Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States of America.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, United States of America.
PLoS One. 2019 Aug 20;14(8):e0218724. doi: 10.1371/journal.pone.0218724. eCollection 2019.
Despite improvements in mortality rates over the past several decades, cardiovascular (CV) disease remains the leading cause of death for African-Americans (AAs). Innovative approaches through mobile health (mHealth) interventions have the potential to support lifestyle change for CV disease prevention among AAs. We aimed to translate a behavioral theory-informed, evidence-based, face-to-face health education program into an mHealth lifestyle intervention for AAs. We describe the design and development of a culturally relevant, CV health and wellness digital application (app) and pilot testing using a community-based participatory research (CBPR) approach with AA churches.
This mixed methods study used a 4-phase iterative development process for intervention design with the AA community. Phase 1 included focus groups with AA community members and church partners (n = 23) to gain insight regarding potential app end user preferences. In Phase 2, the interdisciplinary research team synthesized Phase 1 input for preliminary app design and content development. Phase 3 consisted of a sequential 3-meeting series with church partners (n = 13) for iterative app prototyping (assessment, cultural tailoring, final review). Phase 4, a single group pilot study among AA church congregants (n = 50), assessed app acceptability, usability, and satisfaction.
Phase 1 focus groups indicated general and health-related apps preferences: multifunctional, high-quality graphics/visuals, evidence-based, yet simple health information and social networking capability. Phase 2 integrated these preferences into the preliminary app prototype. Phase 3 feedback was used to refine the app prototype for pilot testing. Phase 4 pilot testing indicated high app acceptability, usability, and satisfaction.
This study illustrates integration of formative and CBPR approaches to design a culturally relevant, mHealth lifestyle intervention to address CV health disparities among AAs. Given the positive app perceptions, our study supports the use of an iterative development process by others interested in implementing an mHealth lifestyle intervention for racial/ethnic minority communities.
Clinicaltrials.gov NCT03084822.
尽管在过去几十年中死亡率有所提高，但心血管（CV）疾病仍是非裔美国人（AA）的主要死因。通过移动健康（mHealth）干预措施的创新方法有可能支持 AA 人群预防 CV 疾病的生活方式改变。我们旨在将基于行为理论、循证的面对面健康教育计划转化为针对 AA 的 mHealth 生活方式干预。我们描述了使用基于社区的参与性研究（CBPR）方法与 AA 教堂合作，设计和开发具有文化相关性的 CV 健康和健康数字应用程序（app）的设计和开发。
这项混合方法研究使用了 4 阶段迭代开发过程，用于与 AA 社区的干预设计。第 1 阶段包括与 AA 社区成员和教堂合作伙伴（n = 23）进行焦点小组讨论，以了解潜在应用程序最终用户的偏好。在第 2 阶段，跨学科研究团队综合了第 1 阶段的输入，进行了初步的应用程序设计和内容开发。第 3 阶段由与教堂合作伙伴（n = 13）进行的连续 3 次会议系列组成，用于迭代应用程序原型设计（评估、文化定制、最终审查）。第 4 阶段，在 AA 教堂会众中进行了一项单组试点研究（n = 50），评估了应用程序的可接受性、可用性和满意度。
第 1 阶段的焦点小组表明了对一般和健康相关应用程序的偏好：多功能、高质量的图形/视觉效果、基于证据的但简单的健康信息和社交网络功能。第 2 阶段将这些偏好整合到初步的应用程序原型中。第 3 阶段的反馈用于改进试点测试的应用程序原型。第 4 阶段的试点测试表明，该应用程序具有很高的可接受性、可用性和满意度。
本研究说明了形成性和 CBPR 方法的综合应用，以设计一种针对 AA 人群的具有文化相关性的 mHealth 生活方式干预措施，以解决 CV 健康方面的差异。鉴于对应用程序的积极看法，我们的研究支持其他对为少数族裔社区实施 mHealth 生活方式干预感兴趣的人使用迭代开发过程。
Clinicaltrials.gov NCT03084822。
