self-Management App: Mixed-Methods Study. JMIR Form Res 2018; 2:e10055. [PMID: 30684424 PMCID: PMC6334705 DOI: 10.2196/10055] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/25/2018] [Accepted: 06/21/2018] [Indexed: 01/27/2023] Open
Abstract
Background Approximately 10% of adolescents in the United States have asthma. Adolescents widely use apps on mobile phones and tablet technology for social networking and gaming purposes. Given the increase in recreational app use among adolescents, leveraging apps to support adolescent asthma disease management seems warranted. However, little empirical research has influenced asthma app development; adolescent users are seldom involved in the app design process. Objective The aim of this mixed-methods study was to assess adolescent preferences and design recommendations for an asthma self-management app. Methods A total of 20 adolescents with persistent asthma (aged 12-16 years) provided feedback on two asthma self-management apps during in-person semistructured interviews following their regularly scheduled asthma clinic visit and via telephone 1 week later. Interviews were audiorecorded, transcribed verbatim, analyzed using SPSS v24, and coded thematically using MAXQDA 11. Results Regarding esthetics, app layout and perceived visual simplicity were important to facilitate initial app use. Adolescents were more likely to continually engage with apps that were deemed useful and met their informational needs. Adolescents also desired app features that fit within their existing paradigm or schema and included familiar components (eg, medication alerts that appear and sound like FaceTime notifications and games modeled after Quiz Up and Minecraft), as well as the ability to customize app components. They also suggested that apps include other features, such as an air quality tracker and voice command. Conclusions Adolescents desire specific app characteristics including customization and tailoring to meet their asthma informational needs. Involving adolescents in early stages of app development is likely to result in an asthma app that meets their self-management needs and design preferences and ultimately the adoption and maintenance of positive asthma self-management behaviors.
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Affiliation(s)
- Courtney Roberts
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Adam Sage
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lorie Geryk
- Center for Health Systems Effectiveness, Oregon Health and Sciences University, Portland, OR, United States
| | - Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,The Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Delesha Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Asheville, Asheville, NC, United States
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Al-Motlaq M, Al-Sheyab N. Attitudes of Non-Asthmatic Children Towards Their Asthmatic Peers: Influence of interactions with asthmatic relatives and peers. Sultan Qaboos Univ Med J 2018; 18:e161-e166. [PMID: 30210845 DOI: 10.18295/squmj.2018.18.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/06/2017] [Accepted: 01/18/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to examine non-asthmatic children's acceptance of and attitudes towards their asthmatic peers in Jordan. Methods This descriptive cross-sectional study was conducted between September 2015 and January 2016 among 1,812 non-asthmatic children aged 9-13 years old at 10 schools in Zarqa, Jordan. Arabic versions of the Peers Attitude Towards Children with Asthma scale and the Asthma Knowledge Test for Children were used to assess attitudes towards children with asthma and asthma-related knowledge, respectively. Results A total of 1,586 children participated in the study (response rate: 87.5%). Of these, 158 (10%) and 399 (25.2%) children reported a family history of asthma or knew at least one person with asthma, respectively. Although 50.3% stated that they would sit next to such children in the classroom, only 34.9% reported that they would be friends with an asthmatic child. However, 73.1% of the non-asthmatic children believed that asthmatic children were not pretending to be ill and 61.4% believed that such children were not ill due to their own carelessness. Female non-asthmatic children (P <0.001), those with a family history of asthma (P = 0.004) and those who knew other individuals with asthma (P <0.001) had significantly more positive attitudes towards and acceptance of their asthmatic peers. In addition, age was significantly related to attitude scores (P <0.001). However, there was no correlation between asthma-related knowledge and the children's attitudes towards peers with asthma (P = 0.611). Conclusion Previous interactions with asthmatic family members or peers were found to significantly influence non-asthmatic children's attitudes towards their asthmatic peers.
