Objective Medication non-adherence is linked to adverse clinical outcomes (i.e. rehospitalization, mortality) among patients with coronary heart disease. Given its global adoption and growing popularity among older adults, mobile technology may be an effective strategy to improve medication adherence. The aim of this article is to present the perceptions, attitudes, and beliefs of individuals with coronary heart disease about using text messaging and mobile phone applications for medication adherence. Methods We recruited 28 participants (veterans and non-veterans) with a history of coronary heart disease and antiplatelet medication use in Northern California. We formed six focus groups of individuals who participated in three sessions (total 18 sessions). We analyzed our data using grounded theory. Results The median age was 69.5 ± 10.8 years for non-veterans (50% male) and 70 ± 8.6 years for veterans (100% male). In the first session, we found that participants perceived text message reminders as a convenient, easy, and flexible tool to establish a routine for taking medications. In the second session, participants were eager to use applications for their greater interactivity, individualized health monitoring, and personalized medication information. The third session, participants shared preferred features (i.e. drug interactions, tracking symptoms) after using two applications at home for 2 weeks. Conclusions Older adults are engaged and can be proficient mobile technology users. Text messaging and mobile phone applications are perceived as helpful tools for medication adherence. Future research should include rigorous clinical trials to test the efficacy of mobile health technology to promote medication adherence in populations that require strict medication adherence.
Breast cancer among Filipinas in the United States is a major but largely neglected cancer disparity. In 2004, a community– university partnership resulted in the first Filipina breast cancer support group in the San Francisco Bay Area. Building on this partnership, we explored the social and cultural contexts of Filipinas’ experiences with breast cancer to inform development of culturally appropriate and sustainable support services and outreach. We utilized multiple qualitative methods (participant observation, individual and small group in-depth qualitative interviews) to identify meanings of survivorship and support. Interviews and observations revealed the influences of social context and immigration experiences on women’s understandings of cancer, what “surviving” cancer means, and what it means to take care of someone with breast cancer (or be taken care of). Our findings highlight the importance of a transnational perspective for the study of immigrant women’s experiences of cancer and survivorship.
San Francisco Bay Area Filipinas with breast cancer underutilize support services. Our partnership engaged in community-based participatory research (CBPR) that involved formation of a community advisory board (CAB) representing low-income, low-English-proficient Filipinas with breast cancer. While CABs are a standard component of CBPR projects, the process of establishing and fostering CAB involvement has been under studied. This commentary explores the process our team used—building upon the Filipino cultural method of pakikisama which stresses making the other feel welcome, safe, and nurtured—to overcome barriers to active engagement. Challenges included minimizing power imbalances between the research team and CAB, and the establishment of an environment of familiarity, trust and caring among CAB members. We recorded all CAB meetings, transcribed them verbatim, and Tagalog portions were transcribed into English for analysis. Mobilizing pakikisama supported partnership building and allowed CAB members to engage in inclusive dialogue and formulate a culturally relevant support model.
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