Feasibility of mHealth Technology for Improving Self-Management and Adherence Among Asthmatic Adolescents

哮喘自我管理对于预防病情恶化和减轻疾病负担至关重要。 然而，不遵守处方治疗和对症状的认识不佳会导致减少 哮喘控制，特别是在青少年中。研究表明，青少年缺乏对 自我管理，以及就诊期间哮喘教育不足，导致哮喘不足 管理层。移动技术，特别是移动应用程序，是提高 患者与提供者之间的沟通，提供哮喘治疗方面的反馈，并提供哮喘教育。 我们的试点工作表明，一款应用程序可以有效地改善青少年的哮喘控制 12-17岁，青少年对利用mHealth技术进行哮喘管理充满热情，但 现有的应用程序对青少年群体的吸引力或吸引力不足以维持长期的 使用。在这项试点研究中，我们将测试智能手机应用程序的可行性、可接受性和依从性 哮喘自我管理，以获得完成未来APP大疗效试验所需的数据 患有持续性哮喘的青少年。该项目的目标是使用敏捷、迭代、以用户为中心的 设计流程以定制我们现有的概念验证应用程序以满足青少年用户的偏好，并使用混合- 方法对其可行性、可接受性、依从性和初步疗效进行检验。长期目标是 确定促进慢性病自我管理的移动健康技术方法，特别是 在青少年中推广这些方法，并制定营销战略，促进对这些方法的长期支持。 这个项目的基本原理是，青少年很快就会接受移动技术，有很高的 智能手机的使用，并且正处于从父母对他们慢性病的管理向自我管理的过渡阶段 管理，使这一群体成为制定针对哮喘控制的干预措施的优先人群。 对于这个项目，我们有两个具体的目标：1)完善一款适用于患有哮喘的青少年的自我管理应用程序 持续性哮喘；以及2)评估该应用程序的可行性、可接受性和依从性 随机对照试验。这种方法是创新的，因为我们融入了以用户为中心的设计 在定制的mHealth工具中集成促进哮喘自我管理的多个组件的过程 技术接受模式框架内的青少年。尽管研究表明，mHealth 工具可能是有效的，很少有人优先考虑青少年受众或与标准工具相比对工具进行评估 使用严格的混合方法进行护理。这项研究具有重要意义，因为哮喘是 在美国，儿童时期常见的慢性病和这种疾病的患病率持续上升，因此 迫切需要改进疾病自我管理的创新工具。

Asthma self‐management is essential for preventing exacerbations and reducing the burden of the disease. However, poor adherence to prescribed treatment and poor recognition of symptoms leads to reduced asthma control, particularly among adolescents. Studies show that adolescents lack understanding about self‐management, and that asthma education during clinic visits is deficient, resulting in insufficient asthma management. Mobile technology, specifically, mobile applications (or apps) are an efficient way to increase patient‐provider communication, provide feedback on asthma management, and deliver asthma education. Our pilot work has demonstrated that an app can be effective at improving asthma control in adolescents aged 12‐17, and that adolescents are enthusiastic about utilizing mHealth technologies for asthma management, but that existing apps are not engaging or appealing enough to an adolescent population to sustain long‐term use. For this pilot study, we will test the feasibility, acceptability, and adherence to a smartphone app for asthma self‐management in order to obtain data necessary to complete a future large efficacy trial of the app in adolescents with persistent asthma. The objective of this project is to use an agile, iterative, user‐centered design process to tailor our existing proof of concept app to adolescent user preferences and to use a mixed‐ methods approach to test feasibility, acceptability, adherence, and preliminary efficacy. The long‐term goal is to identify mHealth technological approaches that facilitate self‐management of chronic diseases, particularly among adolescents, and to develop marketing strategies to promote long‐term support of these approaches. The rationale for this project is that adolescents are quick to adopt mobile technologies, have a high degree of smartphone use, and are at a point of transition from parental management of their chronic condition to self‐ management, making this a priority population for the development of interventions targeting asthma control. For this project, we have two specific aims: 1) To refine an asthma self‐management app for adolescents with persistent asthma; and 2) To assess feasibility, acceptability, and adherence to the app in a small randomized controlled trial. The approach is innovative because we are incorporating a user‐centered design process to integrate multiple components for facilitating asthma self‐management in a mHealth tool tailored for adolescents within the Technology Acceptance Model framework. Despite studies showing that mHealth tools can be effective, few have prioritized an adolescent audience or evaluated the tool compared to standard of care using rigorous, mixed‐method approaches. This research is significant because asthma is the most common chronic disease of childhood in the US and the prevalence of the condition continues to rise, and so innovative tools to improve self‐management of the disease are critically needed.