333 - Does use of digital health technologies improve asthma?

Publication Number: 2322.333

Kandia Lewis, Nemours Children's Hospital, Wilmington, DE, United States; Cynthia Zettler-Greeley, Nemours Children's Health, Jacksonville, FL, United States; Aaron Chidekel, NemoursAlfred I. duPont Hospital for Children, Wilmington, DE, United States; David Fedele, Nemours Children's Hospital, Jacksonville, FL, United States

Background: Uncontrolled asthma is costly and can lead to substantial morbidity and healthcare utilization. Digital health technologies may assist caregivers in pediatric asthma management.

Objective: This study examined the integration of a digital health application in pediatric asthma care. The purpose was to examine: 1) whether more app use predicted better asthma outcomes, 2) which app features predicted better asthma outcomes, and 3) whether caregiver and child demographics correlated with a) more app use and b) better asthma outcomes.

Design/Methods: The ongoing parent study is a pre-post, randomized controlled trial. Sixty-two caregivers and their 5-11-year-old child with uncontrolled asthma, defined as scoring ≤19 on the Childhood Asthma Control Test (C-ACT © 2025 GSK), enrolled in the six-month trial. Caregivers completed digital surveys and health literacy phone screeners at pretest and posttest. Caregiver app utilization and child asthma health were recorded retrospectively, one year prior to enrollment, and throughout the study. App features included asthma symptom tracker, education resources, action plan, air quality index, telehealth, and messages with providers.

Results: Data collection will conclude by the end of 2025. Of the 62 participants enrolled (Table 1), most completed all pretest study activities (82%; n=51). Children's average C-ACT © score (range=0-27, higher numbers indicate better asthma control) at pretest was 16.15 (SD=3.18) and 18.14 (SD=4.52) at posttest. Caregivers' average health literacy score (range=0-6, higher numbers indicate higher health literacy) at pretest was 4.76 (SD=1.23) and 5.11 (SD=1.06) at posttest. Current data indicates 98% of participants used the app, averaging 120.61 log ins (SD=114.64), 3.59 symptom tracker entries (SD=7.73), and 7.28 messages sent (SD=8.19) in a year. Messages (58%) and symptom tracker (45%) were the most frequently used features. Receiving Medicaid was related to more frequent app log ins (r=.26, p<.047) and caregivers of White children tended to send more messages (r=.33, p<.049). Sending more messages was correlated with lower pretest C-ACT (r=-.49, p<.013) and higher posttest health literacy (r=.46, p<.040) scores.

Conclusion(s): Preliminary data indicate caregivers across socioeconomic, racial, and ethnic backgrounds used a digital health app to help manage their child's asthma. This study demonstrates how integrating digital health technologies into asthma care may lead to improved pediatric asthma outcomes. Moreover, findings showcase potential benefits of using digital health to provide care among diverse patient populations.

Table 1. Descriptives of Caregiver-Child Participants