Effective deployment of technology-supported management of chronic respiratory conditions: a call for stakeholder engagement

Figures & data

Figure 1 Sources of health and contextualising data other than disease-specific apps or devices.

Figure 2 Number of available mobile phone applications for asthma.

Note: Data from Burbank et al and Wu et al.^21,57

Figure 3 Technology-based solutions can be considered in terms of current technical capability, clinical requirement, and commercial demand.

Table 1 World Health Organization mERA reporting checklist for respiratory studies

Criteria	Item no	Notes
Infrastructure (population level)	1	Clearly presents the availability of infrastructure to support technology operations in the study location. This refers to physical infrastructure such as electricity, access to power, connectivity etc. in the local context. Reporting X% network coverage rate in the country is insufficient if the study is not being conducted at the country level
Technology platform	2	Describes and provides justification for the technology architecture. This includes a description of software and hardware and details of any modifications made to publicly available software
Interoperability/HIS context	3	Describes how mHealth intervention can integrate into existing health information systems. Refers to whether the potential of technical and structural integration into existing HIS or program has been described, irrespective of whether such integration has been achieved by the existing system
Intervention delivery	4	The delivery of the mHealth intervention is clearly described. This should include frequency of mobile communication, mode of delivery of intervention (that is, SMS, face-to-face, interactive voice response), timing and duration over which delivery occurred
Intervention content	5	Details of the content of the intervention are described. Source and any modifications of the intervention content is described
Usability/content testing	6	Describe formative research and/or content and/or usability testing with target group(s) clearly identified, as appropriate
User feedback	7	Describes user feedback about the intervention or user satisfaction with the intervention. User feedback could include user opinions about content or user interface, their perceptions about usability, access, connectivity, etc
Access of individual participants	8	Mentions barriers or facilitators to the adoption of the intervention among study participants. Relates to individual-level structural, economic and social barriers or facilitators to access such as affordability, and other factors that may limit a user’s ability to adopt the intervention
Cost assessment	9	Presents basic costs assessment of the mHealth intervention from varying perspectives. This criteria broadly refers to the reporting of some cost considerations for the mHealth intervention in lieu of a full economic analysis. If a formal economic evaluation has been undertaken, it should be mentioned with appropriate references. Separate reporting criteria are available to guide economic reporting
Adoption inputs/program entry	10	Describes how people are informed about the program, including training, if relevant. Includes description of promotional activities and/or training required to implement the mHealth solution among the user population of interest
Limitations for delivery at scale	11	Clearly presents mHealth solution limitations for delivery at scale
Contextual adaptability	12	Describes the adaptation, or not, of the solution to a different language, different population or context. Any tailoring or modification of the intervention that resulted from pilot testing/usability assessment is described
Replicability	13	Detailed intervention to support replicability. Clearly presents the source code/screenshots/flowcharts of the algorithms or examples of messages to support replicability of the mHealth solution in another setting
Data security	14	Describes the data security procedures/confidentiality protocols
Compliance with national guidelines or regulatory statutes	15	Mechanism used to assure that content or other guidance/information provided by the intervention is in alignment with existing national/regulatory guidelines and is described
Fidelity of the intervention	16	Was the intervention delivered as planned? Describe the strategies employed to assess the fidelity of the intervention. This may include assessment of participant engagement, use of backend data to track message delivery and other technological challenges in the delivery of the intervention

Abbreviations: HIS, health information systems; mERA, mHealth Evidence Reporting and Assessment.

HuckvaleKMorrisonCOuyangJGhaghdaACarJThe evolution of mobile apps for asthma: an updated systematic assessment of content and toolsBMC Med2015135825857569

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WuACCarpenterJFHimesBEMobile health applications for asthmaJ Allergy Clin Immunol Pract201533446448e441e41625725939

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