A partnership between Louisville, Kentucky city leaders, a non-profit, and digital respiratory health company Propeller Health has led to clear improvements in local asthmatic residents’ inhaler use and symptoms, according to a study recently published in Health Affairs. 

Furthermore, data collected and made available through the digital respiratory health company’s crowdsourced platform offered clear policy recommendations that could reduce environmental contaminants and keep these residents healthy, Meredith Barrett, vice president of research at Propeller Health and lead author on the study, and colleagues wrote.

“Cross-sector collaborations that bring together public, private, and philanthropic partners present a useful approach for addressing complex health issues, such as infectious disease, obesity and tobacco use, oral health, and natural disaster preparedness,” the researchers wrote. “However, the knowledge base for developing effective partner-ships and understanding how they create change remains limited. In this study we documented the process and impact of a public-private partnership that successfully tackled the complex public health challenge of asthma.”

Informed by a successful pilot, AIR Louisville — a collaborative team comprised of Louisville government heads; the Institute for Healthy Air, Water, and Soil; and Propeller — devised a 2.5 year study intended to help people control their asthma symptoms, among other goals. The team recruited 497 participants aged four years or older (mean age, 38 years) with self-reported asthma.

Each participant was provided with Propeller’s electronic sensor, which pairs with a standard inhaler and smartphone to capture time- and location-stamped adherence data. Those without a smartphone also received a wireless hub device to ensure data was appropriately collected and transmitted. All of the participants could authorize their health care providers to view data collected by the devices via a secure web dashboard to better inform clinical care.

The researchers found that the frequency of events requiring a dosage of short-acting beta agonists (SABAs) significantly declined over the course of the study period, as did the number frequency of nighttime SABA events and the portion of asthma symptom-free days. Among those with 12 months of follow-up, SABA use declined by 78 percent. That group also saw a 48 percent improvement in the number of symptom-free days.

Feedback from a polled subset of 57 participants showed that 80 percent were satisfied with Propeller’s sensor. Eighty-six percent said they better understood their asthma, and 81 percent were more confident in their ability to avoid severe attacks.

By viewing data collected from the devices, researchers were able to pinpoint regional clusters associated with more frequent SABA use, suggesting that these areas were subject to environmental pollutant exposure. With this data in mind, the team convened a policy summit that included representatives from local city departments, as well as those of other cities.

These meetings led to policy recommendations that included tree removal mitigation, tree canopy enhancement, zoning for air pollution emission buffers, recommended truck routes, and the development of a community asthma notification system. As such, the researchers were hopeful about the impact a multi-stakeholder partnership involving a digital health tool could have on other prevalent diseases.

“This model could be applied in a number of other conditions, such as physical activity, diabetes, cardiovascular disease, cancer, and mental health. We also believe that it can stimulate collective financing to scale public-private partnerships for public good,” the researchers wrote. “There is growing interest in this type of model, and we plan to replicate this model in other regions to strengthen the evidence for local and national policy making.”