Participatory Design of a Social Networking App to Support Type II Diabetes Self-Management in Low-Income Minority Communities

Zachary, Wayne; Michlig, Georgia J.; Kaplan, Avril; Nguyen, Ngoc-Tung; Quinn, Charlene C.; Surkan, Pamela J.

doi:10.1177/2327857917061010

Cited by 15 publications

(12 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the development of digital health interventions to improve outcomes in patients with diabetes, others have also employed user-centered or participatory design and have obtained and successfully incorporated feedback in their development processes [34,35]. Although these studies have enrolled diverse populations, they do not describe whether the feedback they received differed within subgroups of their populations.…”

Section: Discussionmentioning

confidence: 99%

Assessing Mobile Phone Digital Literacy and Engagement in User-Centered Design in a Diverse, Safety-Net Population: Mixed Methods Study

Nouri¹,

Avila-Garcia²,

Cemballi³

et al. 2019

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

Background Health care systems are rapidly deploying digital tools for disease management; however, few studies have evaluated their usability by vulnerable populations. To understand the barriers to app usage among vulnerable populations, we employed user-centered design (UCD) methods in the development of a new text messaging app. Objective The study aimed to describe variations in patients’ engagement in the app design process, focusing on limited health literacy (LHL), limited English proficiency (LEP), and limited digital literacy (LDL). Methods We conducted 20 in-depth semistructured interviews with primary care patients at a public health care system, used open-ended discussions and card sorting tasks to seek input about mobile phones and text messaging, and used open coding to categorize the patterns of mobile phone usage and to evaluate engagement in the card sorting process. We examined qualitative differences in engagement by examining the extensiveness of participant feedback on existing and novel text messaging content and calculated the proportion of patients providing extensive feedback on existing and novel content, overall and by health literacy, English proficiency, and digital literacy. Results The average age of the 20 participants was 59 (SD 8) years; 13 (65%) were female, 18 (90%) were nonwhite, 16 (80%) had LHL, and 13 (65%) had LEP. All had depression, and 14 (70%) had diabetes. Most participants had smartphones (18/20, 90%) and regularly used text messaging (15/20, 75%), but 14 (70%) of them reported having difficulty texting because of inability to type, physical disability, and low literacy. We identified 10 participants as specifically having LDL; 7 of these participants had LEP, and all 10 had LHL. Half of the participants required a modification of the card sorting activity owing to not understanding it or not being able to read the cards in the allotted time. The proportion of participants who gave extensive feedback on existing content was lower in participants with limited versus adequate English proficiency (4/13, 30% vs 5/7, 71%), limited versus adequate health literacy (7/16, 44% vs 3/4, 75%), and limited versus adequate digital literacy (4/10, 40% vs 6/10, 60%); none of these differences were statistically significant. When examining the proportion of patients who gave extensive feedback for novel messaging content, those with LHL were less engaged than those with adequate health literacy (8/16, 50% vs 4/4, 100%); there were no statistical differences by any subgroup. Conclusions Despite widespread mobile phone use, digital literacy barriers are common among vulnerable populations. Engagement in the card sorting activity varied among participants and appeared to be lower among those with LHL, LEP, and LDL. Researchers employing traditional UCD methods should routinely measure these communication domains among their end-user samples. Future work is needed to replicate our findings in larger samples, but augmentation of card sorting with direct observation and audiovisual cues may be more productive in eliciting feedback for those with communication barriers.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing Mobile Phone Digital Literacy and Engagement in User-Centered Design in a Diverse, Safety-Net Population: Mixed Methods Study

Nouri¹,

Avila-Garcia²,

Cemballi³

et al. 2019

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…The navigation panel also included a More glyph that could be used to navigate to a group of settings, as shown in Figure 1 . Details on the process of functional and navigation design can be found in Zachary et al [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

“…From Phase I, we analyzed participants’ opinions on design concepts for a smartphone app [ 18 ]. In Phase II, we explored reactions of community members and providers to those design concepts through one community forum with people with prediabetes or T2DM and family or friends, as well as through interviews with providers, due to difficulties in organizing providers into groups.…”

Section: Methodsmentioning

confidence: 99%

Perspectives From Underserved African Americans and Their Health Care Providers on the Development of a Diabetes Self-Management Smartphone App: Qualitative Exploratory Study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Type 2 diabetes mellitus (T2DM) affects approximately 10% of the US population, disproportionately afflicting African Americans. Smartphone apps have emerged as promising tools to improve diabetes self-management, yet little is known about the use of this approach in low-income minority communities. Objective The goal of the study was to explore which features of an app were prioritized for people with T2DM in a low-income African American community. Methods Between February 2016 and May 2018, we conducted formative qualitative research with 78 participants to explore how a smartphone app could be used to improve diabetes self-management. Information was gathered on desired features, and app mock-ups were presented to receive comments and suggestions of improvements from smartphone users with prediabetes and T2DM, their friends and family members, and health care providers; data were collected from six interactive forums, one focus group, and 15 in-depth interviews. We carried out thematic data analysis using an inductive approach. Results All three types of participants reported that difficulty with accessing health care was a main problem and suggested that an app could help address this. Participants also indicated that an app could provide information for diabetes education and self-management. Other suggestions included that the app should allow people with T2DM to log and track diabetes care–related behaviors and receive feedback on their progress in a way that would increase engagement in self-management among persons with T2DM. Conclusions We identified educational and tracking smartphone features that can guide development of diabetes self-management apps for a low-income African American population. Considering those features in combination gives rise to opportunities for more advanced support, such as determining self-management recommendations based on data in users’ logs.

show abstract

“…That concept was based on an analogy to recent work by members of the team in developing a smartphone app for persons with Type 2 Diabetes Mellitus (which is also a major risk factor for CVD) living in low-income urban communities. That prior research used a similar participatory design approach (see Zachary, Michlig, et al, 2017). We hypothesized that the app for RCs with CVD or risk factors would help the user create a private local social network of household/family/support-persons that would, in turn, help that RC improve heart health behaviors, such as adhering to medication, finding people and safe settings for exercise, and sharing information and positive social reinforcement.…”

Section: Resultsmentioning

confidence: 99%

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

Zachary

Wilkin

Puglisi

et al. 2020

Proceedings of the International Symposium on Human Factors and

View full text Add to dashboard Cite

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.

show abstract

Participatory Design of a Social Networking App to Support Type II Diabetes Self-Management in Low-Income Minority Communities

Cited by 15 publications

References 25 publications

Assessing Mobile Phone Digital Literacy and Engagement in User-Centered Design in a Diverse, Safety-Net Population: Mixed Methods Study

Assessing Mobile Phone Digital Literacy and Engagement in User-Centered Design in a Diverse, Safety-Net Population: Mixed Methods Study

Perspectives From Underserved African Americans and Their Health Care Providers on the Development of a Diabetes Self-Management Smartphone App: Qualitative Exploratory Study

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

Contact Info

Product

Resources

About