222765 InSpire to PLAY (promote lung assessment in youth): Evolving the self-management and adherence paradigms of young people with asthma

Tuesday, November 9, 2010 : 5:15 PM - 5:30 PM

Pierre Elias, Rice University Department of Sociology, Finger Fellow for Sustainable Health , Sociology Department, Rice University & The Abramson Center for the Future of Health, Houston, TX
Nithin O. Rajan , Abramson Center for the Future of Health, Houston, TX
Kara McArthur, MA , Abramson Center for the Future of Health, Houston, TX
Harold Farber, MD, MSPH , Pediatric Pulmonology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
Cliff Dacso, MD, MPH, MBA , The Abramson Center for the Future of Health, The Methodist Hospital Research Institute, Houston, TX
Background: Asthma is the most common chronic disease in childhood, disproportionately affecting urban, minority, and disadvantaged children. Individualized care plans supported by daily lung-function monitoring can reduce morbidity and mortality. However, despite 20 years of interventions to increase adherence, barely 50% of US youth accurately follow their care plans. We present a feasibility study of a novel approach to increasing childrens' adherence to lung-function monitoring and care plans. InSpire combines an inexpensive, portable spirometer with the motivational power and convenience of mobile-phones and videogames.

Methods: InSpire is an incentivized system that encourages youth to monitor their lung-function correctly and follow their care plans through games that incorporate spirometry maneuvers, quizzes for increasing “Asthma Locus of Control,” weather reports on asthma triggers in the child's community, care-plan-based instant-messaging, lung-function tracking, and rewards for adherence.

Results: A pilot study of InSpire assessed likability of the graphical user interface as well as children's interest in our incentivizing system. Nearly 100% of children surveyed said they would play games like those in InSpire if they involved breathing into a spirometer. Two-thirds said they would prefer InSpire over the Piko-6, whereas 1/3 would prefer having both. No children said they would prefer the Piko-6 over InSpire.

Conclusions: Previous efforts at home-monitoring of asthma in children have experienced rapid decline in adherence. An inexpensive monitoring technology combined with the computation, communication, and display ability of a mobile-phone is a promising approach to sustainable adherence to lung-function monitoring and care plans.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Clinical medicine applied in public health
Communication and informatics
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
1. Discuss the barriers to adherence to guided self-management plans in children with asthma. 2. List three issues that are important to consider when developing new monitoring technologies for children with asthma. 3. Identify key variables in the success of using technology to improve health paradigms in youth.

Keywords: Asthma, Self-Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have worked on the design and evaluation of serious games for health education and promotion in children with asthma since 2009. In addition, I currently hold a research fellowship in sustainable health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.