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Affiliation(s)
- Mohammad Al-Motlaq
- Department of Maternal, Child & Family Health, Hashemite University, Zarqa, Jordan
| | - Nihaya Al-Sheyab
- Department of Maternal Child Health, Jordan University of Science & Technology, Irbid, Jordan
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25
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Clifton DC, Benjamin RW, Brown AR, Ostrovsky DA, Narayan AP. A Tablet-Based Educational Tool: Toward More Comprehensive Pediatric Patient Education. Clin Pediatr (Phila) 2018; 57:1176-1182. [PMID: 29575940 DOI: 10.1177/0009922818766621] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is a paucity of data on the impact of mobile technology on physician-led education in the pediatric population. We performed a prospective pilot study in a pediatric diabetes clinic to evaluate the impact of tablet-based patient education. A total of 106 patients and caregivers completed postclinic surveys, 64 (60%) in the intervention group and 42 (40%) in the control group. The majority of the intervention group patients (86%) liked tablet use and felt it was better or similar (99%) to baseline. Moreover, a majority receiving tablet-based education perceived an increase in diabetes knowledge (57%) compared with baseline (39%), though the difference did not reach statistical significance ( P = .059). Those who received tablet-based education felt they were educated on more diabetes-related topics. As the use of mobile technology in medicine grows, additional research is needed to compare mobile technology with traditional methods in providing education to the pediatric population.
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26
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Doyle R, Albright K, Hurley LP, Chávez C, Stowell M, Dircksen S, Havranek EP, Anderson M. Patient Perspectives on a Text Messaging Program to Support Asthma Management: A Qualitative Study. Health Promot Pract 2018; 20:585-592. [PMID: 29732922 DOI: 10.1177/1524839918770209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction. This study investigated participants' acceptance of a short messaging service (SMS) intervention designed to support asthma management, including suggestions regarding program delivery and message content. Methods. Individual and group interviews were conducted with patients from a safety-net health care system in Denver, Colorado. Eligible participants were English or Spanish speakers between the ages of 13 and 40 years, with diagnosed persistent asthma. All individual and group interviews were digitally recorded, transcribed, translated from Spanish to English (where applicable), and analyzed for thematic content by experienced analysts using established qualitative content techniques. The qualitative software package ATLAS.ti was used for data analysis and management. Results. This study included a total of 43 participants. In general, participants were receptive toward the SMS program and supported the use of tailored and interactive messages. Adolescents supported the idea of enhancing care by sending messages to a support person, such as a parent or guardian. However, adults were less receptive toward this idea. Participants also preferred directive educational messages and cues to action, while general messages reminding them of their asthma diagnosis were viewed less favorably. Implications. The results from this study will inform a randomized control trial evaluating the efficacy of the SMS intervention.
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Affiliation(s)
- Reina Doyle
- 1 Denver Health and Hospital Authority, Denver, CO, USA
| | - Karen Albright
- 2 University of Denver, Denver, CO, USA.,3 University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Laura P Hurley
- 1 Denver Health and Hospital Authority, Denver, CO, USA.,2 University of Denver, Denver, CO, USA
| | - Catia Chávez
- 3 University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Boyd C, Wood K, Whitaker D, Ashorobi O, Harvey L, Oster R, Holmes RP, Assimos DG. Accuracy in 24-hour Urine Collection at a Tertiary Center. Rev Urol 2018; 20:119-124. [PMID: 30473637 PMCID: PMC6241899 DOI: 10.3909/riu0807] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is a paucity of studies addressing the accuracy of 24-hour urine collection for assessing stone risk parameters. Collection accuracy is thought to be essential for assigning optimal therapy for stone prevention. The objective of this study was to determine factors associated with accurate and inaccurate collections. During a 2-year period (2015-2016), 241 stone formers completed 24-hour urine collections. They were divided into accurate collectors (AC), defined as at least one accurate urine collection, and inaccurate collectors (IC). Accuracy was assessed by 24-hour urine creatinine (Cr) excretion indexed to body weight (normal: males, 20-25 mg Cr/kg; females, 15-20 mg Cr/kg). Demographic data analyzed included age, gender, race, insurance status, partner status, income, and education. Statistical analysis methods included the chi-square test, Fisher's exact test, and the two-group t-test. Average age was 50.7 years at the time of collection; 50.2% were men, 86% were white, and 14% were black. Overall, 51.0% of collections were inaccurate. There was no statistical significance between AC and IC for gender (P = 0.85), race (P = 0.90), insurance status (P = 0.85), recurrence (P = 0.87), stone type (P = 0.57), education (P = 0.35), income (P 5 0.42), or poverty (P = 0.35). Older age (P = 0.017) and having a partner (P = 0.022) were significantly associated with AC. The high rate of inaccurate 24-hour urine collections is a concern. The only factors we identified as influencing collection accuracy were age and partner status. These results underscore the importance of developing methods to improve the accuracy of collecting 24-hour urine samples.
