Conducting Patient and Clinician Participatory Design Sessions to Create a User-Centered Mobile Application for Adults with Asthma
Amanda Miao
Division of Allergy/Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
Doreen Khakshour
Department of Medicine, New York Presbyterian Queens, Flushing, NY, United States.
Emine Cosar
Division of Allergy/Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
Brian Hsia
Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, United States.
Kai Zheng
Department of Informatics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, Irvine, CA, United States.
Savneet Kaur
Division of Allergy/Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
Anjani K. Singh
Division of Allergy/Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
Obumneme Njeze
Division of Allergy/Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
Jonathan Feldman
Department of Pediatrics, Division of Academic General Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Bronx, NY, United States and Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States.
Marina Reznik
Department of Pediatrics, Division of Academic General Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Bronx, NY, United States.
Sunit P. Jariwala *
Division of Allergy/Immunology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
*Author to whom correspondence should be addressed.
Abstract
Objective: ASTHMAXcel is a patient-facing mobile health self-management application associated with improvements in asthma knowledge and clinical outcomes. The goal of this study was to gain feedback from adult patients and primary care clinicians regarding the ASTHMAXcel mobile app for asthma patients.
Materials and Methods: We conducted two participatory design sessions; one with underserved adult patients and one with outpatient primary care clinicians. Participant attitudes were assessed regarding current asthma care gaps, the usefulness of asthma apps, and desired features of an app. Thematic maps were used to qualitatively analyze the data and structured using affinity diagrams.
Results: Nine patients (67% F, mean age 48.0) and seven clinicians (71% F, mean age 54.6) participated in the study. Qualitative analyses of both groups suggested the improvement in education of patients with asthma, self-tracking, peer support, and motivational content. All participants acknowledged that patients miss signs of asthma exacerbations and lack the knowledge for appropriate self-management. Both patients and clinicians recommended adding specific educational content including medication side effects and breathing exercises. They sought the ability to track symptoms, medications, and visits across hospital systems. Patients suggested social engagement as a way of reducing stigmatization related to asthma.
Conclusion: Participatory design sessions enabled subject feedback to guide the refinement of ASTHMAXcel and facilitated the development of ASTHMAXcel PRO, an updated app encompassing many of the discussed features. Main updates include self-tracking patient-reported outcomes (PROs), tailored medication reminders, and a user leaderboard to encourage the collection of PROs.
Keywords: Asthma, mobile health, technology, participatory design session, patient education, asthma knowledge, underserved population