Adolescent Feedback On Predisposing, Reinforcing And Enabling Features In Asthma Self-Management Apps

Objective: Mobile health apps hold potential to support and reinforce positive health behaviours, especially among young people with chronic diseases like asthma that require continual self-management. We aimed to gain feedback from adolescents with asthma on two existing asthma self-management apps to guide the development of an evidence- and theory-based asthma app that meets their asthma management needs. Design: A qualitative interview study was conducted with adolescents with persistent asthma (n = 20), aged 12-16. Setting: Interviews took place after the individual's clinic appointment and during telephone interviews one week later. Methods: Participants provided feedback on two asthma self-management apps during two semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed thematically using MAXQDA 11. The Precede-Proceed Model (PPM) was used as a framework to evaluate perceptions of app features, including utility. Suggestions for improvements, including addition of predisposing, reinforcing and enabling PPM features, were identified. Results: The majority of app features functioned as enabling (e.g. inputting triggers, recording doctor's appointments and tracking peak flow). However, participants recommended addition of predisposing and reinforcing features, including knowledge on dealing with asthma triggers (predisposing) and a reward system for daily peak flow entry (reinforcing), to support their asthma management. Conclusion: Findings suggest that including predisposing, reinforcing and enabling features in asthma apps could facilitate asthma self-management. Public health professionals should partner with app developers in the development of asthma self-management apps that include predisposing, reinforcing and enabling features to meet user needs and ensure they are effective and accepted behaviour change apps.