Abstract
BackgroundCommunity-based participatory research is an effective tool for improving health outcomes in minority communities. Few community-based participatory research studies have evaluated methods of optimizing smartphone apps for health technology-enabled interventions in African Americans.ObjectiveThis study aimed to utilize focus groups (FGs) for gathering qualitative data to inform the development of an app that promotes physical activity (PA) among African American women in Washington, DC.MethodsWe recruited a convenience sample of African American women (N=16, age range 51-74 years) from regions of Washington, DC metropolitan area with the highest burden of cardiovascular disease. Participants used an app created by the research team, which provided motivational messages through app push notifications and educational content to promote PA. Subsequently, participants engaged in semistructured FG interviews led by moderators who asked open-ended questions about participants’ experiences of using the app. FGs were audiorecorded and transcribed verbatim, with subsequent behavioral theory-driven thematic analysis. Key themes based on the Health Belief Model and emerging themes were identified from the transcripts. Three independent reviewers iteratively coded the transcripts until consensus was reached. Then, the final codebook was approved by a qualitative research expert.ResultsIn this study, 10 main themes emerged. Participants emphasized the need to improve the app by optimizing automation, increasing relatability (eg, photos that reflect target demographic), increasing educational material (eg, health information), and connecting with community resources (eg, cooking classes and exercise groups).ConclusionsInvolving target users in the development of a culturally sensitive PA app is an essential step for creating an app that has a higher likelihood of acceptance and use in a technology-enabled intervention. This may decrease health disparities in cardiovascular diseases by more effectively increasing PA in a minority population.
Highlights
Cardiovascular disease remains the leading cause of death in the United States, and African Americans bear a disproportionate burden, leading to significant and excessive morbidity and mortality [1,2]
As 62% of all smartphone users access health information via their mobile phones, capitalizing on apps to deliver health interventions may facilitate access to communities with lower health care utilization, such as African Americans [7]. This is substantiated by the finding that African American women are willing to participate in Mobile health technology (mHealth) research that uses technology, such as fitness trackers and smartphone apps [8]
The study sample consisted of 16 African American women with a mean age of 62.1 (SD 6.6) years (Table 1)
Summary
Cardiovascular disease remains the leading cause of death in the United States, and African Americans bear a disproportionate burden, leading to significant and excessive morbidity and mortality [1,2]. Cardiovascular disease risk factors are more prevalent among both low-income and racial or ethnic minority populations, emphasizing the need to design interventions that address these risk factors and, reduce health disparities [1]. National averages for women and African Americans are higher, at 29.5% and 26.4%, respectively [3]. A systematic review conducted by Joseph et al found that African American women face unique barriers to PA, including neighborhood safety concerns, financial costs, and hair maintenance, among others [4]. Tailored community-based interventions that combine education, support, and tools to improve cardiovascular health are especially useful when addressing disparities in resource-limited settings [5]. Community-based participatory research is an effective tool for improving health outcomes in minority communities.
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