Development and Usability of a Digital Asthma Self-management Education Platform: BRinging Exercise, Asthma Assessments, and TeacHing to Everyone (BREATHE).

Abstract

Asthma self-management education (ASME) encourages behavior that helps achieve disease control. Most adults with asthma (AwAs) do not receive ASME, and a digital ASME platform may improve access. Our objectives were to use a user-centered design approach to develop an ASME platform containing features important to AwAs with health care access challenges (health disparities) and assess its usability by AwAs and health care providers (HCPs). The Blue Marble Health Platform-BREATHE (BRinging Exercise, Asthma Assessments, and TeacHing to Everyone)-was developed and pilot-tested in 2 studies. Study 1 consisted of a survey and semistructured interviews with AwAs (n = 26) and HCPs (n = 9) for user-centered app development. Study 2 was a single-site, nonrandomized feasibility pilot study of BREATHE evaluated for 2 weeks by AwAs with health disparities (n = 10) and HCPs (n = 7). Feasibility was measured by challenges in downloading the app, considered behavior changes, and lesson evaluations. Usability was measured with the System Usability Scale and Net Promoter Score (NPS). A BREATHE prototype was developed and contained asthma lessons (with images reflecting diverse populations), an exercise tracker, asthma control assessments, and an Asthma Action Plan. The content was translated into Spanish, with bilingual voice-over narration. An HCP administrative web dashboard that captured and visualized data was implemented. All feasibility and usability goals were achieved. The AwAs scored the app usability at the 81st percentile, and HCPs scored the dashboard usability at the 76th percentile. The NPS was 8.6/10 for AwAs and 7.7/10 for HCPs. BREATHE, a digital ASME platform designed using user-centered design approaches, is feasible and has the potential to address health disparities by enabling access.