title: Understanding clinicians' attitudes toward a mobile health strategy to childhood asthma management: A qualitative study.
abstract: OBJECTIVE
  Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs have not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe if a sensor-based mobile intervention is useful in caring for patients with asthma.
  
  
  METHODS
  We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT. Forty-one participated in four focus groups, which included a demonstration of the technology. Participants were probed with open-ended questions on the type, frequency, and format of inter-visit patient information they found useful.
  
  
  RESULTS
  41 participants (mean age 49 (±13.7) years) were board-certified clinicians (41% MDs and 20% mid-level practitioners), practiced medicine on an average of 19 (±14) years, were primarily white (59%) and women (78%). Clinicians wanted 1) adherence to prescribed inhaler therapy and 2) data on inhaler technique. Clinicians wanted it at the time of a scheduled clinic visit but also wanted inter-visit alerts for excessive use of rescue therapy. Pulmonologists liked the mobile spirometer's provision of inter-visit lung function data; pediatricians did not share this view. Concerns with data accuracy were raised due to families who shared inhalers, access to smartphones, and protection of health information.
  
  
  CONCLUSIONS
  Overall, clinicians view an asthma mobile health technology as enhancing the patient-centered medical home. Pediatric primary care clinicians and pulmonologists want different information from a mobile app.
authors.affiliation: a Department of Pediatrics , University of Connecticut School of Medicine, Asthma Center, CT Children's Medical Center , Hartford , CT , USA.
authors.forename: Jessica P
authors.initials: JP
authors.lastname: Hollenbach
authors.affiliation: b Icahn School of Medicine at Mount Sinai, CoHero Health , New York , NY , USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Cushing
authors.affiliation: c CoHero Health , New York , NY , USA.
authors.forename: Emilie
authors.initials: E
authors.lastname: Melvin
authors.affiliation: c CoHero Health , New York , NY , USA.
authors.forename: Bryanna
authors.initials: B
authors.lastname: McGowan
authors.affiliation: d Department of Pediatrics and Medicine , University of Connecticut Health Center, Asthma Center, Connecticut Children's Medical Center , Hartford , CT , USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Cloutier
authors.affiliation: b Icahn School of Medicine at Mount Sinai, CoHero Health , New York , NY , USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Manice
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D057286:Electronic Health Records / Q000458:organization & administration; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D063731:Mobile Applications; D011320:Primary Health Care / Q000379:methods; D000072106:Pulmonologists / Q000523:psychology; D036301:Qualitative Research; D058998:Remote Sensing Technology / Q000295:instrumentation; D012129:Respiratory Function Tests; D012648:Self Care; D017216:Telemedicine; D014505:Urban Population
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Adherence; children; mHealth; self-management