Adaptive Mobile Health Intervention for Adolescents with Asthma: Iterative User-Centered Development

Area of Science:

• Digital Health Interventions
• Adolescent Health
• Asthma Management

Background:

• Adolescents with persistent asthma frequently underuse inhaled corticosteroids (ICS), increasing morbidity risk.
• Developing self-regulation and problem-solving skills are crucial for adolescent asthma self-management.
• Mobile health systems can support adherence during developmental transitions in disease management responsibility.

Purpose of the Study:

• Describe the user-centered, evidence-based design process for the Responsive Asthma Care for Teens (ReACT) mobile health system.
• Detail the methods used to incorporate adolescent and caregiver feedback into intervention content development.
• Explain how ReACT aims to enhance self-regulation and problem-solving for improved ICS adherence.

Main Methods:

• User-centered design incorporating individual interviews (n=20) with adolescents (13-17 years) and caregivers.
• National crowdsourcing feedback (n=257) on intervention content.
• Advisory board (n=4) review and refinement of ReACT content and components.
• Iterative development process involving a total of 280 adolescents and caregivers.

Main Results:

• Adolescents identified intrapersonal (e.g., forgetfulness) and external (e.g., routine changes) barriers to ICS adherence.
• 93% of ReACT intervention messages received favorable feedback during crowdsourcing.
• An advisory board refined content and suggested improvements for videos and message flow.

Conclusions:

• Stakeholder engagement through qualitative methods and crowdsourcing was integral to ReACT's development.
• Participant feedback validated ReACT's focus on adaptive, personalized content for self-regulation and problem-solving.
• The iterative process successfully incorporated user recommendations, refining the intervention content.