Development and Usability Testing of the Mobile Childhood Asthma Management Program (mCHAMP) App: Sequential Mixed Methods Study

BACKGROUND: More than 6 million children in the United States have asthma, and more than 20% are clinically obese. Youth with asthma and obesity are susceptible to poor health outcomes, including greater asthma symptom severity and hospitalizations, reduced physical activity, and poorer quality of life. Mobile health technologies can increase access to chronic disease self-management interventions, and family members can be powerful influencers given their substantial control over a child's behavior and home environment.

OBJECTIVE: The Mobile Childhood Asthma Management Program (mCHAMP) app is based on the in-person Childhood Asthma Management Program (CHAMP) behavioral family intervention pilot trial of school-aged children with asthma and obesity. In this study, we translated the CHAMP content into digital content and conducted summative testing to measure the usability, learnability, and efficiency of the mCHAMP app.

METHODS: We applied a sequential mixed methods approach. The mCHAMP app targeted adult caregivers of children living with asthma and obesity aged 6 to 12 years. A consumer-centered approach was used to guide the identification of user requirements and conduct of summative usability testing. While the mCHAMP app is primarily caregiver facing, it is intended to connect caregivers with registered nurse (RN) interventionists. Therefore, we sought feedback from RNs as key stakeholders.

RESULTS: Caregivers (n=10) were female (n=10, 100%) and mostly African American (n=8, 80%), and half (n=5, 50%) had an annual household income of <US $25,000; most of their children (n=6, 60%) were in the 99th BMI percentile. Post-Study eHealth Usability Questionnaire scores indicated high overall satisfaction, usefulness, and quality of the mCHAMP app. Most caregivers (n=7, 70%) were able to complete all 15 tasks across the 6 modules with 2 or fewer hints. The average total time to complete all tasks was 17 (SD 3.9; range 11.4-24.1) minutes. Most caregivers (n=7, 70%) wanted information in static form but also preferred alternatives (eg, audio or video) to support flexibility with consuming the content. Caregivers expressed the need for more child-facing content as well as tailored decision support related to diet and exercise. RNs (n=5) strongly endorsed their role and use of the mCHAMP app to promote self-management among caregivers of children with obesity and asthma. They noted the importance of integrating the mCHAMP app into a local electronic health record and existing workflows.

CONCLUSIONS: Caregivers expressed a desire for an intervention that was easy to use and could integrate into their busy family lives. We met this expectation based on the usability, learnability, and efficiency results of our study. The mCHAMP app has the potential to increase self-management for parents and pediatric patients with asthma with multimorbidity, which could improve patient and health system outcomes. The use of mCHAMP may also enable novel clinical outcome studies based on patient-reported data from the app.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/13549.