Background The ASTHMAXcel mobile application has been linked to favorable outcomes among adult patients with asthma. Objective We assessed the impact of ASTHMAXcel Adventures, a gamified, guideline-based, pediatric version on asthma control, knowledge, health care utilization, and patient satisfaction. Methods Pediatric patients with asthma received the ASTHMAXcel Adventures mobile intervention on-site only at baseline (visit 1), 4 months (visit 2), and 6 months (visit 3). The asthma control test, asthma illness representation scale–self-administered, pediatric asthma impact survey, and Client Satisfaction Questionnaire-8 were used to assess asthma control, knowledge, and patient satisfaction. Patients reported the number of asthma-related emergency department (ED) visits, hospitalizations, and oral prednisone use. Results A total of 39 patients completed the study. The proportion of controlled asthma increased from visit 1 to visits 2 and 3 (30.8% vs 53.9%, P = .04; 30.8% vs 59.0%, P = .02), and largely seen in boys. The mean asthma illness representation scale–self-administered scores increased from baseline pre- to postintervention, with sustained improvements at visits 2 and 3 (3.55 vs 3.76, P < .001; 3.55 vs 3.80, P = .001; 3.55 vs 3.99, P < .001). The pediatric asthma impact survey scores improved from baseline to visits 2 and 3 (43.33 vs 34.08, P < .001; 43.33 vs 31.74, P < .001). ED visits and prednisone use significantly decreased from baseline to visits 2 and 3 (ED: 0.46 vs 0.13, P = .03; 0.46 vs 0.02, P = .02; prednisone use, 0.49 vs 0.13, P = .02; 0.49 vs 0.03, P = .003. Satisfaction was high with mean client satisfaction questionnaire score of approximately 30 (out of 32) at all visits. Conclusion ASTHMAXcel Adventures improved asthma control, knowledge, and quality of life, and reduced ED visits and prednisone use with high satisfaction scores.

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Kids' Health Connections. RATIONALE: Digital asthma interventions have been associated with improved outcomes, but evidence among Medicaid-enrolled participants remains limited. We aimed to evaluate the impact of a digital asthma intervention, combined with a collaborative asthma education program, on SABA use among children in Detroit. METHODS: Children (ages 6-13) with asthma living in four ZIP codes of southwest Detroit were eligible to participate in the program sponsored by the Detroit Health Department. Participants were recruited by Kids Health Connection (KHC) to enroll in an asthma education program supplemented with electronic medication monitors (EMMs) to capture the date and time of SABA use, and a companion smartphone app to provide education, feedback and reminders. Caregivers and providers were invited to monitor the data and discuss trends with KHC. Paired t-tests (?50.05) estimated change in mean daily SABA use and SABA-free days from first to last month of participation. RESULTS: 51 participants enrolled, had > 60 days of EMM data and were included in analyses (median age: 12 years, with a mean of 8.4 months of data). From the first to last month, mean SABA use decreased from 0.68 to 0.25 puffs/day (-0.43, 95% CI: -0.67, -0.20; p<0.001), and mean SABAfree days increased from 25.2 to 28.1 days/month (2.9 days, 95% CI: 1.7, 4.1, p<0.001). 76% of participants improved their number of SABA-free days, while 7.8% maintained and 15.7% worsened. CONCLUSIONS: Analysis demonstrated a statistically significant reduction in SABA use and an increase in SABA-free days among Medicaidenrolled children in a digital asthma intervention in southwest Detroit.