Development of a Living Lab for a Mobile-Based Health Program for Korean-Chinese Working Women in South Korea: Mixed Methods Study

Abstract

Background Korean-Chinese (KC) women make up the largest group of female migrants in South Korea. To prevent and manage chronic diseases in middle-aged KC women working full time, it is necessary to develop health promotion programs that utilize an online platform because such a platform would allow individuals to participate in health promotion interventions at their convenience. Objective This study aimed to develop a living lab for a mobile-based health (LLm Health) program focused on improving the physical activity and cultural adaptation of KC women workers. Methods We used a mixed methods design. Living lab principles were factored into the LLm Health program, including the use of multiple methods, user engagement, multistakeholder participants, real-life settings, and cocreation. The program was developed using the 4 steps of the intervention mapping method: needs assessment, setting of objectives, identification of intervention strategies, and intervention design. Needs assessment was conducted through a literature review, focus group interviews with a total of 16 middle-aged KC women, and an online survey related to health promotion of migrant workers given to 38 stakeholders. KC middle-aged women participated in the early stages of program development and provided the idea of developing programs and mobile apps to enhance physical activity and acculturation. The mobile app developed in the program was validated with the help of 12 KC women and 4 experts, including 3 nursing professors and a professor of physical education. They were asked to rate each item based on content, interface design, and technology on a 4-point scale using a 23-item Smartphone App Evaluation Tool for Health Care. Results The LLm Health program comprised a 24-week walking program using Fitbit devices, the mobile app, and social cognitive interventions. The mobile app contained 6 components: a step counter, an exercise timer, an online chat function, health information, level of cardiovascular risk, and health status. The cultural aspects and lifestyles of KC women were accommodated in the entire process of program development. The content validity of the mobile app was found to be 0.90 and 0.96 according to the 12 KC women and 4 experts, respectively. Conclusions The mobile app was found to be valid and acceptable for KC women. The living lab approach was a useful strategy for developing a culturally adaptive LLm Health program for KC women workers, leading to their active participation in the overall research process, including needs assessment, program composition, and pre-evaluation.

Factors Influencing Physical Activity Participation among Midlife Immigrant Women: A Systematic Review

“…Five (23%, 5/22) studies incorporated various logistical adjustments by implementing interventions at convenient locations and appropriate times with features such as childcare services and transportation vouchers [ 27 , 33 , 39 , 40 , 43 ]. Most of the included studies that were conducted in-person took place in convenient settings such as community centers, religious centers and even individual participant homes which were agreed upon by researchers and participants.…”

“…Another study conducted among midlife Korean–Chinese women found that both location and time were convenient for participants when orientations and assessments were performed at a migrant resource center on Sundays [ 27 ]. These findings regarding setting convenience were in contrast to the findings of an mHealth physical activity intervention among Korean–Chinese immigrant women, which suggested that home-based or mobile interventions were more feasible for a cohort of midlife immigrant women in place of on-site interventions, due to convenience [ 43 ]. Complimentary services and incentives were also provided to participants throughout the intervention via transportation vouchers and childcare services [ 33 , 40 ].…”

“…Five (23%, 5/22) studies utilized mobile-based technologies for various purposes including intervention administration, and motivational or assistive reminders [ 40 , 42 , 43 , 44 , 45 ]. The administration of a walking intervention among Korean–Chinese midlife women found that the use of a mobile-phone-based pedometer was practical for accurately self-monitoring daily physical activity [ 44 ].…”

“…The administration of a walking intervention among Korean–Chinese midlife women found that the use of a mobile-phone-based pedometer was practical for accurately self-monitoring daily physical activity [ 44 ]. Another mHealth intervention among Korean–Chinese midlife immigrant women found that administering an intervention through phones was cost-effective since over 91% of individuals in the study region utilized smartphones [ 43 ]. In addition, smartphone technology was utilized for the purposes of information sharing, motivation, or assistance with engaging in physical activity [ 40 , 42 , 43 , 44 , 45 ].…”

Network Support Using Social Networking Services to Increase Exercise Adherence Among Korean-Chinese Middle-Aged Migrant Women: Mixed Methods Study

“…A community-based project was conducted to improve physical and mental health of KC migrant women through a 6-month, culturally adaptive, mobile app–based walking intervention between May 2017 and February 2019 [ 29 ]. For recruiting participants, we visited a public health center, the Korea Support Center for Foreign Workers, and a KC church; distributed leaflets; and promoted the health intervention program.…”