Making of Mobile SunSmart: Co-designing a Just-in-Time Sun Protection Intervention for Children and Parents

Huh, Jimi; Lee, Kung Jin; Roldan, Wendy; Castro, Yasmine; Kshirsagar, Saurabh; Rastogi, Pankhuri; Kim, Ian; Miller, Kimberly A.; Cockburn, Myles; Yip, Jason

doi:10.1007/s12529-021-09987-9

Cited by 7 publications

(3 citation statements)

References 66 publications

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“…While meta-analysis of mHealth interventions demonstrates significant improvements in a range of paediatric health behaviours and outcomes, there are relatively few examples that apply adaptive intervention techniques 33. Studies of asthma and promotion of physical activity provide promising early evidence 28 34 35. Where RE-PACT is unique is in the application of a JITAI framework to the complex care clinic, inclusion of both families and care providers in the decision rule algorithm and the deep reliance on user-centred design principles.…”

Section: Discussionmentioning

confidence: 99%

Barriers to and facilitators of a just-in-time adaptive intervention for respiratory illness in cerebral palsy: a qualitative study

Singh-Verdeflor,

Kloster,

Lerner

et al. 2023

BMJ Open

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ObjectiveTo understand caregiver, healthcare professional and national expert perspectives on implementation of a just-in-time adaptive intervention, RE-PACT (Respiratory Exacerbation-Plans for Action and Care Transitions) to prevent respiratory crises in severe cerebral palsy.DesignQualitative research study.SettingPaediatric complex care programmes at two academic medical institutions.ParticipantsA total of n=4 focus groups were conducted with caregivers of children with severe cerebral palsy and chronic respiratory illness, n=4 with healthcare professionals, and n=1 with national experts.MethodsParticipants viewed a video summarising RE-PACT, which includes action planning, mobile health surveillance of parent confidence to avoid hospitalisation and rapid clinical response at times of low confidence. Moderated discussion elicited challenges and benefits of RE-PACT’s design, and inductive thematic analysis elicited implementation barriers and facilitators.ResultsOf the 19 caregivers recruited, nearly half reported at least one hospitalisation for their child in the prior year. Healthcare professionals and national experts (n=26) included physicians, nurses, respiratory therapists, social workers and researchers. Four overarching themes and their barriers/facilitators emphasised the importance of design and interpersonal relationships balanced against health system infrastructure constraints. Intervention usefulness in crisis scenarios relies on designing action plans for intuitiveness and accuracy, and mobile health surveillance tools for integration into daily life. Trust, knowledge, empathy and adequate clinician capacity are essential components of clinical responder-caregiver relationships.ConclusionsRE-PACT’s identified barriers are addressable. Just-in-time adaptive interventions for cerebral palsy appear well-suited to address families’ need to tailor intervention content to levels of experience, preference and competing demands.

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Section: Discussionmentioning

confidence: 99%

Barriers to and facilitators of a just-in-time adaptive intervention for respiratory illness in cerebral palsy: a qualitative study

Singh-Verdeflor,

Kloster,

Lerner

et al. 2023

BMJ Open

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“…While limited improvements were seen in attitudes on tanning, this study was unique its use of discussions with the target audience (10 th grade students) to develop and revise the intervention [ 85 ]. Similarly, Huh et al held discussions with children and parents from predominantly Hispanic local communities in California to co-design a mobile SunSmart application that incorporated games, location sensing, and real-time adaptive reminders [ 103 ]. Zhou et al’s interventional trial on college students in Longyan, China fostered the intention to use sunscreen among participants by having them devise individualized action plans for using sunscreen and coping plans to address anticipated barriers [ 104 ].…”

Section: Methodsmentioning

confidence: 99%

Reinforcing Photoprotection for Skin of Color: A Narrative Review

Tsai¹,

Chien²

2023

Dermatol Ther (Heidelb)

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Skin of color (SOC) is characterized by increased tendency for tanning and decreased likelihood of sunburns due to the attenuation of sunlight by epidermal melanin. Although this contributes to the decreased incidence of skin cancer among SOC populations, individuals with SOC remain susceptible to various health consequences associated with sun exposure, including non-melanoma skin cancer, photoaging, pigmentary disorders, and photodermatoses — many of which not only present differently, but also disproportionately affect SOC. Prior epidemiological studies have found lower prevalence of sun protection behaviors among individuals with SOC, particularly in sunscreen use, signifying an unmet area for improvement in the prevention of sun-induced dermatologic conditions in these populations. The objective of this narrative review was to summarize the biology and health consequences of sun exposure in SOC, as well as cognitive and behavioral factors that affect the practice of photoprotection behaviors in SOC populations. We also review prior interventions that have been used to enhance photoprotection knowledge and behaviors among individuals with SOC, either in racially and ethnically diverse communities or within specific SOC populations.

