Guidelines to Establish an Equitable Mobile Health Ecosystem

Fortuna, Karen L.; Kadakia, Arya; Cosco, Theodore D.; Rotondi, Armando J.; Nicholson, Joanne; Mois, George; Myers, Amanda; Hamilton, Jennifer; Brewer, LaPrincess C; Collins-Pisano, Caroline; Barr, Paul; Hudson, Matthew F.; Joseph, Kalisa; Mullaly, Christa; Booth, Mark; Lebby, Stephanie R; Walker, R. M.

doi:10.1176/appi.ps.202200011

Cited by 9 publications

(6 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Taken together, our findings highlight the potential for Our Plan, as a couples-based DHI by potential implementers in community settings. Study findings also highlighted importance of utilizing Health Equity Implementation Frameworks in the development-implementation process ( 43 - 45 ). Implementation determinants were often intertwined with principles of social justice.…”

Section: Discussionmentioning

confidence: 88%

Understanding the potential implementation determinants of Our Plan: a couples-based digital human immunodeficiency virus prevention intervention for same-gender male couples

Gamarel,

Rodriguez-Bañuelos,

Ubong

et al. 2024

mHealth

View full text Add to dashboard Cite

Background There has been a proliferation of digital health interventions (DHIs) focused on addressing human immunodeficiency virus (HIV) prevention and treatment outcomes, including couples-based interventions with same-gender male couples. However, the barriers and facilitators of implementing couples-based HIV and sexually transmitted infection (STI) prevention interventions using digital platforms in community-based organizations remains largely unknown. The goal of this study was to explore the implementation determinants of Our Plan, a couples-based DHI designed for new relationships of same-gender male couples and dyadic, sexual partnerships. Methods Qualitative interviews were conducted with 40 organization leaders, healthcare providers, and staff at acquired immunodeficiency syndrome (AIDS)-service and community-based organizations in 13 states serving populations in Ending the HIV Epidemic jurisdictions. Interview items and follow-up questions were guided by the Consolidated Framework for Implementation Research (CFIR) to inquire about implementation determinants of Our Plan. Results Most participants highlighted several relative advantages of Our Plan: increasing capacity to support couples, potential synergy with existing programs, and opportunities to increase patient engagement. Participants also discussed relative disadvantages: misalignment with organizational values in the provision of patient-centered models of care and low interest from some priority populations. Participants emphasized the need for adaptability of Our Plan to fit within their local contexts, which encompassed support for both implementers and end-users, cultural tailoring, and privacy and security features. The desired evidence needed to implement Our Plan focused on data on impact, acceptability, and usability and functionality from communities most heavily impacted by the HIV epidemic. The majority of participants described how Our Plan could be integrated within service delivery and aligned with their organization’s aspirational values; however, some noted that their organizational culture valued in-person interactions, particularly among patients experiencing structural vulnerabilities. Finally, participants discussed how the implementation of Our Plan would require additional training and funding for staff to support end-users and a relationship with the developers so that they could demonstrate their investment in the communities that their organizations served. Conclusions Our Plan was deemed a promising tool among potential implementers. To ensure optimal implementation and organizational fit, Our Plan refinement and evaluation must include implementers and end-users most impacted by the HIV epidemic throughout the entire process.

show abstract

Section: Discussionmentioning

confidence: 88%

Understanding the potential implementation determinants of Our Plan: a couples-based digital human immunodeficiency virus prevention intervention for same-gender male couples

Gamarel,

Rodriguez-Bañuelos,

Ubong

et al. 2024

mHealth

View full text Add to dashboard Cite

show abstract

“…Universal design is “the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.” Universal design is incorporated to support the readability and learnability of health-related information. It is accessible to people with varying literacy levels and impairments in vision and hearing, including people with SMI . This framework can improve usability and learnability (eg, by reducing memory and cognitive loads).…”

Section: Resultsmentioning

confidence: 99%

“…It is accessible to people with varying literacy levels and impairments in vision and hearing, including people with SMI. 54 This framework can improve usability and learnability (eg, by reducing memory and cognitive loads).…”

Section: Recommendationsmentioning

confidence: 99%

Lived Experience–Led Research Agenda to Address Early Death in People With a Diagnosis of a Serious Mental Illness

