Disadvantaged, urban, and minority children incur a disproportionate share of asthma prevalence and morbidity. Interventions have been shown to improve underrepresented minority (URM) youths' adherence to NIH asthma care guidelines (e.g., proper use of long-term control medication) thereby reducing asthma morbidity. One particularly promising method of intervention delivery is via mobile technology-it is widely accessed by urban minority parents and children, and it is a cost effective and efficient tool for monitoring, providing feedback, and thereby changing health behavior. In addition, there is evidence to suggest that racial disparities in asthma morbidity may be due in part to children's home environments; indoor air quality can have an important influence on asthma-related health because children spend as much as 90% of their time indoors. Therefore, we propose to develop a mobile health (mHealth) tool intended to help urban, minority families independently identify and address asthma triggers in their homes and improve their child's asthma self- management. In the proposed project, we will apply an iterative, user-centered design process to develop a prototype asthma home monitoring system (Aspira) involving a tablet app, digital spirometer, and particulate monitor, linked to a data management server. To this end, we will conduct key informant interviews, develop user personas, hold team design workshops, develop an integrated data management platform, and conduct usability testing of low-fidelity prototypes. Then we will conduct a mixed-methods pilot study to determine feasibility and preliminary efficacy of the resulting high-fidelity Aspira prototype among ten African American parents and their children (ages 7-12) with asthma living in Washington, DC. The successful completion of this project will show the feasibility of our concept and set the stage for system improvements, a randomized control trial and commercialization efforts in Phase II.
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