Responsive Asthma Care for Teens (ReACT): An Evaluation of the Usability of an Adaptive Mobile Health Intervention for Adolescents with Asthma (Preprint)

BACKGROUND Adolescent asthma is a significant contributor to youth morbidity and is known to be best managed through consistent medication use and symptom management. However, adolescents often struggle to accurately perceive their symptoms and consistently use their medication at the recommended rate, risking worsened symptoms and impaired quality of life. The Responsive Asthma Care for Teens (ReACT) system is a project directed at identifying and supporting the various reasons adolescents may be struggling with asthma management. By integrating both software and hardware elements to monitor medication adherence, ReACT provides a personalized support plan to eventually increase asthma management and subsequently, quality of life. OBJECTIVE The objective of this study is to conduct a proof-of-concept assessment of the ReACT system following an initial pilot study and adjusting for the feedback received. In addition to assessing the acceptability and usability of the current version, this study aims to assess whether the proposed ReACT system shows indication of improvement in medication adherence as a result of the personalized support plans. METHODS Participants in the study were five 15-17 year-old adolescents recruited using a combination of consent-to-contact forms delivered via an in-person asthma clinic and Qualtrics panels. As a part of this study, participants were asked to meet with the study team three times over the course of the month. After completing initial surveys on stress, problem solving, and asthma related quality of life, participants were oriented on the ReACT platform and asked to interact with it as normal. After the month, participants conducted an interview discussing the system and completed surveys assessing their opinions on acceptability and usability. RESULTS On a four-point scale, participants reported high acceptability (mean 3), would use ReACT again (mean 4), recommend it to a friend (mean 3.75), and that ReACT was helpful (mean 3.5). At post-intervention adolescents demonstrated pre-post changes in problem-solving ability (Cohen d=0.43), motivation (Cohen d=0.84), and asthma-related stress (school Cohen d=0.91; leisure Cohen d=0.67; responsibility Cohen d=0.56). CONCLUSIONS Our findings suggest ReACT is an acceptable and usable mHealth intervention to improve adolescent asthma self-management through promising results for improving self-regulation, problem-solving, and ultimately asthma control. As the system continues improving from participant feedback and a larger sample size, ReACT hopes to aid adolescent development while delivering highly personalized support to best aid each individual user.