Abstract
BackgroundCompared with national averages, rural Appalachians experience extremely elevated rates of premature morbidity and mortality. New opportunities, including approaches incorporating personal technology, may help improve lifestyles and overcome health inequities.ObjectiveThis study aims to gather perspectives on whether a healthy lifestyle intervention, specifically an app originally designed for urban users, may be feasible and acceptable to rural residents. In addition to a smartphone app, this program—Make Better Choices 2—consists of personalized health coaching, accelerometer use, and financial incentives.MethodsWe convened 4 focus groups and 16 key informant interviews with diverse community stakeholders to assess perspectives on this novel, evidence-based diet and physical activity intervention. Participants were shown a slide presentation and asked open-ended follow-up questions. The focus group and key informant interview sessions were audiotaped, transcribed, and subjected to thematic analysis.ResultsWe identified 3 main themes regarding Appalachian residents’ perspectives on this mobile health (mHealth) intervention: personal technology is feasible and desirable; challenges persist in implementing mHealth lifestyle interventions in Appalachian communities; and successful mHealth interventions should include personal connections, local coaches, and educational opportunities. Although viewed as feasible and acceptable overall, lack of healthy lifestyle awareness, habitual behavior, and financial constraints may challenge the success of mHealth lifestyle interventions in Appalachia. Finally, participants described several minor elements that require modification, including expanding the upper age inclusion, providing extra coaching on technology use, emphasizing personal and supportive connections, employing local coaches, and ensuring adequate educational content for the program.ConclusionsBlending new technologies, health coaching, and other features is not only acceptable but may be essential to reach vulnerable rural residents.
Highlights
This paper describes the perceptions of Make Better Choices 2 (MBC2), a multi-component diet and physical activity intervention
We examined Appalachian residents’ perspectives on the feasibility and acceptability of a mobile health (mHealth) intervention that promotes healthy diet and active lifestyle
We focused on the mHealth component of the intervention because other components have been extensively described and characterized in this population
Summary
OverviewThis paper describes the perceptions of Make Better Choices 2 (MBC2), a multi-component diet and physical activity intervention. MBC2 has been shown to improve outcomes in urban population, the program has never been implemented among rural residents [1] In part, this lack of implementation stems from the assumed limited acceptability of, access to, and use of technology, which forms a core component of MBC2. The purpose of this study is to better understand the perceived feasibility and acceptability of the mobile health (mHealth) intervention and adaptations that should be made to improve fit among the rural Appalachian community before implementing the intervention. Results: We identified 3 main themes regarding Appalachian residents’ perspectives on this mobile health (mHealth) intervention: personal technology is feasible and desirable; challenges persist in implementing mHealth lifestyle interventions in Appalachian communities; and successful mHealth interventions should include personal connections, local coaches, and educational opportunities. Conclusions: Blending new technologies, health coaching, and other features is acceptable but may be essential to reach vulnerable rural residents
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