JMIR Publications

ABSTRACT

Background:

The use of smartphone and tablet applications (apps) to deliver healthcare education is becoming increasingly common and has been identified as an effective way to improve patient knowledge and treatment adherence. This has also been demonstrated in the asthma population. Despite asthma being more prevalent in paediatrics, there are minimal apps which are targeted specifically for children. Only half of children have acceptable control of their asthma symptoms and over 90% do not use their asthma inhalers correctly. With children being increasingly connected to technology, there is an opportunity to improve asthma inhaler technique education by delivery via smartphone/tablet apps. Augmented reality (AR) delivered via a smartphone/tablet app was utilised in this study to capitalise on growing technological innovations.

Objective:

Our aims of this study are to describe a co-design process, development and design outcomes of a smartphone/tablet app which incorporates AR technology to deliver asthma inhaler technique education to children with asthma. This study also aims to provide usability evaluation using the System Usability Scale (SUS) of the designed intervention to inform our work and future research, and to be able to provide recommendations for others performing similar work.

Methods:

The development of the AR asthma inhaler technique education app was based on an iterative co-design process with likely end-users (children with asthma, their caregivers and health care professionals) to maximise the likelihood of the successful uptake of the intervention within a clinical setting. The design process involved multiple stages: recruitment of end-users for qualitative interviews and usability testing on a previously designed educational intervention which utilised an AR-embedded smartphone/tablet app, ideation of content for a specific asthma inhaler technique education intervention with asthmatic children and health professionals, development of the asthma inhaler specific intervention, and two further rounds of qualitative interviews and usability testing with re-design of the initial prototype.

Results:

Using a co-design process, the AR asthma inhaler technique education app was able to be designed with incorporation of the preferences of asthmatic children, their caregivers and health professionals who had experience in asthma education delivery. Using this process, ease of use of the application and the novel nature of the intervention was frequently described, with key suggestions of addition of animation and increased AR experiences able to be applied to later iterations. It was also possible to remove elements of the intervention which were identified as burdensome. Usability of the intervention overall was perceived to be excellent, and the mean SUS score of the intervention was found to be highest in the final round of evaluation.

Conclusions:

Results from this co-design process and usability evaluation will be used to develop a final AR asthma inhaler technique educational intervention for children to be evaluated in the clinical setting. Clinical Trial: ACTRN12621000306819