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Although mobile apps can support self-management in chronic diseases, there is little evidence that this approach applies to people with limited health literacy. We aimed to determine the acceptability of a self-management app in adults living with asthma and have limited health literacy and the feasibility of delivering the intervention and assessing outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We recruited eligible adults from the Klang Asthma Cohort registry in primary care for a 3-month mixed-method study plus a 2-month extended observation. We collected baseline data on socio-demography, health literacy and asthma control level. The outcomes of the intervention were assessed at 1- and 3-month: i) adoption (app download and usage), ii) adherence (app usage), iii) retention (app usage in the observation period), iv) health outcomes (e.g., severe asthma attacks) and v) process outcomes (e.g., ownership and use of action plans). At 1-month, participants were purposively sampled for in-depth interviews, which were audio-recorded, transcribed verbatim, and analysed deductively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We recruited 48 participants; 35 participants (23 Female; median age\u2009=\u200943\u00a0years; median HLS score\u2009=\u200928) completed the 3\u00a0months study. Of these, 14 participants (10 Female; median age\u2009=\u200948\u00a0years; median HLS score\u2009=\u200928) provided interviews. Thirty-seven (77%) participants adopted the app (downloaded and used it in the first month of the study). The main factor reported as influencing adoption was the ease of using the app. A total of 950 app usage were captured during the 3-month feasibility study. App usage increased gradually, peaking at month 2 (355 total log-ins) accounting for 78% of users. In month 5, 51.4% of the participants used the app at least once. The main factors influencing continued use included adherence features (e.g., prompts and reminders), familiarity with app function and support from family members.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>An asthma self-management app intervention was acceptable for adults with limited health literacy and it was feasible to collect the desired outcomes at different time points during the study. A future trial is warranted to estimate the clinical and cost-effectiveness of the intervention and to explore implementation strategies.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-023-02300-6","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T05:02:37Z","timestamp":1695790957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A self-management app to improve asthma control in adults with limited health literacy: a mixed-method feasibility study"],"prefix":"10.1186","volume":"23","author":[{"given":"Hani","family":"Salim","sequence":"first","affiliation":[]},{"given":"Ai Theng","family":"Cheong","sequence":"additional","affiliation":[]},{"given":"Sazlina","family":"Sharif-Ghazali","sequence":"additional","affiliation":[]},{"given":"Ping Yein","family":"Lee","sequence":"additional","affiliation":[]},{"given":"Poh Ying","family":"Lim","sequence":"additional","affiliation":[]},{"given":"Ee Ming","family":"Khoo","sequence":"additional","affiliation":[]},{"given":"Norita","family":"Hussein","sequence":"additional","affiliation":[]},{"given":"Noor Harzana","family":"Harrun","sequence":"additional","affiliation":[]},{"given":"Bee Kiau","family":"Ho","sequence":"additional","affiliation":[]},{"given":"Hilary","family":"Pinnock","sequence":"additional","affiliation":[]},{"name":"RESPIRE Collaboration","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"2300_CR1","unstructured":"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. 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This study also received sponsorship approval from the Academic and Clinical Central Office for Research & Development (ACCORD) at the University of Edinburgh. Informed consent was obtained from all the individuals participating in the study. All methods were performed in accordance with relevant local and international guidelines and regulations. This study was reported following the Good Reporting of a Mixed Methods Study (GRAMMS) checklist.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"HP, EMK, ATC, SSG, and NH report grants and HS received PhD sponsorship from the UK National Institute for Health and Care Research (NIHR) (Global Health Research Unit on Respiratory Health, RESPIRE); 16\/136\/109. HP reports personal fees from Boehringer-Ingelheim for a lecture on \u2018Supported self-management for asthma\u2019. EMK reports personal fees from AstraZeneca and is the President of the International Primary Care Respiratory Group and the Primary Care Respiratory Group Malaysia. All other authors had no competing interest in the conduct of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"194"}}