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Games Health J. 2019 Oct;8(5):357-365. doi: 10.1089/g4h.2019.0011. Epub 2019 Jun 3.

Dose Matters: A Smartphone Application to Improve Asthma Control Among Patients at an Urban Pediatric Primary Care Clinic.

Author information

1
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
2
Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
3
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
4
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
5
Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Abstract

Objective: As the most common chronic condition of childhood, asthma is a frequent target for family education. However, current educational strategies rarely tailor to learning style or literacy level. Thus, we developed and implemented a smartphone application (app) leveraging gamified features entitled CHANGE Asthma ("Clinic, Home, And on the Go Education for Asthma"). We subsequently assessed its impact on asthma control. Methods: Patients aged 4-11 years with a previously documented childhood asthma control test (C-ACT) score of <20, indicating poor control, were recruited to participate in this randomized control pilot study. The intervention group downloaded CHANGE Asthma; asthma control was assessed at enrollment and at follow-up. The changes in C-ACT score in both groups were compared using analysis of covariance (primary outcome). App usage was monitored for 4 months following download, and the relationship between usage time, and the change in C-ACT score was assessed via linear regression. Results: The control and intervention groups both included 20 caregivers with 75% of participants completing follow-up. Although C-ACT scores among intervention participants significantly improved at follow-up, compared to their own baseline (P = 0.04), the change of C-ACT score did not significantly differ from that of the control group (P = 0.78). Among the intervention participants, there was a positive, dose-dependent relationship between app usage time and positive change in C-ACT score (P = 0.03). Conclusion: Usage of a gamified app was associated with a dose-dependent improvement in asthma control over time, suggesting that further evaluation of apps for asthma education, and perhaps for other chronic conditions, is warranted.

KEYWORDS:

App; Asthma; Games; Parent education; Smartphone

PMID:
31157983
DOI:
10.1089/g4h.2019.0011

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