Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Nash, Whitney

Committee Member

Robertson, Sara

Author's Keywords

asthma; asthma management; adolescent; mobile device application; ASTHMAXcel; healthcare literacy



Background: Asthma is the leading chronic illness among pediatric patients. One of the most significant obstacles facing asthma care is adherence to asthma management plans. In the pediatric population, adolescents (ages 12-17) traditionally have poor asthma management. Research shows that adolescents respond well to technology-based education and that improving adolescent healthcare literacy leads to better asthma control.

Environment: This project took place at an allergy and asthma specialists office. This private practice includes primary care allergy, asthma, and immunology services that follows roughly 120 adolescents with asthma.

Purpose: The purpose of this project was to provide the allergy and asthma office staff with an additional educational resource to give adolescent asthma patients. This technology-based, mobile device application was meant to help prevent unnecessary office calls and non-routine office visits by increasing patient healthcare literacy.

Procedures: The intervention was an in-service which instructed the office staff to educate patients within the demographic population during office visits on the use of the ASTHMAXcel applications. For eight weeks, the staff provided the education and resource to the inclusive population and documented the encounters on a data entry log. The staff was also instructed to document patients who received the education at a previous appointment on a separate data entry log. At the end of weeks 4 and 8, the staff participated in an open-ended question and feedback document.

Measures: The project was measured through two data entry logs and two open-ended questions. The first data entry log measured if the education was given, and if not, then why, the date and time the education was given, and the age of the patient receiving education. The second data entry log was intended for patients who received the education and were returning for another appointment within the implementation dates. This log included date and time of the encounter, age of the patient, and if the patient downloaded and used the applications. The results of these logs were compared to a total number of patients within the inclusion criteria that were seen within the implementation dates, provided through an EMR review by the office manager. The open-ended question document contained the question: What factors are preventing the ASTHMAXcel discharge education? The document also had a section for constructive feedback.

Data Analysis: Analysis reported that 83.7% of the total number of patients seen were offered the education. Of that group, 86% agreed to participate in receiving the education. Major barriers to implementation mostly included cancellations due to illness or weather. Five patients (14%) refused the intervention for various reasons but mostly due to reason for office visit.

Discussion: The ASTHMAXcel application education intervention was delivered at an exceptionally high rate. The staff of the implementing office expressed interest in continuing to make the application available to their adolescent patients. Follow-up on the rate of application usage and a measurement of asthma-related healthcare literacy among patients receiving the application education would be beneficial to support further application implementation.

Conclusion: ASTHMAXcel is an easily accessible resource for primary care services to improve adolescent asthma patients’ healthcare literacy. ASTHMAXcel is as efficacious as an in-person educational class and is more suited for the adolescent age group.

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