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dc.contributor.authorFedele, David A.
dc.contributor.authorCushing, Christopher C.
dc.contributor.authorKoskela-Staples, Natalie
dc.contributor.authorPatton, Susana R.
dc.contributor.authorMcQuaid, Elizabeth L.
dc.contributor.authorSmyth, Joshua M.
dc.contributor.authorPrabhakaran, Sreekala
dc.contributor.authorGierer, Selina
dc.contributor.authorNezu, Arthur M.
dc.date.accessioned2022-09-06T18:54:58Z
dc.date.available2022-09-06T18:54:58Z
dc.date.issued2020-05-06
dc.identifier.citationFedele DA, Cushing CC, Koskela-Staples N, Patton SR, McQuaid EL, Smyth JM, Prabhakaran S, Gierer S, Nezu AM. Adaptive Mobile Health Intervention for Adolescents with Asthma: Iterative User-Centered Development. JMIR Mhealth Uhealth 2020;8(5):e18400. doi: 10.2196/18400. PMID: 32374273. PMCID: 7240449.en_US
dc.identifier.urihttp://hdl.handle.net/1808/33430
dc.description.abstractBackground: Adolescents diagnosed with persistent asthma commonly take less than 50% of their prescribed inhaled corticosteroids (ICS), placing them at risk for asthma-related morbidity. Adolescents’ difficulties with adherence occur in the context of normative developmental changes (eg, increased responsibility for disease management) and rely upon still developing self-regulation and problem-solving skills that are integral for asthma self-management. We developed an adaptive mobile health system, Responsive Asthma Care for Teens (ReACT), that facilitates self-regulation and problem-solving skills during times when adolescents’ objectively measured ICS adherence data indicate suboptimal rates of medication use.

Objective: The current paper describes our user-centered and evidence-based design process in developing ReACT. We explain how we leveraged a combination of individual interviews, national crowdsourced feedback, and an advisory board comprised of target users to develop the intervention content.

Methods: We developed ReACT over a 15-month period using one-on-one interviews with target ReACT users (n=20), national crowdsourcing (n=257), and an advisory board (n=4) to refine content. Participants included 13-17–year-olds with asthma and their caregivers. A total of 280 adolescents and their caregivers participated in at least one stage of ReACT development.

Results: Consistent with self-regulation theory, adolescents identified a variety of salient intrapersonal (eg, forgetfulness, mood) and external (eg, changes in routine) barriers to ICS use during individual interviews. Adolescents viewed the majority of ReACT intervention content (514/555 messages, 93%) favorably during the crowdsourcing phase, and the advisory board helped to refine the content that did not receive favorable feedback during crowdsourcing. Additionally, the advisory board provided suggestions for improving additional components of ReACT (eg, videos, message flow).

Conclusions: ReACT involved stakeholders via qualitative approaches and crowdsourcing throughout the creation and refinement of intervention content. The feedback we received from participants largely supported ReACT’s emphasis on providing adaptive and personalized intervention content to facilitate self-regulation and problem-solving skills, and the research team successfully completed the recommended refinements to the intervention content during the iterative development process.
en_US
dc.publisherJMIR Publicationsen_US
dc.rights©David A Fedele, Christopher C Cushing, Natalie Koskela-Staples, Susana R Patton, Elizabeth L McQuaid, Joshua M Smyth, Sreekala Prabhakaran, Selina Gierer, Arthur M Nezu. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 06.05.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectAsthmaen_US
dc.subjectMobile healthen_US
dc.subjectAdherenceen_US
dc.subjectAdolescenceen_US
dc.subjectSelf-regulationen_US
dc.subjectProblem-solvingen_US
dc.subjectAdolescentsen_US
dc.subjectYouthen_US
dc.titleAdaptive Mobile Health Intervention for Adolescents with Asthma: Iterative User-Centered Developmenten_US
dc.typeArticleen_US
kusw.kuauthorCushing, Christopher C.
kusw.kudepartmentClinical Child Psychology Programen_US
kusw.kudepartmentLife Span Instituteen_US
dc.identifier.doi10.2196/18400en_US
dc.identifier.orcidhttps://orcid.org/0000-0003-0896-910Xen_US
dc.identifier.orcidhttps://orcid.org/0000-0001-8452-8096en_US
dc.identifier.orcidhttps://orcid.org/0000-0003-1553-2301en_US
dc.identifier.orcidhttps://orcid.org/0000-0002-8902-6965en_US
dc.identifier.orcidhttps://orcid.org/0000-0001-9573-3781en_US
dc.identifier.orcidhttps://orcid.org/0000-0002-0904-5390en_US
dc.identifier.orcidhttps://orcid.org/0000-0001-8717-9338en_US
dc.identifier.orcidhttps://orcid.org/0000-0001-5186-3410en_US
dc.identifier.orcidhttps://orcid.org/0000-0002-1651-2102en_US
kusw.oaversionScholarly/refereed, publisher versionen_US
kusw.oapolicyThis item meets KU Open Access policy criteria.en_US
dc.rights.accessrightsopenAccessen_US


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©David A Fedele, Christopher C Cushing, Natalie Koskela-Staples, Susana R Patton, Elizabeth L McQuaid, Joshua M Smyth, Sreekala Prabhakaran, Selina Gierer, Arthur M Nezu. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 06.05.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Except where otherwise noted, this item's license is described as: ©David A Fedele, Christopher C Cushing, Natalie Koskela-Staples, Susana R Patton, Elizabeth L McQuaid, Joshua M Smyth, Sreekala Prabhakaran, Selina Gierer, Arthur M Nezu. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 06.05.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License.