JMIR Publications

ABSTRACT

Background:

Asthma is one of the most common pediatric conditions affecting millions of US children. Digital health applications may provide children and their families with ways to manage asthma and improve health and educational outcomes.

Objective:

As digital health technology becomes more prevalent to help manage chronic conditions, like asthma, this study examined the reported benefits and barriers of caregiver (parent/legal guardian) interactions with an asthma-specific app. The app, created by physicians and digital health development professionals, was designed to educate, inform, and help caregivers to manage the health of their child. We evaluated app log ins and feature use (collectively defined as “app engagement”), for caregivers of children with asthma ages 5-11 years using a mixed methods approach. We examined whether: (a) app engagement differed due to childrens’ demographic and asthma health characteristics, (b) themes about app engagement emerged from caregiver reported app experiences, (c) these themes correlated with demographic and asthma health characteristics, and (d) engagement with the app was associated with reduced school absences.

Methods:

Eighty caregivers and their children with asthma participated. Pretest (Time 1) and Posttest (Time 2) data were collected over six months on caregiver and child demographic and health characteristics, healthcare utilization, app engagement, and app experiences. Additionally, caregiver app engagement data and child healthcare data were collected retrospectively, two years prior to the start of the study.

Results:

Logistic regression revealed that caregivers of White children (OR = 8.57) with uncontrolled asthma (OR = 17.81) who earned a college degree (OR = 6.94) were statistically significantly more likely to use the app than caregivers of children of other races with controlled asthma without a college degree (P<.001). Qualitative findings support and expand on the logistic regression results. Five themes regarding app engagement emerged, including relevancy, acceptability and understandability, technology barriers and limitations, educational barriers, and information and communication benefits. A statistically significant decline in school absences was related to app engagement (χ2 = 16.96, P=.001).

Conclusions:

Understanding caregiver and child experiences in using digital health technologies for managing asthma may inform ways to support app engagement amongst diverse patient-families in the effort to improve patient health outcomes.