A mixed method observational study of strategies to promote adoption and usage of an application to support asthma self-management

Chi Yan Hui, Brian McKinstry, Robert Walton, Hilary Pinnock

Abstract


BACKGROUND: Apps can potentially support asthma self-management, however attracting downloads and encouraging on-going adherence is challenging.

OBJECTIVES: We observed the impact of different recruitment strategies and app features on adoption and continued use.

METHODS: Practice nurses in five practices in Lothian/Oxford approached adults with active asthma to try out a prototype app. We also advertised the app via social media (Asthma UK; AUK Centre for Applied Research). We observed patients’ download and retention rates and sent pre- and post-trial questionnaires. We sampled 15 patients for interviews before and after using our app for one month to explore motivations, triggers and barriers to adoption and usage. Interviews were transcribed and analysed thematically with reference to the Fogg behaviour model.

RESULTS: Social media attracted 87 users, but only 15 (17%) used the app for 30 days.  Practices recruited 24 patients, 13 (54%) continued for 30 days. Successful adoption was dependent on ease of downloading and sufficient motivation. Some patients needed technological assistance with downloading the app and starting to use the features.   Adherence was dependent on motivation derived from a sense that the healthcare professional and/or researcher was interested in the results, and that using an app to support their self-management could improve their asthma control.

CONCLUSION: Social media attracted more downloads in a short time. However, most patients stopped using the app within a month.  Practices recruited fewer patients, but patents adhered longer to the app.  Dual promotion strategies (social media with practice support) may be the optimal approach to encourage adoption and adherence to telehealth.

Keywords


Asthma, Self-Management, Telehealth, Mobile application, Social media

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References


Asthma UK. Time to take action on asthma. 2014. Available from: https://www.asthma.org.uk/globalassets/campaigns/compare-your-care-2014.pdf. Accessed 7 April 2018.

Levy M, Andrews R, Buckingham R, Evans H, Francis C, Houston R, et al. Why asthma still kills: the National Review of Asthma Deaths (NRAD). Royal College of Physcians; 6 May 2014. Available from: https://www.rcplondon.ac.uk/sites/default/files/why-asthma-still-kills-full-report.pdf. Accessed 7April 2018.

Pinnock H, Parke HL, Panagioti M, Daines L, Pearce G, Epiphaniou E, et al. Systematic meta-review of supported self-management for asthma: a healthcare service perspective. BMC Medicine 2017;15:64. https://doi.org/10.1186/s12916-017-0823-7. PMid:28302126; PMCid:PMC5356253.

Fogg BJ. A behavior model for persuasive design. In Proceedings of the 4th international Conference on Persuasive Technology, p. 40, 26 April 2009. Association for Computing Machinery. https://doi.org/10.1145/1541948.1541999. PMid:19715259; PMCid:PMC3089419.

Asthma UK Twitter. Available from: https://twitter.com/asthmauk. Accessed 4 August 2017.

Asthma UK Facebook. Available from: https://www.facebook.com/AsthmaUK/. Accessed 4 August 2017.

Asthma UK Centre for Applied Research (AUKCAR) Twitter. Available from: https://twitter.com/AUKCAR. Accessed 4 August 2017.

Hui CY, Walton R, McKinstry B, Jackson T, Parker R, Pinnock H. The use of mobile applications to support self-management for people with asthma: a systematic review of controlled studies to identify features associated with clinical effectiveness and adherence. Journal of the American Medical Informatics Association 2016;ocw143. https://doi.org/10.1093/jamia/ocw143. PMid:27694279.

Hui CY, Walton R, McKinstry B, Vasileiou E, Pinnock H. What do people with asthma want to see in an asthma self-management app? A review of views expressed in online social discussion forums. Proceedings of the British Computer Science Health Informatics conference, 2017 (in press).

Pinnock H, Burton C, Campbell S, Gruffydd-Jones K, Hannon K, Hoskins G, et al. Clinical implications of the Royal College of Physicians three questions in routine asthma care: a real-life validation study. Primary Care Respiratory Journal 2012; 21:288–94. https://doi.org/10.4104/pcrj.2012.00052.

Asthma UK. Asthma action plan. Available from: https://www.asthma.org.uk/advice/manage-your-asthma/action-plan. Accessed 7 April 2018.

Google Play Store. Available from: https://play.google.com/store?hl=en. Accessed 7 April 2018.

Apple App Store via iTunes. Available from: https://www.apple.com/uk/itunes/charts/free-apps. Accessed 7 April 2018.

NHS Employers. Quality and outcomes framework guideline 2014/15. Available from: http://www.nhsemployers.org/~/media/Employers/Documents/Primary%20care%20contracts/QOF/2014-15/2014-15%20General%20Medical%20Services%20contract%20-%20Quality%20and%20Outcomes%20Framework.pdf. Accessed 7 April 2018.

Bitly Online Platform. Available from: https://bitly.com/. Accessed 7 April 2018.

Google Analytics. Available from: https://analytics.google.com. Accessed 7 April 2018.

Localytics Analysis. Mobile app user engagement and retention benchmarks in Q4 2015. Available from: http://www.marketingcharts.com/industries/media-and-entertainment-66465/attachment/localytics-mobile-app-usage-benchmarks-mar2016. Accessed 7 April 2018.

Creswell JW, Klassen AC, Plano Clark VL, Smith KC. Best practices for mixed methods research in the health sciences. August 2011. National Institutes of Health. Available from: https://obssr.od.nih.gov/training/online-training-resources/mixed-methods-research/. Accessed July 2018.

International Telecommunication Union. IMT traffic estimates for the years 2020 to 2030. Available from: https://www.itu.int/dms_pub/itu-r/opb/rep/R-REP-M.2370-2015-PDF-E.pdf. Accessed 7 April 2018.

McCarney R, Warner J, Iliffe S, Van Haselen R, Griffin M, Fisher P. The Hawthorne Effect: a randomised, controlled trial. BMC Medical Research Methodology 2007;7:30. https://doi.org/10.1186/1471-2288-7-30. PMid:17608932; PMCid:PMC1936999.

Peel E, Douglas M, Lawton J. Self-monitoring of blood glucose in type 2 diabetes: longitudinal qualitative study of patients’ perspectives. BMJ 2007;335:493. https://doi.org/10.1136/bmj.39302.444572.DE. PMid:17761996; PMCid:PMC1971180.

Hanley J, Fairbrother P, McCloughan L, Pagliari C, Paterson M, Pinnock H, et al. Qualitative study of telemonitoring of blood glucose and blood pressure in type 2 diabetes. BMJ Open 2015;5:e008896. https://doi.org/10.1136/bmjopen-2015-008896. PMid:26700275; PMCid:PMC4691739.

Hanlon P, Daines L, Campbell C, McKinstry B, Weller D, Pinnock H. Telehealth Interventions to support self-management of long-term conditions: a systematic metareview of diabetes, heart failure, asthma, chronic obstructive pulmonary disease, and cancer. Journal of Medical Internet Research 2017;19:e172. https://doi.org/10.2196/jmir.6688. PMid:28526671; PMCid:PMC5451641.

Paterson M, McAulay A, McKinstry B. Integrating third-party telehealth records with the general practice electronic medical record system: a solution. Journal of Innovation in Health Informatics 2017;24:317–22. https://doi.org/10.14236/jhi.v24i4.915. PMid:29334351.




DOI: http://dx.doi.org/10.14236/jhi.v25i4.1056

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