A Smartphone App (mDASHNa-CC) to Support Healthy Diet and Hypertension Control for Chinese Canadian Seniors: Protocol for Design, Usability and Feasibility Testing

Abstract

Background This proposed study aims to translate the Dietary Approach to Stop Hypertension with Sodium (Na) Reduction for Chinese Canadians (DASHNa-CC), a classroom-based, antihypertensive, dietary educational intervention, to an innovative smartphone app (mDASHNa-CC). This study will enable Chinese Canadian seniors to access antihypertensive dietary interventions anytime, regardless of where they are. It is hypothesized that senior Chinese Canadians will be satisfied with their experiences using the mDASHNa-CC app and that the use of this app could lead to a decrease in their blood pressure and improvement in their health-related quality of life. Objective The goal of this study is to design and test the usability and feasibility of a smartphone-based dietary educational app to support a healthy diet and hypertension control for Chinese Canadian seniors. Methods A mixed-method two-phase design will be used. The study will be conducted in a Chinese immigrant community in Toronto, Ontario, Canada. Chinese Canadian seniors, who are at least 65 years old, self-identified as Chinese, living in Canada, and with elevated blood pressure, will be recruited. In Phase I, we will design and test the usability of the app using a user-centered approach. In Phase II, we will test the feasibility of the app, including implementation (primary outcomes of accrual and attrition rates, technical issues, acceptability of the app, and adherence to the intervention) and preliminary effectiveness (secondary outcomes of systolic and diastolic blood pressure, weight, waist circumference, health-related quality of life, and health service utilization), using a pilot, two-group, randomized controlled trial with a sample size of 60 participants in a Chinese Canadian community. Results The study is supported by the Startup Research Grant from Nipissing University, Canada. The research ethics application is under review by a university research ethics review board. Conclusions The study results will make several contributions to the existing literature, including illustrating the rigorous design and testing of smartphone app technology for hypertension self-management in the community, exploring an approach to incorporating traditional medicine into chronic illness management in minority communities and promoting equal access to current technology among minority immigrant senior groups. Trial Registration Clinicaltrials.gov NCT03988894; https://clinicaltrials.gov/ct2/show/NCT03988894 International Registered Report Identifier (IRRID) PRR1-10.2196/15545

The Usability of a Smartphone-Based Fall Risk Assessment App for Adult Wheelchair Users: Observational Study

“…On average, the first round of testing in iterative design identifies 85% of usability problems, and the second round identifies an additional 13% [30]. This approach has been successful in the development of various health apps [31][32][33], including 2 recent fall risk apps for older adults [18] and patients with multiple sclerosis [34].…”

Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption

“…Health education technology can help the elderly understand which behaviors affect their health, and to reduce or eliminate the risk factors. Studies by Zou, Richard, et al demonstrate that an app and a web-based system can carry out health education [2,41]. In their study, Zou et al applied a diet education app that provided proper diet knowledge for elderly users, supported them in forming a healthy diet, and controlling hypertension [2].…”

“…Studies by Zou, Richard, et al demonstrate that an app and a web-based system can carry out health education [2,41]. In their study, Zou et al applied a diet education app that provided proper diet knowledge for elderly users, supported them in forming a healthy diet, and controlling hypertension [2]. Richard et al proved that a web-based system can become an educational tool, covering many people using different online platforms.…”

“…In addition, if the users' training willingness can be clarified and their training needs met, the existing digital gap can be addressed, which will be conducive to the promotion of IHMT [13]. In terms of service implementation, collaboration with the community to provide workshops, information sessions, support groups, and social media interviews will promote the use of related apps in the community [2]. Navigation functions can assist in supporting obesity wellness intervention with the advantage of enhancing health promotion in a remote, geographically constrained community [48].…”

“…To date, many scholars have undertaken further research on the use of IHMT in the elderly. For example, by recruiting Chinese Canadians over the age of 65 with hypertension, a previous study used a smartphone application (app) to carry out healthy diet education and control hypertension, to verify the availability and feasibility of the app [2]. The rise and popularity of wearable devices have also promoted relevant research.…”