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Affiliation(s)
- Carter Boyd
- University of Alabama-Birmingham School of Medicine Birmingham, AL
| | - Kyle Wood
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Dustin Whitaker
- University of Alabama-Birmingham School of Medicine Birmingham, AL
| | - Omotola Ashorobi
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Lisa Harvey
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Robert Oster
- Department of Medicine, University of Alabama-Birmingham Birmingham, AL
| | - Ross P Holmes
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
| | - Dean G Assimos
- Department of Urology, University of Alabama-Birmingham Birmingham, AL
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Davis SR, Peters D, Calvo RA, Sawyer SM, Foster JM, Smith L. "Kiss myAsthma": Using a participatory design approach to develop a self-management app with young people with asthma. J Asthma 2017; 55:1018-1027. [PMID: 29064746 DOI: 10.1080/02770903.2017.1388391] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: Young people with asthma often lack engagement in self-management. Smartphone apps offer an attractive, immediate method for obtaining asthma information and self-management support. In this research we developed an evidence-based asthma app tailored to young peoples needs, created using a participatory design approach to optimize user engagement. This paper describes the participatory design process. Methods: This multi-phased research included concept generation and ideation of app design by young people with asthma, and development of asthma information by the research team. Clinical review was sought regarding safety and accuracy of app content. Participants suggestions for improvement and any problems with the app were logged throughout. Our young co-designers were invited back to test a high fidelity prototype app using a "think aloud" process and completed a usability questionnaire. Results: Twenty asthma patients aged 15-24 years contributed to the initial app design. Three respiratory specialists and two pharmacists suggested minor corrections to clinical terminology in the app which were all incorporated. Nine co-designers acted as expert reviewers of the prototype app, of whom eight completed a usability questionnaire. Median usability scores (maximum score 6) indicated high satisfaction with app content, usefulness and ease of use [median item score 5.3 (range 4.7-6.0)]. All feedback was incorporated to create an updated prototype app. Conclusions: A clinically sound asthma app has been developed which is considered highly acceptable to the young co-designers. A six-week test of the engagement, acceptability, and usefulness of the app in young people not involved in the participatory design will follow.
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Affiliation(s)
- S R Davis
- a Faculty of Pharmacy , University of Sydney , NSW , Australia
| | - D Peters
- b School of Electrical and Information Engineering , University of Sydney , Sydney , NSW , Australia
| | - R A Calvo
- b School of Electrical and Information Engineering , University of Sydney , Sydney , NSW , Australia
| | - S M Sawyer
- c Centre for Adolescent Health, Royal Children's Hospital, Department of Paediatrics , The University of Melbourne, Murdoch Childrens Research Institute , Melbourne , VIC , Australia
| | - J M Foster
- d Clinical Management Group, Woolcock Institute of Medical Research , University of Sydney , Sydney , NSW , Australia
| | - L Smith
- a Faculty of Pharmacy , University of Sydney , NSW , Australia
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Farzandipour M, Nabovati E, Sharif R, Arani MH, Anvari S. Patient Self-Management of Asthma Using Mobile Health Applications: A Systematic Review of the Functionalities and Effects. Appl Clin Inform 2017; 8:1068-1081. [PMID: 29241254 PMCID: PMC5802317 DOI: 10.4338/aci-2017-07-r-0116] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 09/16/2017] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this systematic review was to summarize the evidence regarding the effects of mobile health applications (mHealth apps) for self-management outcomes in patients with asthma and to assess the functionalities of effective interventions. Methods We systematically searched Medline, Scopus, and the Cochrane Central Register of Controlled Trials. We included English-language studies that evaluated the effects of smartphone or tablet computer apps on self-management outcomes in asthmatic patients. The characteristics of these studies, effects of interventions, and features of mHealth apps were extracted. Results A total of 10 studies met all the inclusion criteria. Outcomes that were assessed in the included studies were categorized into three groups (clinical, patient-reported, and economic). mHealth apps improved asthma control (five studies) and lung function (two studies) from the clinical outcomes. From the patient-reported outcomes, quality of life (three studies) was statistically significantly improved, while there was no significant impact on self-efficacy scores (two studies). Effects on economic outcomes were equivocal, so that the number of visits (in two studies) and admission and hospitalization-relevant outcomes (in one study) statistically significantly improved; and in four other studies, these outcomes did not improve significantly. mHealth apps features were categorized into seven categories (inform, instruct, record, display, guide, remind/alert, and communicate). Eight of the 10 mHealth apps included more than one functionality. Nearly all interventions had the functionality of recording user-entered data and half of them had the functionality of providing educational information and reminders to patients. Conclusion Multifunctional mHealth apps have good potential in the control of asthma and in improving the quality of life in such patients compared with traditional interventions. Further studies are needed to identify the effectiveness of these interventions on outcomes related to medication adherence and costs.
