Refinement of a Parent–Child Shared Asthma Management Mobile Health App: Human-Centered Design Study

Abstract

Background The school-age years, approximately ages 7 through 11, represent a natural transition when children begin assuming some responsibility for their asthma management. Previously, we designed a theoretically derived, tailored parent–child shared asthma management mobile health app prototype, Improving Asthma Care Together (IMPACT). Objective The purpose of this study was to use human-centered design (HCD) to iteratively refine IMPACT to optimize user experience and incorporate evidence-based longitudinal engagement strategies. Methods This study used a mixed methods design from December 2019 to April 2021. Our app refinement used the HCD process of research, ideation, design, evaluation, and implementation, including 6 cycles of design and evaluation. The design and evaluation cycles focused on core app functionality, child engagement, and overall refinement. Evaluation with parent–child dyads entailed in-person and remote concept testing and usability testing sessions, after which rapid cycle thematic analyses identified key insights that informed future design refinement. Results Twelve parent–child dyads enrolled in at least one round of this study. Eight of the 12 child participants were male with a mean age of 9.9 (SD 1.6) years and all parent participants were female. Throughout evaluation cycles, dyads selected preferred app layouts, gamification concepts, and overall features with a final design prototype emerging for full-scale development and implementation. Conclusions A theoretically derived, evidence-based shared asthma management app was co-designed with end users to address real-world pain points and priorities. An 8-week pilot study testing app feasibility, acceptability, and preliminary efficacy is forthcoming.

The Acceptability of Using Augmented Reality as a Mechanism to Engage Children in Asthma Inhaler Technique Training: Qualitative Interview Study With Deductive Thematic Analysis

“…A target sample size of 15 to 20 participants was determined to achieve a large enough size to ensure sufficient breadth and depth of data but small enough to achieve meaningful analysis, which was a similar approach to other qualitative studies [ 46 ].…”

Improving Asthma Care Together (IMPACT) mobile health intervention for school-age children with asthma and their parents: a pilot randomised controlled trial study protocol

“… 27 Next, dyads worked alongside the study team to select the type of intervention (mobile health app and wearable) and refine the features to ensure they address dyad-identified priorities. 26 27 Finally, dyads participated in extensive usability testing and refinement to ensure IMPACT emerged as an engaging, useful and functional system to support shared asthma management. 26 Parent–child dyads will not be involved in participant recruitment for this pilot RCT, but study results will be disseminated to all families that contributed to the development of IMPACT.…”

“… 26 27 Finally, dyads participated in extensive usability testing and refinement to ensure IMPACT emerged as an engaging, useful and functional system to support shared asthma management. 26 Parent–child dyads will not be involved in participant recruitment for this pilot RCT, but study results will be disseminated to all families that contributed to the development of IMPACT.…”

“…Using a Human-Centred Design framework, we collaborated with parent–child dyads to codesign Improving Asthma Care Together (IMPACT), a tailored shared management mobile health (mHealth) application that pairs the parent and child together as a shared management team. 26 27 IMPACT aims to help families tailor asthma management strategies to fit the realities of their social environments while facilitating intentional transition of asthma management to the child. We hypothesise that by giving children a voice in their own care, we will not only improve asthma management in the present but also support the successful future transition of asthma management to those individuals who will ultimately assume sole responsibility in managing their lifelong condition.…”

Advancing rapid adaptation for urgent public health crises: Using implementation science to facilitate effective and efficient responses

“…Structured approaches to rapid adaptations, based on conceptual models or research design principles, are needed. Rapid research methods, used to guide rapid adaptations, are not unique to D&I science; fields such as human factors engineering and frameworks such as human-centered design have long embraced rapid-cycle research to iteratively improve (i.e., adapt) products and processes to effectively and efficiently meet end-user needs ( 13 – 16 ). D&I science is learning from these areas, and while not comprehensive, we highlight several D&I approaches for rapid responses (also see Figure 1 ).…”