Interventions To Help Asthma Clinical Adherence

The primary hypothesis is to conduct a pilot test to estimate the effect of the SmartInhaler
device in improving daily asthma controller medication adherence rates in children with
monolingual Spanish- speaking guardians who have LEP during a six-week intervention period
when compared to baseline medication adherence rates in a preceding six-week run-in period.
The secondary hypothesis is to determine whether the patient reminder system can improve
asthma symptom control during the same six-week intervention period. The third hypothesis is
to assess if there are specific, patient behavior characteristics which are associated with
the success of a novel asthma medication reminder system.

Inclusion Criteria:

1. The investigators will recruit 30 participants ages 5 to 17 years with a diagnosis of
persistent asthma who require a daily inhaled corticosteroid metered dose inhaler and
whose guardian is the person responsible for administering their daily asthma
medication.

2. The investigators will recruit only participants who have received or receive care at
San Francisco General Hospital's 6M Children's Health Center.

3. The investigators will recruit participants whose daily inhaled corticosteroid are
metered dose inhalers (MDI) of either Flovent (fluticasone propionate) HFA
(Hydrofluoroalkane) or Qvar (beclamethasone dipropionate) HFA.

4. The Investigators will recruit only participants whose guardian responsible for
administering their daily asthma medication has Limited English Proficiency (LEP) and
whose primary language is Spanish.

Exclusion Criteria:

1. The Investigators will exclude participants whose guardian responsible for
administering their daily asthma medication does not have a Bluetooth enabled cell
phone capable of receiving text messages.

2. The Investigators will exclude participants whose guardian responsible for
administering their daily asthma medication does not have an available reliable power
outlet where they can recharge the battery of their SmartInhaler.

3. The Investigators will exclude participants whose guardian responsible for
administering their daily asthma medication is unable to demonstrate correct
medication technique based on standard evaluation (Press, 2011) after completion of a
standard teaching protocol.

4. The Investigators will exclude participants with chronic lung disease.

5. The Investigators will exclude participants who do not have an operating system of iOS
or Android on their cell phone and who have no data plan with their cellular phone
plan.

6. The Investigators will exclude participants whose asthma medication regimen is being
managed by an asthma subspecialist or health provider outside of the 6M Children's
Health Center at San Francisco General Hospital.

7. The Investigators will exclude participants who are using an inhaled long acting
beta-agonist (LABA) as part of their asthma management plan.