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Affiliation(s)
- Mehrdad Farzandipour
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran
| | - Reihane Sharif
- Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Shima Anvari
- Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
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Jonsson M, Schuster M, Protudjer JLP, Bergström A, Egmar AC, Kull I. Experiences of Daily Life Among Adolescents With Asthma - A Struggle With Ambivalence. J Pediatr Nurs 2017; 35:23-29. [PMID: 28728764 DOI: 10.1016/j.pedn.2017.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 01/25/2017] [Accepted: 02/03/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE There is limited knowledge about how adolescents with asthma view their disease in daily life and how these views impact on management. The aim of this study was to describe experiences of daily life, with particular focus on thoughts, feelings and management of adolescents with asthma. METHODS In this qualitative study, data were obtained from 10 interviews with adolescents (aged 16-18 years) with asthma recruited from the Swedish population-based prospective birth cohort, BAMSE. Data were analysed through Systematic Text Condensation. RESULTS Experiences of daily life among adolescents with asthma were defined in four categories: Insight and understanding; Asthma not the focus of daily life; Being acknowledged and, Being affected by asthma symptoms. The adolescents had developed an insight into and understanding of their disease, but did not want asthma to be the focus of their daily lives. The adolescents wanted their asthma to be acknowledged, but not to the point that they were defined by their asthma. They reported having many asthma symptoms, especially during physical activity, but also described a desire to feel healthy, "normal" and like their peers. CONCLUSIONS Having asthma in adolescence involves several struggles with ambivalence between adapting socially, feeling healthy and managing one's asthma. IMPLICATIONS IN CLINICAL PRACTICE The provision of person-centred care may be one way to handle the ambivalence among adolescents with asthma and thereby help them to manage their asthma.
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Affiliation(s)
- Marina Jonsson
- Centre of Occupational and Environmental Medicine, Stockholm County Council, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Sweden.
| | - Marja Schuster
- The Swedish Red Cross University College, Department of Technology and Welfare, Sweden
| | - Jennifer L P Protudjer
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Centre for Allergy Research, Karolinska Institutet, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Centre for Allergy Research, Karolinska Institutet, Sweden
| | - Ann-Charlotte Egmar
- The Swedish Red Cross University College, Department of Public Health and Medicine, Sweden; Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, Sweden; Sachs' Children's Hospital, Södersjukhuset, Sweden; Department of Clinical Science and Education, Stockholm South General Hospital, Karolinska Institutet, Sweden
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Peters D, Davis S, Calvo RA, Sawyer SM, Smith L, Foster JM. Young People's Preferences for an Asthma Self-Management App Highlight Psychological Needs: A Participatory Study. J Med Internet Res 2017; 19:e113. [PMID: 28400353 DOI: 10.2196/jmir.6994] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 03/09/2017] [Accepted: 03/12/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although the prevalence of mental illness among young people with asthma is known to be twice the rate of the wider population, none of the asthma apps reported have acknowledged or attempted to include psychological support features. This is perhaps because user involvement in the development of asthma apps has been scarce. User involvement, facilitated by participatory design methods, can begin to address these issues while contributing insights to our understanding of the psychological experience associated with asthma and how technology might improve quality of life. OBJECTIVE The goal of this participatory user research study was to explore the experience, needs, and ideas of young people with asthma while allowing them to define requirements for an asthma app that would be engaging and effective at improving their well-being. METHODS Young people aged 15-24 years with doctor-diagnosed asthma were invited to participate in a participatory workshop and to complete a workbook designed to elicit their thoughts and ideas about living with asthma, technology use, and the design of an app. Participants generated a number of artifacts (including collages, concept maps, and paper prototypes) designed to reify their ideas, tacit knowledge, and experience. RESULTS A total of 20 participants (mean age 17.8 years; 60%, 12/20 female) representing a range from inadequately to well-controlled asthma completed a workbook and 13 of these also took part in a workshop (four workshops were held in total), resulting in 102 participant-generated artifacts. Theoretical thematic analysis resulted in a set of personal needs, feature ideas, and app characteristics considered relevant by young people for an asthma support app. The data revealed that psychological factors such as anxiety, and impediments to autonomy, competence, and relatedness (as consistent with self-determination theory [SDT]), were considered major influences on quality of life by young people with asthma. Furthermore, the incorporation of features pertaining to psychological experience was particularly valued by participants. CONCLUSIONS In addition to practical features for asthma management, an app for young people with asthma should include support for the mental health factors associated with lived experience (ie, anxiety, lack of autonomy, and social disconnectedness). We show how support for these factors can be translated into design features of an app for asthma. In addition to informing the development of asthma-support technologies for young people, these findings could have implications for technologies designed to support people with chronic illness more generally.
