Elias Pierre, Rajan Nithin O, McArthur Kara, Dacso Clifford C
Duke University School of Medicine Durham, NC United States.
BSX Athletics Houston, TX United States.
Med 2 0. 2013 May 21;2(1):e1. doi: 10.2196/med20.2014. eCollection 2013 Jan-Jun.
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, only 50% of US youth accurately follow their care plans, which leads to millions of preventable hospitalizations, emergency room visits, and sick days every year. We present a feasibility study of a novel, user-centered approach to increasing young people's lung-function monitoring and asthma self-care. Promoting Lung Assessment in Youth (PLAY) helps young people become active managers of their asthma through the Web 2.0 principles of participation, cocreation, and information sharing. Specifically, PLAY combines an inexpensive, portable spirometer with the motivational power and convenience of mobile phones and virtual-community gaming.
The objective of this study was to develop and pilot test InSpire, a fully functional interface between a handheld spirometer and an interactive game and individualized asthma-care instant-messaging system housed on a mobile phone.
InSpire is an application for mobile smartphones that creates a compelling world in which youth collaborate with their physicians on managing their asthma. Drawing from design-theory on global timer mechanics and role playing, we incentivized completing spirometry maneuvers by making them an engaging part of a game young people would want to play. The data can be sent wirelessly to health specialists and return care recommendations to patients in real-time. By making it portable and similar to applications normally desired by the target demographic, InSpire is able to seamlessly incorporate asthma management into their lifestyle.
We describe the development process of building and testing the InSpire prototype. To our knowledge, the prototype is a first-of-its kind mobile one-stop shop for asthma management. Feasibility testing in children aged 7 to 14 with asthma assessed likability of the graphical user interface as well as young people's interest in our incentivizing system. Nearly 100% of children surveyed said they would play games like those in PLAY if they involved breathing into a spirometer. Two-thirds said they would prefer PLAY over the spirometer alone, whereas 1/3 would prefer having both. No children said they would prefer the spirometer over PLAY.
Previous efforts at home-monitoring of asthma in children have experienced rapid decline in adherence. An inexpensive monitoring technology combined with the computation, interactive communication, and display ability of a mobile phone is a promising approach to sustainable adherence to lung-function monitoring and care plans. An exciting game that redefines the way youth conduct health management by inviting them to collaborate in their health better can be an incentive and a catalyst for more far-reaching goals.
哮喘是儿童期最常见的慢性疾病，对城市、少数族裔和弱势儿童的影响尤为严重。由日常肺功能监测支持的个性化护理计划可降低发病率和死亡率。然而，尽管进行了20年的干预以提高依从性，但美国只有50%的青少年能准确遵循其护理计划，这导致每年数百万次可预防的住院、急诊就诊和病假。我们开展了一项可行性研究，采用一种新颖的、以用户为中心的方法来增加青少年的肺功能监测和哮喘自我护理。青少年肺功能促进项目（PLAY）通过参与、共同创造和信息共享等Web 2. .0原则，帮助青少年成为积极的哮喘管理者。具体而言，PLAY将一种价格低廉的便携式肺活量计与手机和虚拟社区游戏的激励力量及便利性相结合。
本研究的目的是开发并进行初步测试InSpire，这是一种在手持肺活量计与手机上的交互式游戏及个性化哮喘护理即时通讯系统之间的全功能接口。
InSpire是一款适用于智能手机的应用程序，它创建了一个引人入胜的世界，让青少年与他们的医生合作管理哮喘。借鉴全球定时器机制和角色扮演的设计理论，我们通过使肺活量测定操作成为青少年想玩的游戏中引人入胜的一部分来激励他们完成这些操作。数据可以无线发送给健康专家，并实时将护理建议反馈给患者。通过使其便于携带且类似于目标人群通常想要的应用程序，InSpire能够将哮喘管理无缝融入他们的生活方式。
我们描述了构建和测试InSpire原型的开发过程。据我们所知，该原型是首个用于哮喘管理的移动一站式服务平台。对7至14岁哮喘儿童进行的可行性测试评估了图形用户界面的受欢迎程度以及青少年对我们激励系统的兴趣。近100%接受调查的儿童表示，如果游戏涉及对着肺活量计吹气，他们会玩类似PLAY中的游戏。三分之二的人表示他们更喜欢PLAY而不是单独使用肺活量计，而三分之一的人表示两者都想要。没有儿童表示他们更喜欢肺活量计而不是PLAY。
以往儿童哮喘家庭监测的努力在依从性方面迅速下降。一种价格低廉的监测技术与手机的计算、交互式通信和显示能力相结合，是一种有望实现持续肺功能监测和护理计划依从性的方法。一款令人兴奋的游戏通过邀请青少年更好地参与自身健康管理来重新定义他们进行健康管理的方式，可以成为实现更远大目标的激励因素和催化剂。
