scholarly journals A Patient-Centered Mobile Health System That Supports Asthma Self-Management (breathe): Design, Development, and Utilization (Preprint)

2018 ◽  
Author(s):  
Plinio Pelegrini Morita ◽  
Melanie S Yeung ◽  
Madonna Ferrone ◽  
Ann K Taite ◽  
Carole Madeley ◽  
...  
Keyword(s):  
Health System ◽  
Real Time ◽  
Asthma Control ◽  
Mobile Health ◽  
Peak Flow ◽  
Action Plan ◽  
Self Management ◽  
Evidence Based ◽  
Web Based ◽  
Physician Visits

BACKGROUND Uncontrolled asthma poses substantial negative personal and health system impacts. Web-based technologies, including smartphones, are novel means to enable evidence-based care and improve patient outcomes. OBJECTIVE The aim of this study was to design, develop, and assess the utilization of an asthma collaborative self-management (CSM) platform (breathe) using content based on international evidence-based clinical guidelines. METHODS We designed and developed breathe as a Web-based mobile health (mHealth) platform accessible on smartphones, tablets, or desktop with user-centered design methods and International Organization for Standardization–certified quality development processes. Moreover, breathe was envisioned as a multifunctional, CSM mHealth platform, with content based on international clinical practice guidelines and compliant with national privacy and security specifications. The system enabled CSM (patient, provider, and breathe) and self-monitoring of asthma patients through (1) assessment of asthma control, (2) real-time access to a dynamic asthma action plan, (3) access to real-time environmental conditions, and (4) risk-reduction messaging. The data collection protocol collected user data for 12 months, with clinic visits at baseline and 6 and 12 months. Utilization outcomes included user interactions with the platform, user impressions, self-reported medication use, asthma symptom profile, reported peak flow measurement, and the delivery and impact of email reminders. RESULTS We enrolled 138 patients with a mean age of 45.3 years to receive the breathe intervention. Majority were female (100/138, 72.5%), had a smartphone (92/138, 66.7%), and had a mean Asthma Control Test score of 18.3 (SD 4.9). A majority reported that breathe helped in the management of their asthma. Moreover, breathe scored 71.1 (SD 18.9) on the System Usability Scale. Overall, 123 patients had complete usage analytics datasets. The platform sent 7.96 reminder emails per patient per week (pppw), patients accessed breathe 3.08 times, journaled symptoms 2.56 times, reported medication usage 0.30 times, and reported peak flow measurements 0.92 times pppw. Furthermore, breathe calculated patients’ action plan zone of control 2.72 times pppw, with patients being in the green (well-controlled) zone in 47.71% (8300/17,396) of the total calculations. Usage analysis showed that 67.5% (83/123) of the participants used the app at week 4 and only 57.7% (71/123) by week 45. Physician visits, email reminders, and aged 50 years and above were associated with higher utilization. CONCLUSIONS Individuals with asthma reported good usability and high satisfaction levels, reacted to breathe notifications, and had confidence in the platform’s assessment of asthma control. Strong utilization was seen at the intervention’s initiation, followed by a rapid reduction in use. Patient reminders, physician visits, and being aged 50 years and above were associated with higher utilization. CLINICALTRIAL ClinicalTrials.gov NCT01964469; https://clinicaltrials.gov/ct2/show/NCT01964469

scholarly journals Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study

2013 ◽  
Vol 20 (4) ◽  
pp. 301-306 ◽  
Author(s):  
Christopher J Licskai ◽  
Todd W Sands ◽  
Madonna Ferrone
Keyword(s):  
Knowledge Translation ◽  
Health System ◽  
Mobile Health ◽  
Action Plan ◽  
Smartphone Application ◽  
Ease Of Use ◽  
Self Management ◽  
Life Questionnaire ◽  
Health Technologies ◽  
Asthma Action Plan

BACKGROUND: Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool.OBJECTIVE: To design, develop and pilot a mobile health system to support asthma self-management.METHODS: The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smart-phone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts.RESULTS: Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047).CONCLUSIONS: A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

scholarly journals Acceptance of Mobile Health Apps for Disease Management Among People With Multiple Sclerosis: Web-Based Survey Study (Preprint)