Fortuna,

Lebby,

Geiger

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportancePeople with serious mental illness (SMI), defined as a diagnosis of schizophrenia spectrum disorder, bipolar disorder, or disabling major depressive disorder) die approximately 10 to 25 years earlier than the general population.ObjectiveTo develop the first-ever lived experience–led research agenda to address early mortality in people with SMI.Evidence ReviewA virtual 2-day roundtable comprising 40 individuals convened on May 24 and May 26, 2022, and used a virtual Delphi method to arrive at expert group consensus. Participants responded to 6 rounds of virtual Delphi discussion via email that prioritized research topics and agreement on recommendations. The roundtable was composed of individuals with lived experience of mental health and/or substance misuse, peer support specialists, recovery coaches, parents and caregivers of people with SMI, researchers and clinician-scientists with and without lived experience, policy makers, and patient-led organizations. Twenty-two of 28 (78.6%) of the authors who provided data represented people with lived experiences. Roundtable members were selected by reviewing the peer-reviewed and gray literature on early mortality and SMI, direct email, and snowball sampling.FindingsThe following recommendations are presented in order of priority as identified by the roundtable participants: (1) improve the empirical understanding of the direct and indirect social and biological contributions of trauma on morbidity and early mortality; (2) advance the role of family, extended families, and informal supporters; (3) recognize the importance of co-occurring disorders and early mortality; (4) redefine clinical education to reduce stigma and support clinicians through technological advancements to improve diagnostic accuracy; (5) examine outcomes meaningful to people with an SMI diagnosis, such as loneliness and sense of belonging, and stigma and their complex relationship with early mortality; (6) advance the science of pharmaceuticals, drug discovery, and choice in medication use; (7) use precision medicine to inform treatment; and (8) redefine the terms system literacy and health literacy.Conclusions and RelevanceThe recommendations of this roundtable are a starting point for changing practice and highlighting lived experience–led research priorities as an option to move the field forward.

show abstract

“…80 , 81 This highlights the importance of ongoing efforts to address the digital divide. 82 , 83 Participants will be recruited from academic medical centers, which may limit generalizability to medically underserved populations. In addition, because of constraints of the intervention platform at this time, this study could not accommodate non–English‐speaking individuals, a population that is highly underrepresented in CR programs.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Adherence Rates of a Novel Community‐Informed Virtual World‐Based Cardiac Rehabilitation Program: Protocol for the Destination Cardiac Rehab Randomized Controlled Trial

Brewer,

Abraham,

Clark

et al. 2023

JAHA

Self Cite

View full text Add to dashboard Cite

Background Innovative restructuring of cardiac rehabilitation (CR) delivery remains critical to reduce barriers and improve access to diverse populations. Destination Cardiac Rehab is a novel virtual world technology‐based CR program delivered through the virtual world platform, Second Life, which previously demonstrated high acceptability as an extension of traditional center‐based CR. This study aims to evaluate efficacy and adherence of the virtual world–based CR program compared with center‐based CR within a community‐informed, implementation science framework. Methods Using a noninferiority, hybrid type 1 effectiveness‐implementation, randomized controlled trial, 150 patients with an eligible cardiovascular event will be recruited from 6 geographically diverse CR centers across the United States. Participants will be randomized 1:1 to either the 12‐week Destination Cardiac Rehab or the center‐based CR control groups. The primary efficacy outcome is a composite cardiovascular health score based on the American Heart Association Life's Essential 8 at 3 and 6 months. Adherence outcomes include CR session attendance and participation in exercise sessions. A diverse patient/caregiver/stakeholder advisory board was assembled to guide recruitment, implementation, and dissemination plans and to contextualize study findings. The institutional review board–approved randomized controlled trial will enroll and randomize patients to the intervention (or control group) in 3 consecutive waves/year over 3 years. The results will be published at data collection and analyses completion. Conclusions The Destination Cardiac Rehab randomized controlled trial tests an innovative and potentially scalable model to enhance CR participation and advance health equity. Our findings will inform the use of effective virtual CR programs to expand equitable access to diverse patient populations. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT05897710.

show abstract

Guidelines to Establish an Equitable Mobile Health Ecosystem

Cited by 9 publications

References 46 publications

Understanding the potential implementation determinants of Our Plan: a couples-based digital human immunodeficiency virus prevention intervention for same-gender male couples

Understanding the potential implementation determinants of Our Plan: a couples-based digital human immunodeficiency virus prevention intervention for same-gender male couples

Lived Experience–Led Research Agenda to Address Early Death in People With a Diagnosis of a Serious Mental Illness

Efficacy and Adherence Rates of a Novel Community‐Informed Virtual World‐Based Cardiac Rehabilitation Program: Protocol for the Destination Cardiac Rehab Randomized Controlled Trial

Contact Info

Product

Resources

About