title: Young People's Preferences for an Asthma Self-Management App Highlight Psychological Needs: A Participatory Study.
abstract: Although the prevalence of mental illness among young people with asthma is known to be twice the rate of the wider population, none of the asthma apps reported have acknowledged or attempted to include psychological support features. This is perhaps because user involvement in the development of asthma apps has been scarce. User involvement, facilitated by participatory design methods, can begin to address these issues while contributing insights to our understanding of the psychological experience associated with asthma and how technology might improve quality of life.
  
  
  
  The goal of this participatory user research study was to explore the experience, needs, and ideas of young people with asthma while allowing them to define requirements for an asthma app that would be engaging and effective at improving their well-being.
  
  
  
  Young people aged 15-24 years with doctor-diagnosed asthma were invited to participate in a participatory workshop and to complete a workbook designed to elicit their thoughts and ideas about living with asthma, technology use, and the design of an app. Participants generated a number of artifacts (including collages, concept maps, and paper prototypes) designed to reify their ideas, tacit knowledge, and experience.
  
  
  
  A total of 20 participants (mean age 17.8 years; 60%, 12/20 female) representing a range from inadequately to well-controlled asthma completed a workbook and 13 of these also took part in a workshop (four workshops were held in total), resulting in 102 participant-generated artifacts. Theoretical thematic analysis resulted in a set of personal needs, feature ideas, and app characteristics considered relevant by young people for an asthma support app. The data revealed that psychological factors such as anxiety, and impediments to autonomy, competence, and relatedness (as consistent with self-determination theory [SDT]), were considered major influences on quality of life by young people with asthma. Furthermore, the incorporation of features pertaining to psychological experience was particularly valued by participants.
  
  
  
  In addition to practical features for asthma management, an app for young people with asthma should include support for the mental health factors associated with lived experience (ie, anxiety, lack of autonomy, and social disconnectedness). We show how support for these factors can be translated into design features of an app for asthma. In addition to informing the development of asthma-support technologies for young people, these findings could have implications for technologies designed to support people with chronic illness more generally.
authors.affiliation: School of Electrical and Information Engineering, Faculty of Engineering, University of Sydney, Sydney, Australia.
authors.forename: Dorian
authors.identifier: 0000-0002-4767-4198
authors.initials: D
authors.lastname: Peters
authors.affiliation: Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Sharon
authors.identifier: 0000-0002-0818-6239
authors.initials: S
authors.lastname: Davis
authors.affiliation: School of Electrical and Information Engineering, Faculty of Engineering, University of Sydney, Sydney, Australia.
authors.forename: Rafael Alejandro
authors.identifier: 0000-0003-2238-0684
authors.initials: RA
authors.lastname: Calvo
authors.affiliation: Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia.|Department of Paediatrics, The University of Melbourne, Melbourne, Australia.|Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Susan M
authors.identifier: 0000-0002-9095-358X
authors.initials: SM
authors.lastname: Sawyer
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, Australia.
authors.forename: Lorraine
authors.identifier: 0000-0002-3499-1514
authors.initials: L
authors.lastname: Smith
authors.affiliation: Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Juliet M
authors.identifier: 0000-0003-0780-6034
authors.initials: JM
authors.lastname: Foster
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D063731:Mobile Applications; D057240:Patient Preference; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D055815:Young Adult
keywords: adolescents; asthma; chronic disease; mental health; mhealth; mobile applications; participatory design; quality of life