Designing a Cardiovascular Health App for Citizens Returning from Incarceration: Where You Start May Not Be Where You End Up

Abstract

A mobile health (mHealth) smartphone app can help persons returning from incarceration better manage cardiovascular disease (CVD) and CVD risk factors during their re-entry period. A successful intervention to educate and increase self-efficacy in this population around cardiovascular health has potential to produce broad population health benefits. A participatory design (PD) approach was used to define the features and functionality of such an intervention in the form of a smart phone app. The PD process forced the research team to view CV health in the broader context of other challenges that RCs face day to day. It also led to a broadening of the process to include other stakeholders that work closely with RCs, and to explore how these challenges affect the re-entry process. Ultimately, PD led to an app design that emphasized a common problem-solving approach that can be applied to a broad range of problems. An interactive prototype of the app’s interface was assessed by a sample of RCs, users, with consensus that the problem-areas were appropriate and that the app was easy to use and to navigate. A quantitative assessment with the System Usability Survey instrument, yielded an average score of 81.5, placing it in the 90th percentile.

Attending to cardiovascular disease risk factors after incarceration: A study of empowerment and structural barriers to care

“…Between March and August 2019, 117 individuals participated in the study: 98 people who were formerly incarcerated and family and friends and 19 key informants (see Table 1 [Surkan et al, 2021; Zachary et al, 2020]. )…”

“…We conducted a secondary analysis of qualitative data collected through interviews and interactive discussion forums that focused on experiences of navigating care for CVD and risk factors for CVD after release from incarceration. The primary study explored the health‐related needs of people released from incarceration and if and how those needs could be met through a smartphone application (Surkan, Puglisi, Butler, Elmi, & Zachary, 2021; Zachary et al, 2020). The resulting data provided opportunities for secondary analysis.…”

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

“…Many studies focused on creating and evaluating mobile apps, typically aimed at addressing the needs of patients and consumers. These mobile apps focused on a variety of chronic diseases such as diabetes and hypertension [ 63 , 122 ], cardiovascular health [ 30 , 58 , 121 ], cancer care [ 58 , 127 ], mental health [ 13 , 23 , 25 , 57 , 110 ], seizure management [ 57 ], bladder monitoring [ 56 ], tuberculosis treatment [ 15 ], and parental education [ 40 , 41 ]. A small number of studies focused on telehealth [ 10 , 14 , 140 ] and personal health records or patient portals [ 38 , 109 , 141 ].…”