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“…Only a few studies have documented the design process of sun protection digital interventions [26][27][28]. As part of our intervention work to improve sun safety among children from diverse backgrounds [29], this study sought to address the following research questions (RQs) on JITAIs; co-design; and working with historically marginalized families, including Black, Indigenous, and people of color (BIPOC) children and adults, with regard to improving sun protection behaviors: (1) What are the value tensions that occur as families co-design new technologies supporting sun-protective behavior changes? (RQ 1), (2) How can co-design methods and techniques be used to center the lived experiences of children and parents in health behavioral intervention projects?…”

Section: Introductionmentioning

confidence: 99%

Co-design Tensions Between Parents, Children, and Researchers Regarding Mobile Health Technology Design Needs and Decisions: Case Study

Yip¹,

Oh²,

Sultan³

et al. 2023

JMIR Form Res

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Background Just-in-time adaptive interventions (JITAIs) in mobile health are an intervention design that provides behavior change support based on an individual’s changing and dynamic contextual state. However, few studies have documented how end users of JITAI technologies are involved in their development, particularly from historically marginalized families and children. Less is known for public health researchers and designers of the tensions that occur as families negotiate their needs. Objective We aimed to broaden our understanding of how historically marginalized families are included in co-design from a public health perspective. We sought to address research questions surrounding JITAIs; co-design; and working with historically marginalized families, including Black, Indigenous, and people of color (BIPOC) children and adults, regarding improving sun protection behaviors. We sought to better understand value tensions in parents’ and children’s needs regarding mobile health technologies and how design decisions are made. Methods We examined 2 sets of co-design data (local and web-based) pertaining to a larger study on mobile SunSmart JITAI technologies with families in Los Angeles, California, United States, who were predominantly of Latinx and multiracial backgrounds. In these co-design sessions, we conducted stakeholder analysis through perceptions of harms and benefits and an assessment of stakeholder views and values. We open coded the data and compared the developed themes using a value-sensitive design framework by examining value tensions to help organize our qualitative data. Our study is formatted through a narrative case study that captures the essential meanings and qualities that are difficult to present, such as quotes in isolation. Results We presented 3 major themes from our co-design data: different experiences with the sun and protection, misconceptions about the sun and sun protection, and technological design and expectations. We also provided value flow (opportunities for design), value dam (challenges to design), or value flow or dam (a hybrid problem) subthemes. For each subtheme, we provided a design decision and a response we ended up making based on what was presented and the kinds of value tensions we observed. Conclusions We provide empirical data to show what it is like to work with multiple BIPOC stakeholders in the roles of families and children. We demonstrate the use of the value tension framework to explain the different needs of multiple stakeholders and technology development. Specifically, we demonstrate that the value tension framework helps sort our participants’ co-design responses into clear and easy-to-understand design guidelines. Using the value tension framework, we were able to sort the tensions between children and adults, family socioeconomic and health wellness needs, and researchers and participants while being able to make specific design decisions from this organized view. Finally, we provide design implications and guidance for the development of JITAI mobile interventions for BIPOC families.

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Making of Mobile SunSmart: Co-designing a Just-in-Time Sun Protection Intervention for Children and Parents

Cited by 7 publications

References 66 publications

Barriers to and facilitators of a just-in-time adaptive intervention for respiratory illness in cerebral palsy: a qualitative study

Barriers to and facilitators of a just-in-time adaptive intervention for respiratory illness in cerebral palsy: a qualitative study

Reinforcing Photoprotection for Skin of Color: A Narrative Review

Co-design Tensions Between Parents, Children, and Researchers Regarding Mobile Health Technology Design Needs and Decisions: Case Study

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