2018 ◽  
Author(s):  
Jennifer Apolinário-Hagen ◽  
Mireille Menzel ◽  
Severin Hennemann ◽  
Christel Salewski
Keyword(s):  
Multiple Sclerosis ◽  
Disease Management ◽  
Mobile Health ◽  
Behavioral Intentions ◽  
Self Management ◽  
Web Based ◽  
Performance Expectancy ◽  
Effort Expectancy ◽  
The Relationship ◽  
Mhealth Apps

BACKGROUND Mobile health (mHealth) apps might have the potential to promote self-management of people with multiple sclerosis (MS) in everyday life. However, the uptake of MS apps remains poor, and little is known about the facilitators and barriers for their efficient utilization, such as technology acceptance. OBJECTIVE The aim of this study was to examine the acceptance of mHealth apps for disease management in the sense of behavioral intentions to use and explore determinants of utilization among people with MS based on the Unified Theory of Acceptance and Use of Technology (UTAUT). METHODS Participants for this Web-based cross-sectional study were recruited throughout Germany with the support of regional MS associations and self-help groups. To identify determinants of intention to use MS apps, a measure based on the UTAUT was adapted with 4 key determinants (performance expectancy, effort expectancy, social influence, and facilitating conditions) and extended by Intolerance of Uncertainty (IU) and electronic health literacy. Potential influencing effects of both MS and computer self-efficacy (C-SE) as mediators and fatigue as a moderator were analyzed using Hayes’s PROCESS macro (SPSS version 3.0) for IBM SPSS version 24.0. RESULTS A total of 98 participants (mean age 47.03 years, SD 10.17; 66/98, 67% female) with moderate fatigue levels completed the survey. Although most participants (91/98, 92%) were daily smartphone users, almost two-thirds (62/98, 63%) reported no experience with MS apps. Overall, the acceptance was moderate on average (mean 3.11, SD 1.31, minimum=1 and maximum=5), with lower scores among persons with no experience (P=.04) and higher scores among current users (P<.001). In multiple regression analysis (R2=63% variance explained), performance expectancy (beta=.41) and social influence (beta=.33) were identified as significant predictors of acceptance (all P<.001). C-SE was confirmed as a partial mediator in the relationship between IU and acceptance (indirect effect: B=−.095, 95% CI −0.227 to −0.01). Furthermore, a moderated mediation by C-SE was shown in the relationship between IU and behavioral intentions to use MS apps for low (95% CI −0.42 to −0.01) and moderate levels (95% CI −0.27 to −0.01) of fatigue. CONCLUSIONS Overall, this exploratory pilot study indicates for the first time that positive expectations about the helpfulness for self-management purposes and social support might be important factors to be considered for improving the acceptance of MS apps among smartphone users with MS. However, given some inconsistent findings, especially regarding the role of effort expectancy and IU and self-efficacy, the conceptual model needs replication with a larger sample of people with MS, varying more in fatigue levels, and a longitudinal assessment of the actual usage of MS apps predicted by acceptance in the sense of behavioral intentions to use.

scholarly journals Smartphone app for asthma self-management – a literature review of contents and functions

2019 ◽  
Vol 10 (4) ◽  
pp. 3269-3276
Author(s):  
Ghozali MT ◽  
Satibi ◽  
Zullies Ikawati ◽  
Lutfan Lazuardi
Keyword(s):  
Asthma Control ◽  
Action Plan ◽  
Asthma Management ◽  
Self Management ◽  
Smartphone App ◽  
Asthma Control Test ◽  
Quality Health ◽  
The Many ◽  
Air Quality Health Index

