Potential for an ‘app’ to change the behaviour of adults with asthma and limited health literacy: a feasibility study in Malaysia

Clinical Research Results Abstract Introduction: Although mobile applications (apps) can support self-management there is limited evidence that this approach is applicable in people with limited health literacy (and none in the context of asthma).1 We aimed to assess the feasibility of a pictorial asthma action plan delivered through a mobile app for adults with asthma and limited health literacy,2 and to explore how an app could support behaviour change underpinning asthma self-management.Methods: The mixed-method pre-post feasibility study recruited 37 adults from the Klang Asthma Cohort in the Klang District, Malaysia with physician-diagnosed asthma on inhaled corticosteroids and with limited health literacy (using the Malay version of the Health Literacy Scale-Q47 (HLS)). Of these, participants were purposively sampled for in-depth interviews. Interviews were audio-recorded, transcribed verbatim, and analysed deductively. Results: Twelve participants (Female n=8; mean age=51; mean HLS score=26) provided interviews. Emerging themes explored how the ‘app’ enabled self-management and were informed by the Behaviour Change Model (COM-B): Capability: The information available in the app improved participants’ awareness and understanding about asthma and enabled skills to self-manage (i.e., using pictorial asthma action plan, pAAP).Motivation: Visual prompts motivated participants to engage in daily preventer use and pAAP helps to reflect steps to manage deterioration of health. Opportunity: Delivery of the intervention using daily use gadgets provided participants with opportunities to actively manage their own asthma. The app also offered an opportunity for family members to play a significant role in supporting the participants (particularly older participants) in the use of technology to manage health.Discussion: A mobile app tailored to health literacy needs has the potential to support asthma self-management. The strength of family ties and multigenerational household provides a social opportunity for people with asthma to engage actively in managing their own asthma. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest This research was commissioned by the UK NIHR Global Health Research Unit on Respiratory Health (RESPIRE), using UK Aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care. References and Clinical Trial Registry Information 1. Salim H, et al. A systematic review of interventions addressing limited health literacy to improve asthma self-management. J Glob Health. 2020;10(1):010427. jogh-10-010428.pdf2. Salim H, et al. Developing an asthma self-management intervention through a web-based design workshop for people with limited health literacy: User-centered design approach. J Med Internet Res. 2021;23(9): e26434. https://www.jmir.org/2021/9/e26434.