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加重和减轻疾病负担至关重要。 然而，对处方治疗的依从性差和对症状的认识不足导致减少 哮喘控制，尤其是青少年。研究表明，青少年缺乏对 自我管理，以及门诊访视期间的哮喘教育不足，导致哮喘治疗不足 管理移动的技术，特别是移动的应用程序（或应用程序）是提高 患者-提供者沟通，提供哮喘管理的反馈，并提供哮喘教育。 我们的试点工作表明，应用程序可以有效地改善青少年的哮喘控制， 12 - 17，青少年热衷于利用mHealth技术进行哮喘管理，但 现有的应用程序对青少年群体的吸引力不够，无法长期维持 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，以获得必要的数据，以完成未来的应用程序的大型疗效试验， 青少年持续性哮喘这个项目的目标是使用一个敏捷的，迭代的，以用户为中心的 设计流程，根据青少年用户偏好定制我们现有的概念验证应用程序，并使用混合 方法方法测试的可行性，可接受性，坚持，和初步疗效。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，并制定营销战略，以促进对这些方法的长期支持。 该项目的基本原理是，青少年很快就采用了移动的技术， 智能手机的使用，并处于从父母管理他们的慢性病向自我管理的过渡点。 管理，使其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）为青少年完善哮喘自我管理应用程序， 持续性哮喘;和2）评估可行性，可接受性，并坚持在一个小的应用程序 随机对照试验。这种方法是创新的，因为我们采用了以用户为中心的设计 整合多个组件的过程，以促进哮喘自我管理的mHealth工具定制 在技术接受模型框架内的青少年。尽管研究表明， 工具可以是有效的，很少有优先考虑青少年观众或评估的工具相比，标准 使用严格的混合方法进行护理。这项研究意义重大，因为哮喘是最 美国儿童常见的慢性病，患病率持续上升，因此 迫切需要创新工具来改善疾病的自我管理。

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.