Improving Asthma Control through mHealth-Based Home Monitoring

描述(由申请人提供)：弱势儿童、城市儿童和少数族裔儿童的哮喘患病率和发病率不成比例。干预措施已被证明能改善代表不足的少数群体(URM)青年遵守NIH哮喘护理指南(例如，正确使用长期控制药物)的情况，从而降低哮喘发病率。一种特别有希望的干预提供方法是通过移动技术--城市少数族裔父母和儿童广泛使用它，它是一种具有成本效益和效率的工具，用于监测、提供反馈，从而改变健康行为。此外，有证据表明，哮喘发病率的种族差异可能部分归因于儿童的家庭环境；室内空气质量可能对哮喘相关的健康产生重要影响，因为儿童有多达90%的时间在室内。因此，我们建议开发一种移动健康(MHealth)工具，旨在帮助城市少数族裔家庭独立识别和解决家中哮喘的触发因素，并改善他们孩子的哮喘自我管理。在拟议的项目中，我们将应用迭代的、以用户为中心的设计流程来开发一个原型哮喘家庭监测系统(Aspira)，该系统包括平板电脑应用程序、数字肺活量计和颗粒物监测仪，并连接到数据管理服务器。为此，我们将进行关键线人访谈，开发用户角色，举办团队设计研讨会，开发综合数据管理平台，并对低保真原型进行可用性测试。然后，我们将进行一项混合方法的试点研究，以确定在华盛顿特区生活的10名患有哮喘的非裔美国父母及其子女(7-12岁)的高保真阿司匹拉原型的可行性和初步疗效。该项目的成功完成将显示我们的概念的可行性，并为第二阶段的系统改进、随机对照试验和商业化努力奠定基础。

DESCRIPTION (provided by applicant): Disadvantaged, urban, and minority children incur a disproportionate share of asthma prevalence and morbidity. Interventions have been shown to improve underrepresented minority (URM) youths' adherence to NIH asthma care guidelines (e.g., proper use of long-term control medication) thereby reducing asthma morbidity. One particularly promising method of intervention delivery is via mobile technology-it is widely accessed by urban minority parents and children, and it is a cost effective and efficient tool for monitoring, providing feedback, and thereby changing health behavior. In addition, there is evidence to suggest that racial disparities in asthma morbidity may be due in part to children's home environments; indoor air quality can have an important influence on asthma-related health because children spend as much as 90% of their time indoors. Therefore, we propose to develop a mobile health (mHealth) tool intended to help urban, minority families independently identify and address asthma triggers in their homes and improve their child's asthma self- management. In the proposed project, we will apply an iterative, user-centered design process to develop a prototype asthma home monitoring system (Aspira) involving a tablet app, digital spirometer, and particulate monitor, linked to a data management server. To this end, we will conduct key informant interviews, develop user personas, hold team design workshops, develop an integrated data management platform, and conduct usability testing of low-fidelity prototypes. Then we will conduct a mixed-methods pilot study to determine feasibility and preliminary efficacy of the resulting high-fidelity Aspira prototype among ten African American parents and their children (ages 7-12) with asthma living in Washington, DC. The successful completion of this project will show the feasibility of our concept and set the stage for system improvements, a randomized control trial and commercialization efforts in Phase II.