A self-management is an important thing in achieving optimum health outcomes. One of the many effective ways that help improve the outcomes of self-management in asthma is through the use of smartphone applications or popularly known as apps. The apps have been designed to help patients in controlling asthma complaints. This study aimed to examine contents and functions featured in the reviewed studies as well as to suggest what functions and contents should be featured in an asthma self-management smartphone app. This study used a systematic approach to examine and review the contents and functions of asthma management apps from selected studies. Inclusion criteria of the study included studies related to the use of asthma control or asthma self-management apps, providing information about contents and features of asthma apps, apps in the reviewed studies designed for laypersons or patients, studies published in peer-reviewed scientific journals in English, and original articles. All the studies had been taken from 2013 to 2018 from three databases, namely Pubmed, Science Direct, and ProQuest. Exclusion criteria included full text unable to be accessed and unable to obtain complete full statistical data. Results of this study showed that the most popular functions and contents featured in the asthma apps involved asthma education, medication use monitor, medication reminder, asthma control test, peak flow meter, asthma symptom monitor, and asthma action plan. Less popular functions and contents included a chat with others, Air Quality Health Index, and Quality of Life Questionnaires. 

scholarly journals Developing an Asthma Self-management Intervention Through a Web-Based Design Workshop for People With Limited Health Literacy: User-Centered Design Approach

10.2196/26434 ◽  
2021 ◽  
Vol 23 (9) ◽  
pp. e26434
Author(s):  
Hani Salim ◽  
Ping Yein Lee ◽  
Sazlina Sharif-Ghazali ◽  
Ai Theng Cheong ◽  
Jasmine Wong ◽  
...  
Keyword(s):  
Health Literacy ◽  
Action Plan ◽  
Real Life ◽  
Mobile App ◽  
Self Management ◽  
Primary Care Center ◽  
Long Term Conditions ◽  
Web Based ◽  
Limited Health Literacy ◽  
Limited Health

Background Technology, including mobile apps, has the potential to support self-management of long-term conditions and can be tailored to enhance adoption. We developed an app to support asthma self-management among people with limited health literacy in a web-based workshop (to ensure physical distancing during the COVID-19 pandemic). Objective The aim of this study is to develop and test a prototype asthma self-management mobile app tailored to the needs of people with limited health literacy through a web-based workshop. Methods We recruited participants from a primary care center in Malaysia. We adapted a design sprint methodology to a web-based workshop in five stages over 1 week. Patients with asthma and limited health literacy provided insights into real-life self-management issues in stage 1, which informed mobile app development in stages 2-4. We recruited additional patients to test the prototype in stage 5 using a qualitative research design. Participants gave feedback through a concurrent thinking-aloud process moderated by a researcher. Each interview lasted approximately 1 hour. Screen recordings of app browsing activities were performed. Interviews were audio-recorded and analyzed using a thematic approach to identify utility and usability issues. Results The stakeholder discussion identified four themes: individual, family, friends, and society and system levels. Five patients tested the prototype. Participants described 4 ways in which the app influenced or supported self-management (utility): offering information, providing access to an asthma action plan, motivating control of asthma through support for medication adherence, and supporting behavior change through a reward system. Specific usability issues addressed navigation, comprehension, and layout. Conclusions This study proved that it was possible to adapt the design sprint workshop to a web-based format with the added advantage that it allowed the development and the testing process to be done efficiently through various programs. The resultant app incorporated advice from stakeholders, including sources for information about asthma, medication and appointment reminders, accessible asthma action plans, and sources for social support. The app is now ready to move to feasibility testing.

scholarly journals The Role of Education, Monitoring, and Symptom Perception in Internet-Based Self-management Among Adolescents With Asthma: Secondary Analysis of a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Thijs Beerthuizen ◽  
E R V M Rikkers-Mutsaerts ◽  
Jiska B Snoeck-Stroband ◽  
Jacob K Sont
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Controlled Trial ◽  
Self Management ◽  
Life Questionnaire ◽  
Symptom Perception ◽  
Web Based ◽  
Randomized Controlled ◽  
Related Quality

