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Smartphone App for monitoring Asthma in children and adolescents

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Abstract

Purpose

The asthma stepwise treatment approach recommended is based on monitoring patients’ symptoms. The Asthma Research in Children and Adolescents (ARCA) cohort was created to provide evidence about the evolution of persistent asthma. This manuscript describes the development of an electronic health tool, comprising a mobile health application for patients with asthma and its associated online platform for pediatricians to monitor them.

Methods

The development process followed 7 phases: the first 5 (Conceptualization, Preparation, Assessment scheduling, Image and user interface, and Technical development) defined and designed the tool, followed by a testing phase (functionality assessment and pilot test with ARCA patients), and a last phase which evaluated usability. Since the target population was aged 6–16 years, three versions were designed within the same smartphone application: parents/proxy, children, and adolescents. The online platform for pediatricians provides real-time information from the application: patients’ responses over time with color-coded charts (red/amber/green, as in traffic lights).

Results

The pilot test through semi-structured phone interviews of the first 50 participants included in the ARCA study (n = 53) detected their misunderstandings. Pediatricians were trained to emphasize that the application is free of charge and requires monthly answers. Median of the System Usability Scale scores (n = 85), ranging 0 (negative)–100 (positive), was > 93 in the three age versions of the application.

Conclusions

Technology has the capability of transforming the use of patient-reported outcomes. Describing all the development phases of a mobile health application for monitoring children and adolescents with asthma may increase the knowledge on how to design applications for young patients.

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Acknowledgements

The authors would like to acknowledge the technical group “STARTCAT APP DEVELOPMENT, S.L.” in charge of the development of the mobile application ARCA, and Aurea Martin for her contributions in discussing on digital divide in Spain with the authors, helping in the English editing, proofreading process, figure creation, and translation, and finalizing this manuscript.

ARCA Group

Montse Ferrer, Yolanda Pardo, Àngels Pont, Olatz Garin, Karina Mayoral, Catalina Lizano, Víctor Zamora (IMIM, Institut Hospital del Mar d’Investigacions Mèdiques); Maria Araceli Caballero, Sara Calpe (Pediatric service. Hospital del Mar); Gimena Hernandez (CAP Vila Olimpica); Manuel Praena (Centro de Salud la Candelaria); Alberto Bercedo (Centro de Salud Dobra); Jose Antonio Castillo (Hospital Infantil Universitario Miguel Servet); Olga Cortés (Centro de Salud Canillejas); Isabel Moneo (Centro de Salud Torre Ramona); Ines de Mir (Hospital Vall d’Hebron); Laura Valdesoiro (Parc Taulí Hospital Universitario); Pilar Ortiz (Centro de Salud Dos de Mayo); María Ángeles Carrasco (Centro de Salud Villa del Prado); Alexandra L. Dima, Eric van Ganse (University Claude Bernard Lyon), Marijn de Bruin (Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare).

Funding

Financial support for this study was provided through grants by the Instituto de Salud Carlos III FEDER: Fondo Europeo de Desarrollo Regional (PI15/00449 and FI16/00071), University of Costa Rica (OAICE-85-2019), and Generalitat de Catalunya (2017 SGR 452). The funding agreements ensure the authors’ independence in designing the study, interpreting the data, and writing and publishing the report.

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Authors and Affiliations

  1. Health Services Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain

    K. Mayoral, O. Garin, C. Lizano Barrantes, Y. Pardo & M. Ferrer

  2. Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    K. Mayoral, M. A. Caballero-Rabasco & M. Ferrer

  3. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain

    K. Mayoral, O. Garin, Y. Pardo & M. Ferrer

  4. Pompeu Fabra University UPF, Barcelona, Spain

    O. Garin & C. Lizano Barrantes

  5. Pediatric Allergy and Pulmonology Unit, Pediatric Service, Hospital del Mar, Barcelona, Spain

    M. A. Caballero-Rabasco

  6. Centro de Salud la Candelaria, Servicio Andaluz de Salud, Seville, Spain

    M. Praena-Crespo

  7. Grupo de Vías Respiratorias de la Asociación Española de Pediatras de Atención Primaria (AEPAP), Madrid, Spain

    M. Praena-Crespo, A. Bercedo, G. Hernandez & J. Castillo

  8. Centro de Salud Dobra, Servicio Cántabro de Salud, Cantabria, Spain

    A. Bercedo

  9. CAP Vila Olimpica, Parc Sanitari Pere Virgili, Barcelona, Spain

    G. Hernandez

  10. Pediatric Pneumology Unit, Pediatric Service, Hospital Infantil Universitario Miguel Servet, Zaragoza, Spain

    J. Castillo

  11. University of Costa Rica, San José, Costa Rica

    C. Lizano Barrantes

  12. Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    Y. Pardo

Authors
  1. K. Mayoral
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  2. O. Garin
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  6. G. Hernandez
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  10. M. Ferrer
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Consortia

ARCA group

Contributions

KM contributed to the conception and design of the article and wrote the article; OG contributed to the conception and design of the article, M-AC, MP, AB, GH, and JC participated in the design of the study and carried out the fieldwork; CL and YP revised important intellectual content and the draft versions of the manuscript; and MF oversaw all aspects, conceived the study, contributed to the conception and design of the article, and contributed to the writing of the article. All the co-authors critically revised the manuscript and approved the final draft before submission and can attest to the validity and legitimacy of the data in the manuscript and agree to be named as author of the manuscript.

Corresponding authors

Correspondence to O. Garin or M. Ferrer.

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Conflict of interest

All authors declare that they have no competing interests.

Ethical approval

The study has the approval of the Parc de Salut Mar ethical committee of clinical research (nº 2015/62/12l), and it was conducted in accordance with the ethical standards of the institutional research committee and the 2000 revision of the Declaration of Helsinki. Informed consent was obtained from the parents or legally authorized representatives of participants, as well as from the children or adolescents.

Transparency

The lead authors (KM and MF) affirm that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

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The members of ARCA group were included in acknowledgements section.

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Mayoral, K., Garin, O., Caballero-Rabasco, M.A. et al. Smartphone App for monitoring Asthma in children and adolescents. Qual Life Res 30, 3127–3144 (2021). https://doi.org/10.1007/s11136-020-02706-z

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