Development and assessment of a digital monitoring tool for pediatric asthma management

Thesis Abstract

Pediatric asthma remains a significant public health challenge, characterized by frequent exacerbations, poor adherence to medication, and difficulties in continuous symptom monitoring, which collectively contribute to increased morbidity and healthcare utilization. Despite advances in asthma management guidelines, gaps persist in effective home-based monitoring and early detection of exacerbations, often leading to delayed interventions and suboptimal outcomes. This study aims to develop, implement, and evaluate a digital monitoring tool tailored for pediatric asthma management that integrates real-time symptom tracking, medication adherence monitoring, and environmental risk assessments to enhance clinical decision-making and empower caregivers. The primary objectives of this research are to (1) design a user-friendly digital monitoring application anchored in health behavior theories such as the Health Belief Model and Self-efficacy Theory, (2) assess the tool’s usability and acceptability among pediatric patients aged 6-12 years and their caregivers, and (3) evaluate its impact on asthma control, adherence rates, and frequency of exacerbations over a six-month period. The research adopts a sequential explanatory mixed-methods design, beginning with a qualitative exploratory phase to gather stakeholder insights and inform the development of the application, followed by a quantitative quasi-experimental study to measure its efficacy. The population comprises 200 pediatric asthma patients attending pediatric clinics at a tertiary healthcare facility, stratified by age, gender, and asthma severity. A purposive sampling technique identifies 150 participants for the intervention group, which will utilize the digital tool, and 50 for the control group receiving standard care. Data collection instruments include structured questionnaires for baseline and follow-up assessments, usability and satisfaction surveys (e.g., System Usability Scale), and respiratory health measures such as Peak Expiratory Flow Rate (PEFR) and Pediatric Asthma Control Test (PAQT). Environmental data from integrated sensors and parental reports augment clinical data. Instrument validity and reliability are ensured through pilot testing, expert review, and Cronbach’s alpha coefficient calculations. Data analysis involves descriptive statistics, paired and independent sample t-tests, chi-square tests, and multiple regression analysis using SPSS to ascertain differences between intervention and control groups. Thematic analysis via NVivo software is employed to analyze qualitative feedback from focus groups and interviews. The expected findings suggest that the digital tool will significantly improve medication adherence (p<0.01), enhance asthma control levels, reduce emergency visits, and increase caregiver engagement. Furthermore, usability evaluations anticipate high satisfaction scores (>80%) and positive feedback on the application's design and functionality, thus supporting its scalability and integration into routine asthma care. This research contributes to the body of knowledge by providing empirical evidence on the effectiveness of digital health interventions specifically tailored for pediatric populations, grounded in health behavior theories. It advances understanding of how technology can facilitate self-management among children and their caregivers, addressing a critical gap in asthma care delivery models. The study also offers a validated framework for developing similar mobile health applications in resource-rich and resource-limited settings. In conclusion, the study highlights the potential of a digitally integrated monitoring system to transform pediatric asthma management, fostering proactive disease control and reducing healthcare burden. Based on the findings, it recommends the widespread adoption of such tools within pediatric healthcare services, emphasizes the need for ongoing user training, and advocates for policy support to incorporate digital health solutions into standard asthma care protocols. Further research is suggested to evaluate long-term impacts and cost-effectiveness across diverse healthcare contexts, ultimately contributing to improved health outcomes for children with asthma globally.