Engaging African American Parents to Develop a Mobile Health Technology for Breastfeeding: KULEA-NET

Abstract

Background African Americans breastfeed less than other groups, which has implications for health throughout the life course. Little is known about mobile health technologies to support breastfeeding. Research aims This study proceeded in two phases. The aim of Phase 1 was to identify ideal technological components and content of a mobile health intervention. The aim of Phase 2 was to determine the usability of a prototype, KULEA-NET, based on the Phase 1 findings. Methods For this mixed-methods study, we used community-based participatory research methods and user-centered technology design methods. We used open coding in NVivo 11 to organize data from focus groups and in-depth interviews, then we analyzed the data. We then developed a prototype and tested the prototype’s usability with the System Usability Scale. Fifty pregnant and postpartum African Americans from the District of Columbia participated. Results Participants preferred an app with text messaging technology and identified areas for intervention: self-efficacy, parent-child attachment beliefs, social support, public breastfeeding and social desirability, and returning to work. Desired features included local resources, support person access, baby care logs, identification of public breastfeeding venues, and peer discussions. The System Usability Scale score was 73.8, which indicates above average usability. Conclusions A mobile health technology like KULEA-NET can be used to meet the breastfeeding needs of African Americans, build social desirability, and complement traditional health care. The appeal of an African American-specific intervention is unclear. Responding to mixed feeding practices is challenging. KULEA-NET is a mobile breastfeeding intervention guided by the preferences of African American parents and offers promising usability metrics.

Exploring Views of Technology to Inform Maternal and Child Health Interventions for Black Birthing People

“…Like our focus group participants, women in this study asked for peer discussions as a feature of mobile health technology. 13 In a study looking at technology and COVID-19 communications, investigators found that Black respondents were more likely than NHW respondents to report posting COVID-19-related content on social media. 14 Understanding technological challenges and engagement in populations of interest is critical to ensure that technology is utilized to improve healthcare for all.…”

Consumer Health Informatics for Racial and Ethnic Minoritized Communities: Minor Progress, Major Opportunities

“…A total of twenty articles were included in the review [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. A significant portion of the included articles were original research (n=18) [13,[15][16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32]. One perspective piece and one review were also included [14,27].…”

“…The articles that focused on general technologies explored the inclusion and specific views of Consumer Health Informatics for Racial and Ethnic Minoritized Communities: Minor Progress, Major Opportunities racial and ethnic minoritized populations [18,19,27]. Though most literature had a particular emphasis on African Americans [13,14,16,21,[23][24][25]28], there is still a dearth of literature focused on designing consumer health IT for this community. There were significantly fewer articles focused on indigenous communities [15,17,20,30,31] and Hispanic populations [22].…”

“…Many of the articles reviewed were pilot feasibility studies [13, 16, 21-23, 25, 26, 28, 32]. A significant proportion evaluated the feasibility and acceptability of mobile health, including both text-based and app-based interventions [13,16,22,23,25,26,32]. A few evaluated telehealth systems [21,28].…”

“…In terms of interface, one study discussed incorporating branding with which the intended user population identified with [23]. Other considerations for cultural tailoring included using a platform that would be accepted by the study population, such as a preference for text messages [22,25]. With regards to evaluating cultural tailoring, one study reported that the participants thought the intervention was ethical and appropriate for the intended population [22].…”