JMIR Publications

ABSTRACT

Background:

Inhaled medications, or inhalers, provide first line pharmacotherapeutic treatment for people with asthma for both acute symptomatic relief, as well as long term management to keep symptoms under control. Good inhaler technique requires only basic instruction and training, yet a recent study identified that 92% of children do not follow all correct steps when using inhalers. There is growing interest in technology-enhanced asthma education with evidence demonstrating improvements to knowledge and treatment adherence. Subsequently, calls to explore the role of technology-based solutions to improve asthma management and disease outcomes are coming from public health experts, health professionals and asthma patients. Augmented reality (AR) technology is one such information delivery mechanism with proven efficacy in educational settings outside of health. Using the camera on a smartphone/tablet device, AR displays digital content onto real-world environment, to create an immersive learning experience.

Objective:

To evaluate acceptability of AR as a mechanism to deliver asthma inhaler technique education, from the perspective of children with asthma, their parents and health professionals, examined through the Theoretical Framework of Acceptability (TFA).

Methods:

An asthma education resource enhanced with AR technology was created to deliver inhaler technique education for children. An iterative co-design process was undertaken with target end-users for qualitative evaluation in this study. Participants were 8-12 year old with asthma, their caregivers, and health professionals who had experience in managing asthma. Qualitative data was obtained through semi-structured one-on-one interviews. Deductive thematic analysis using the TFA was undertaken using NVivo software 2020 to assess the acceptability of AR as a delivery modality for asthma inhaler technique education.

Results:

In a sample of n=16, the use of AR in the created asthma inhaler resource was found to be overall acceptable when responses were examined in accordance with the TFA. Each of the seven component constructs of the TFA were coded throughout the 16 interviews, with ‘perceived effectiveness’ and ‘affective attitude’ coded most frequently (157 and 63 times respectively). Positive responses included the intervention being accessible, easy to use, interesting and fitting within users’ value systems. Negative responses included the need to maintain interest in children and concerns of the loss of face-to-face interaction with health professionals.

Conclusions:

AR appears to be an acceptable modality for delivering asthma education to children when explored using the constructs of the TFA. Whilst some challenges were identified with the use of AR, results were predominantly positive. Future designs of asthma educational interventions involving AR should consider results from this study and further research should focus on the feasibility, usability and barriers and facilitators of behaviour change to ensure successful implementation and uptake of AR into clinical settings. Clinical Trial: ACTRN12621000306819