Improving Asthma Control through mHealth-Based Home Monitoring

描述（由申请人提供）：弱势、城市和少数民族儿童在哮喘患病率和发病率中所占比例不成比例。干预措施已被证明可以改善代表性不足的少数民族（URM）青年对NIH哮喘护理指南的依从性（例如，适当使用长期对照药物），从而降低哮喘发病率。一种特别有前途的干预手段是通过移动技术——城市少数民族的父母和儿童广泛使用这种技术，它是一种成本效益高、效率高的监测、提供反馈从而改变健康行为的工具。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；室内空气质量对哮喘相关的健康有重要影响，因为儿童90%的时间都在室内度过。因此，我们建议开发一种移动健康（mHealth）工具，旨在帮助城市少数民族家庭独立识别和解决家中哮喘触发因素，并改善其孩子的哮喘自我管理。在拟议的项目中，我们将采用迭代的、以用户为中心的设计过程来开发一个原型哮喘家庭监测系统（Aspira），包括平板电脑应用程序、数字肺量计和颗粒监测仪，并与数据管理服务器相连。为此，我们将进行关键信息人访谈，开发用户角色，举办团队设计研讨会，开发集成数据管理平台，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10名患有哮喘的非洲裔美国父母及其子女（7-12岁）中产生的高保真Aspira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，并为系统改进、随机对照试验和第二阶段的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.