Department of Medicine, University of Toronto, 30 Bond Street, Toronto, Ontario, Canada.
Respiration. 2012;84(5):406-15. doi: 10.1159/000338112. Epub 2012 Jul 10.
Asthma action plans (AAPs), which decrease hospitalizations and improve symptom control, are recommended in guidelines, but are seldom delivered to patients. Existing AAPs have been developed by experts, without the inclusion of all stakeholders (such as patients with asthma) and without specifically addressing usability and visual design.
Our objective was to develop a more usable AAP by involving all stakeholders and considering design preferences.
We created a Wiki-based system for multiuser AAP development. Pulmonologists, primary care physicians, asthma educators and patients used the system to collaboratively compile a single AAP by making multiple online selections over 1 week. We combined common elements from 3 AAPs developed in this way into 1, optimized visual design features and tested face validity in focus groups.
A total of 41 participants averaged 646 selections/week over a login-time of 28.8 h/week. Of 35 participants, 28 (80%) were satisfied with the final AAP and 32 (91%) perceived that they would be able to use it. The plans created by the 3 groups were very similar, with a unanimous or majority agreement in the handling of 100/110 (91%) AAP options.
Inclusion of multiple stakeholders and focus on design preferences predict enhanced usability and uptake of medical tools. The validity of our AAP is further supported by the similarity between the AAPs created by each group, user engagement and satisfaction with the plan and agreement with existing validity criteria proposed by experts. This AAP can be implemented in care with a concurrent measurement of uptake and health impact.
哮喘行动计划（AAP）可降低住院率并改善症状控制，在指南中被推荐，但很少能提供给患者。现有的 AAP 是由专家制定的，没有纳入所有利益相关者（如哮喘患者），也没有专门解决可用性和视觉设计问题。
我们的目标是通过纳入所有利益相关者并考虑设计偏好来开发更具可用性的 AAP。
我们创建了一个基于 Wiki 的多用户 AAP 开发系统。肺科医生、初级保健医生、哮喘教育者和患者使用该系统通过在一周内进行多次在线选择来共同编写一份 AAP。我们将通过这种方式开发的 3 份 AAP 的常见元素合并为 1 份，优化了视觉设计功能，并在焦点小组中测试了表面有效性。
共有 41 名参与者平均每周登录 28.8 小时，每周进行 646 次选择。在 35 名参与者中，28 名（80%）对最终的 AAP 感到满意，32 名（91%）认为他们能够使用它。3 组创建的计划非常相似，对于 110 个 AAP 选项中的 100 个（91%）的处理方法一致或多数一致。
纳入多个利益相关者并关注设计偏好可预测提高医疗工具的可用性和采用率。每个组创建的 AAP 之间的相似性、用户对计划的参与度和满意度以及与专家提出的现有有效性标准的一致性进一步支持了我们的 AAP 的有效性。该 AAP 可在护理中实施，同时测量采用率和健康影响。
