JMIR Publications

ABSTRACT

Background:

More than 6 million children in the United States have asthma and greater than 20% are clinically obese. Youth with asthma and obesity are susceptible to poor health outcomes, including greater asthma symptoms severity and hospitalizations, reduced physical activity, and poorer quality of life. Mobile health technologies can increase access to chronic disease self-management interventions and family members can be powerful influencers given their substantial direct and indirect control over a child’s behavior and home environment.

Objective:

The Mobile Childhood and Asthma Management Program (mCHAMP) is based on the in-person CHAMP behavioral family intervention pilot trial of school-age children with asthma and obesity. In the current study, we translated the CHAMP content into digital content and conducted summative testing to measure usability, learnability, and efficiency of the mCHAMP application (app).

Methods:

Overall, we applied a sequential mixed-methods approach. The mCHAMP app targeted adult caregivers of children living with asthma and obesity between the ages of 6 and 12 years old. A Consumer-centered Participatory Design framework was used to guide identifying user requirements and conducting summative usability testing. While the mCHAMP app is primarily caregiver facing it is intended to connect caregivers to registered nurse (RN) interventionists. Therefore, we sought feedback from RNs as key stakeholders.

Results:

Caregivers (n=10) were female (100%), mostly African American (80%), and half had an annual household income <$25,000; most of their children (60%) were in the 99th BMI percentile. Post-Study e-Health Usability Questionnaire scores indicated high overall satisfaction, usefulness, and quality of the mCHAMP app. Most caregivers (n=7) were able to complete all 15 tasks across the six modules with two or fewer hints. The average total time to complete all tasks was 17 minutes (SD=3.9, Range=11.4–24.1). Most caregivers wanted information in static form but also preferred alternatives (e.g., audio and/or video) to support flexibility with consuming the content. Caregivers expressed the need for more child facing content as well as tailored decision support related to diet and exercise. RNs (n=5) strongly endorsed their role and use of the mCHAMP app to promote self-management among caregivers of children with obesity and asthma. They noted the importance of integrating the mCHAMP app to a local electronic health record and existing workflows.

Conclusions:

Caregivers expressed a desire for an intervention that was easy to use and could integrate into their busy family lives. We met this expectation based on the usability, learnability, and efficiency results of our testing. The mCHAMP app has the potential to increase self-management for parents and pediatric asthma patients with multimorbidity which could improve patient and health system outcomes. The use of mCHAMP may also enable novel clinical outcomes studies based on patient reported data from the app.