Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 14, 2020
Date Accepted: May 6, 2021
Developing an asthma self-management intervention through an online design workshop for people with limited health literacy: process, evaluations, and practical considerations.
ABSTRACT
Background:
Technology, including mobile applications (App), 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 amongst people with limited health literacy in an online workshop (to ensure social distancing in a COVID-19 pandemic).
Objective:
We aimed to develop a prototype asthma self-management mobile application, tailored to the needs of people with limited health literacy.
Methods:
We recruited participants from a primary care centre in Malaysia. We adapted a Design Sprint methodology to an online workshop in five stages over one-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 to 4. We recruited additional patients to test the prototype in Stage 5 using qualitative research design. Participants gave feedback through concurrent thinking-aloud process moderated by a researcher. Each interview took approximately an hour. Screen recordings of App browsing activities were made. Interviews were audio-recorded and analysed using a framework approach to identify utility and usability issues.
Results:
The four themes in the stakeholder's discussion: individual, family and friends, society and system levels. Five patients tested the prototype. Participants described four ways in which the App influenced or supported self-management (utility); offering information, providing access to an asthma action plan, motivating control asthma through support for medication adherence, and supporting behaviour change through a reward system. Specific usability issues addressed navigation, comprehension, and layout.
Conclusions:
It proved possible to adapt the Design Sprint workshop to an online format with the added advantage that it allowed the development and the testing process to be done efficiently through various programmes. The resultant App incorporated advice from five participants which include sources for information about asthma, medication and appointment reminders, accessible asthma action plan and sources for social support. The App is now ready to move to feasibility testing.
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