Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study.
Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study.
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DOI：
10.2196/resprot.5932
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发表时间：
2016-12-06
影响因子：
1.7
通讯作者：
Carpenter DM
中科院分区：
文献类型：
--
作者：
Geryk LL;Roberts CA;Sage AJ;Coyne-Beasley T;Sleath BL;Carpenter DM
大多数青少年哮喘应用程序在设计时并没有考虑到父母和临床医生的使用，应用程序的开发过程也很少有父母或临床医生的意见。本研究旨在生成家长和临床医生对哮喘移动健康应用程序功能的使用、态度和偏好的形成性数据，父母和临床医生是支持患有哮喘的青少年和促进青少年自我管理技能的重要利益相关者。我们于2013年至2014年进行了一项混合方法研究，采用以用户为中心的设计理念，从20名家长和6名临床医生的方便样本中获取反馈。参与者获得了一个iPod Touch，并被要求评估两个现有哮喘应用程序的10个功能。参与者使用这些应用程序的体验是通过问卷调查和使用MAXQDA对录音和逐字转录（逐字）访谈进行专题分析收集的。计算描述性统计来描述研究样本和应用程序功能反馈。我们进行了独立样本测试来比较家长和临床医生对应用功能有用性的评价（评价：1=完全没用到5=非常有用）。所有父母均为女性（n=20）， 45%为黑人，20%收入≥5万美元，45%拥有学士学位或更高学历。临床医生样本包括2名护士和4名医生，平均执业时间为13年。三个主要主题提供了参与者如何感知他们的角色和使用哮喘应用程序功能来支持青少年哮喘自我管理的理解：监测和监督、教育和沟通/信息共享。在所有被评估的应用功能中，家长对医生报告功能的评价最高，临床医生对医生预约提醒的评价最高。峰值流量监测功能是父母和临床医生评分最低的功能。父母对医生报告（t(10)=2.7， P<.02）、日记（t(10)=2.7， P<.03）和自检测验（t(14)=2.5， P<.02）特征的有用性高于临床医生。参与者还提供了对应用程序增强的具体建议（例如，展示正确使用吸入器的教程、补充提醒、与用药日志绑定的弹出信息、循证管理步骤）。家长和临床医生的评估和建议可以在哮喘应用程序的开发中发挥重要作用，该应用程序旨在帮助支持青少年哮喘管理。家庭和临床医生之间的双向哮喘治疗沟通以及支持青少年自我管理的家庭和临床医生的组成部分应纳入青少年哮喘应用程序。
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. 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. 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). 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. 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.