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Affiliation(s)
- Dorian Peters
- School of Electrical and Information Engineering, Faculty of Engineering, University of Sydney, Sydney, Australia
| | - Sharon Davis
- Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
| | - Rafael Alejandro Calvo
- School of Electrical and Information Engineering, Faculty of Engineering, University of Sydney, Sydney, Australia
| | - Susan M Sawyer
- Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Lorraine Smith
- Faculty of Pharmacy, University of Sydney, Sydney, Australia
| | - Juliet M Foster
- Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
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Sage A, Roberts C, Geryk L, Sleath B, Tate D, Carpenter D. A Self-Regulation Theory-Based Asthma Management Mobile App for Adolescents: A Usability Assessment. JMIR Hum Factors 2017; 4:e5. [PMID: 28148471 PMCID: PMC5311420 DOI: 10.2196/humanfactors.7133] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/12/2017] [Accepted: 01/15/2017] [Indexed: 11/13/2022] Open
Abstract
Background Self-regulation theory suggests people learn to influence their own behavior through self-monitoring, goal-setting, feedback, self-reward, and self-instruction, all of which smartphones are now capable of facilitating. Several mobile apps exist to manage asthma; however, little evidence exists about whether these apps employ user-centered design processes that adhere to government usability guidelines for mobile apps. Objective Building upon a previous study that documented adolescent preferences for an asthma self-management app, we employed a user-centered approach to assess the usability of a high-fidelity wireframe for an asthma self-management app intended for use by adolescents with persistent asthma. Methods Individual interviews were conducted with adolescents (ages 11-18 years) with persistent asthma who owned a smartphone (N=8). Adolescents were asked to evaluate a PDF app wireframe consisting of 76 screen shots displaying app features, including log in and home screen, profile setup, settings and info, self-management features, and graphical displays for charting asthma control and medication. Preferences, comments, and suggestions for each set of screen shots were assessed using the audio-recorded interviews. Two coders reached consensus on adolescent evaluations of the following aspects of app features: (1) usability, (2) behavioral intentions to use, (3) confusing aspects, and (4) suggestions for improvement. Results The app wireframe was generally well received, and several suggestions for improvement were recorded. Suggestions included increased customization of charts and notifications, reminders, and alerts. Participants preferred longitudinal data about asthma control and medication use to be displayed using line graphs. All participants reported that they would find an asthma management app like the one depicted in the wireframe useful for managing their asthma. Conclusions Early stage usability tests guided by government usability guidelines (usability.gov) revealed areas for improvement for an asthma self-management app for adolescents. Addressing these areas will be critical to developing an engaging and effective asthma self-management app that is capable of improving adolescent asthma outcomes.
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Affiliation(s)
- Adam Sage
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Courtney Roberts
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lorie Geryk
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Deborah Tate
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Delesha Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Geryk LL, Roberts CA, Sage AJ, Coyne-Beasley T, Sleath BL, Carpenter DM. Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study. JMIR Res Protoc 2016; 5:e229. [PMID: 27923777 PMCID: PMC5174724 DOI: 10.2196/resprot.5932] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/14/2016] [Accepted: 10/28/2016] [Indexed: 11/24/2022] Open
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.
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Affiliation(s)
- Lorie L Geryk
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Courtney A Roberts
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Adam J Sage
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Tamera Coyne-Beasley
- Division of General Pediatrics and Adolescent Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Betsy L Sleath
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States
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