BACKGROUND Internet-based self-management programs improve asthma control and the asthma-related quality of life in adults and adolescents. The components of self-management programs include education and the web-based self-monitoring of symptoms; the latter requires adequate perception in order to timely adjust lifestyle or medication or to contact a care provider. OBJECTIVE We aimed to test the hypothesis that adherence to education and web-based monitoring and adequate symptom perception are important determinants for the improvement of asthma control in self-management programs. METHODS We conducted a subgroup analysis of the intervention group of a randomized controlled trial, which included adolescents who participated in the internet-based self-management arm. We assessed the impacts that attendance in education sessions, the frequency of web-based monitoring, and the level of perception had on changes in asthma control (Asthma Control Questionnaire [ACQ]) and asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire) from baseline to 12 months after intervention. RESULTS Adolescents who attended education sessions had significant and clinically relevant improvements in asthma control (ACQ score difference: −0.6; <i>P</i>=.03) and exhibited a nonsignificant trend of improvement in asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire score difference: −0.45; <i>P</i>=.15) when compared to those who did not adhere to education. Frequent monitoring alone did not improve asthma control (<i>P</i>=.07) and quality of life (<i>P</i>=.44) significantly, but its combination with education did result in improved ACQ scores (difference: −0.88; <i>P</i>=.02). There were no significant differences in outcomes between normoperceivers and hypoperceivers. CONCLUSIONS Education, especially in combination with frequent web-based monitoring, is an important determinant for the 1-year outcomes of asthma control in internet-based self-management programs for adolescents with partly controlled and uncontrolled asthma; however, we could not establish the effect of symptom perception. This study provides important knowledge on the effects of asthma education and monitoring in daily life.

scholarly journals Developing an Asthma Self-management Intervention Through a Web-Based Design Workshop for People With Limited Health Literacy: User-Centered Design Approach (Preprint)

2020 ◽  
Author(s):  
Hani Salim ◽  
Ping Yein Lee ◽  
Sazlina Sharif-Ghazali ◽  
Ai Theng Cheong ◽  
Jasmine Wong ◽  
...  
Keyword(s):  
Health Literacy ◽  
Action Plan ◽  
Real Life ◽  
Mobile App ◽  
Self Management ◽  
Primary Care Center ◽  
Long Term Conditions ◽  
Web Based ◽  
Limited Health Literacy ◽  
Limited Health

BACKGROUND Technology, including mobile apps, has the potential to support self-management of long-term conditions and can be tailored to enhance adoption. We developed an app to support asthma self-management among people with limited health literacy in a web-based workshop (to ensure physical distancing during the COVID-19 pandemic). OBJECTIVE The aim of this study is to develop and test a prototype asthma self-management mobile app tailored to the needs of people with limited health literacy through a web-based workshop. METHODS We recruited participants from a primary care center in Malaysia. We adapted a design sprint methodology to a web-based workshop in five stages over 1 week. Patients with asthma and limited health literacy provided insights into real-life self-management issues in stage 1, which informed mobile app development in stages 2-4. We recruited additional patients to test the prototype in stage 5 using a qualitative research design. Participants gave feedback through a concurrent thinking-aloud process moderated by a researcher. Each interview lasted approximately 1 hour. Screen recordings of app browsing activities were performed. Interviews were audio-recorded and analyzed using a thematic approach to identify utility and usability issues. RESULTS The stakeholder discussion identified four themes: individual, family, friends, and society and system levels. Five patients tested the prototype. Participants described 4 ways in which the app influenced or supported self-management (utility): offering information, providing access to an asthma action plan, motivating control of asthma through support for medication adherence, and supporting behavior change through a reward system. Specific usability issues addressed navigation, comprehension, and layout. CONCLUSIONS This study proved that it was possible to adapt the design sprint workshop to a web-based format with the added advantage that it allowed the development and the testing process to be done efficiently through various programs. The resultant app incorporated advice from stakeholders, including sources for information about asthma, medication and appointment reminders, accessible asthma action plans, and sources for social support. The app is now ready to move to feasibility testing.

scholarly journals Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project (Preprint)

2018 ◽  
Author(s):  
Kathryn Fletcher ◽  
Fiona Foley ◽  
Greg Murray
Keyword(s):  
Bipolar Disorder ◽  
Lived Experience ◽  
Chronically Ill ◽  
Ethical Framework ◽  
Self Management ◽  
Future Research ◽  
Evidence Based ◽  
Web Based ◽  
Management Interventions ◽  
Online Recovery

