JMIR Publications

ABSTRACT

Background:

Individuals are exposed to a variety of indoor residential toxins including volatile organic compounds (VOCs) and particulates. Indoor residential exposure to VOCs and particulates is associated with asthma symptoms, asthma exacerbations, and decreased lung function in adults with asthma. However, data on these exposures and asthma-related outcomes are generally collected at different times with healthcare providers relying on electronic health records or survey data. The integration of multiple platforms to collect real-time environmental exposure data, asthma symptoms, and lung function has rarely been explored.

Objective:

This paper describes how adults with asthma perceive the acceptability and usability of three integrated devices (1) residential indoor air quality monitor, (2) EMA delivered via smartphones, and (3) home spirometry, over 14 days.

Methods:

Participants (N=40) with uncontrolled asthma were mailed the Awair Omni indoor air quality monitor, ZEPHYRx home spirometer, and detailed instructions required for the in-home monitoring. The air quality monitor, spirometer and app, and the EMA app were set up and tested during a live orientation session via videoconference or phone with a research team member. Midway through the 14-day data collection period, participants completed an interview and were asked about the acceptability of the study devices, instructional materials provided, orientation to the study, and the setup process over the previous days. At the end of the 14-day data collection period, participants completed a modified System Usability Survey (SUS). A random sample of 20 participants also completed a phone interview regarding the acceptability of the study and the impact of the study on their asthma.

Results:

Participants ranged in age from 26 to 77 years (45±13.5 years) and were primarily female (90%), White (82.5%), college graduates (77%), employed (75%), owned their own homes (67.5%), and resided in a single-family home (75%). Most participants indicated that the air quality monitor, the EMA, and the spirometer were easy to set up and use. Challenges with the EMA included repetitive surveys, surveys arriving during the night, and technical issues. While the home spirometer was identified as a plausible means to evaluate lung function in real-time, how to interpret the readings was not clear, and several participants reported side effects from home spirometer use. Overall, the acceptability of the study and the SUS scores were high.

Conclusions:

Study findings indicate the study devices were highly acceptable and usable. Participant feedback was instrumental in identifying technical challenges that should be addressed in future studies. Clinical Trial: NCT05224076