Prescribable mHealth apps using built-in smartphone sensors : A mixed methods study into improving usability of & access to respiratory apps for diagnosis and therapy

Background: Clinicians are cautious about embracing prescription of health and well-being (i.e., mHealth) smartphone apps to patients, citing a lack of evidence regarding safety, reliability and clinical validity as barriers to wider adoption. This doctoral research concerns a new mHealth app (QUT Inspire) which virtualises a longstanding respiratory therapy technique called Incentive Spirometry (i.e., ISy); this new app detects inspired breath using the phone microphone and displays responsive animated on-screen graphics to encourage effort and persistence with ISy therapy. Methodology: In this mixed methods research, a systematic survey of curated (i.e., trusted) health app libraries was conducted to assess availability of “prescribable” smartphone mHealth apps using built-in phone sensors. The technical validity and reliability of the new QUT Inspire app was assessed in non-human quantitative bench testing studies, using mechanical and acoustic simulations of inspiration. Human studies in disease-free subjects will commence in early 2021 to evaluate QUT Inspire performance compared with existing clinical ISy devices, in addition to semi-structured interviews with participants to assess the utility of interface design enhancements such as gamification features. Results/Expected Results: A paucity of “trusted” mHealth apps using built-in phone sensors (n=18) was identified in a systematic survey conducted in late 2019 (Baxter et. al., 2020). Bench testing of the new QUT Inspire app yielded insights into factors contributing to app performance (in press). These included optimal mouth diameter, flow rate and spacing between user and phone for optimal sound detection. It is hoped that human studies will inform interface and gamification refinements to the new app, to improve usability. Conclusion: This research contributes original knowledge in the fields of smartphone mHealth app development, evaluation and interface refinement, offering evidence supporting broader adoption of mHealth for prescription to patients