Merging theory and formative data to create an adolescent asthma self-management app

Introduction. Although asthma self-management applications (apps) have proliferated recently, to our knowledge, a self-management app has not been developed specifically for adolescents. We describe how we integrated formative data from adolescents and their social network members with constructs from Self-Regulation Theory to create a prototype for an adolescent asthma self-management app.

Methods. We recruited adolescents (ages 12-16) with persistent asthma (n=20), their caregivers (n=20), friends (n=3), and physicians (n=6) from two pediatric practices in North Carolina. Participants were asked to critique two existing self-management apps after a clinic visit and again after one week of app use. During semi-structured interviews, participants identified the app features they found most useful for managing asthma. Interviews were digitally recorded, transcribed verbatim, and analyzed thematically using MAXQDA. Qualitative themes were then mapped onto Self-Regulation Theory constructs (italicized below) to identify the features that were most likely to promote self-management behaviors.

Results. Adolescents were primarily Black (47%) and male (60%). The following features promote self-observation, or self-monitoring, behaviors: daily control quizzes and symptom-tracking and medication-tracking charts. These charting features are linked to the adolescent’s asthma action plan to encourage adolescents to self-judge the severity of their asthma. Optional email/text features allow adolescents to engage supportive others when their asthma is not well-controlled. Technical advice from role models and credible sources is linked to the app to promote knowledge, more positive self-management outcome expectations, and increased self-efficacy.

Conclusions. Self-Regulation Theory serves as a useful guide for developing a theory-based app prototype to increase adolescent asthma self-management.