BACKGROUND Bipolar disorder (BD) is a complex, relapsing mood disorder characterized by considerable morbidity and mortality. Web-based self-management interventions provide marked opportunities for several chronic mental health conditions. However, Web-based self-management programs targeting BD are underrepresented compared with programs targeting other psychiatric conditions. OBJECTIVE This paper aims at facilitating future research in the area of self-management of BD and draws insights from the development of one such intervention—the Online, Recovery-Oriented Bipolar Individualised Tool (ORBIT)—that is aimed at improving the quality of life of people with BD. METHODS We have discussed the opportunities and challenges in developing an engaging, evidence-based, safe intervention within the context of the following three nested domains: (1) intervention development; (2) scientific testing of the intervention; and (3) ethical framework including risk management. RESULTS We gained the following insights across the three abovementioned overlapping domains: Web-based interventions can be optimized through (1) codesign with consumers with lived experience to ensure relevance and appropriateness to the target audience; (2) novel content development processes that iteratively combine evidence-based information with lived experience perspectives, capitalizing on multimedia (eg, videos) that the digital health space provides; and (3) incorporating Web-based communities to connect end users and promote constructive engagement by access to a Web-based coach. CONCLUSIONS Self-management is effective in BD, even for those on the more severe end of the spectrum. While there are challenges to be aware of, guided self-management programs, such as those offered by the ORBIT project, which are specifically developed for Web-based delivery provide highly accessible, engaging, and potentially provocative treatments for chronically ill populations who may otherwise have never engaged with treatment. Key questions about engagement, effectiveness, and cost-effectiveness will be answered by the ORBIT project over the next 18 months.

scholarly journals The Role of Education, Monitoring, and Symptom Perception in Internet-Based Self-management Among Adolescents With Asthma: Secondary Analysis of a Randomized Controlled Trial

10.2196/17959 ◽  
2021 ◽  
Vol 4 (4) ◽  
pp. e17959
Author(s):  
Thijs Beerthuizen ◽  
E R V M Rikkers-Mutsaerts ◽  
Jiska B Snoeck-Stroband ◽  
Jacob K Sont
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Controlled Trial ◽  
Self Management ◽  
Life Questionnaire ◽  
Symptom Perception ◽  
Web Based ◽  
Randomized Controlled ◽  
Related Quality

Background Internet-based self-management programs improve asthma control and the asthma-related quality of life in adults and adolescents. The components of self-management programs include education and the web-based self-monitoring of symptoms; the latter requires adequate perception in order to timely adjust lifestyle or medication or to contact a care provider. Objective We aimed to test the hypothesis that adherence to education and web-based monitoring and adequate symptom perception are important determinants for the improvement of asthma control in self-management programs. Methods We conducted a subgroup analysis of the intervention group of a randomized controlled trial, which included adolescents who participated in the internet-based self-management arm. We assessed the impacts that attendance in education sessions, the frequency of web-based monitoring, and the level of perception had on changes in asthma control (Asthma Control Questionnaire [ACQ]) and asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire) from baseline to 12 months after intervention. Results Adolescents who attended education sessions had significant and clinically relevant improvements in asthma control (ACQ score difference: −0.6; P=.03) and exhibited a nonsignificant trend of improvement in asthma-related quality of life (Pediatric Asthma Quality of Life Questionnaire score difference: −0.45; P=.15) when compared to those who did not adhere to education. Frequent monitoring alone did not improve asthma control (P=.07) and quality of life (P=.44) significantly, but its combination with education did result in improved ACQ scores (difference: −0.88; P=.02). There were no significant differences in outcomes between normoperceivers and hypoperceivers. Conclusions Education, especially in combination with frequent web-based monitoring, is an important determinant for the 1-year outcomes of asthma control in internet-based self-management programs for adolescents with partly controlled and uncontrolled asthma; however, we could not establish the effect of symptom perception. This study provides important knowledge on the effects of asthma education and monitoring in daily life.

Sign in / Sign up

Export Citation Format

Share Document