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Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study

BACKGROUND: Mobile health (mHealth) technology using apps or devices to self-manage health behaviors is an effective strategy to improve lifestyle-related health problems such as hypertension, obesity, and diabetes. However, few studies have tested an mHealth intervention with Hispanic/Latino adults...

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Autores principales: Rowland, Sheri, Ramos, Athena K, Trinidad, Natalia, Quintero, Sophia, Johnson Beller, Rebecca, Struwe, Leeza, Pozehl, Bunny
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9823566/
https://www.ncbi.nlm.nih.gov/pubmed/36563025
http://dx.doi.org/10.2196/40379
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author Rowland, Sheri
Ramos, Athena K
Trinidad, Natalia
Quintero, Sophia
Johnson Beller, Rebecca
Struwe, Leeza
Pozehl, Bunny
author_facet Rowland, Sheri
Ramos, Athena K
Trinidad, Natalia
Quintero, Sophia
Johnson Beller, Rebecca
Struwe, Leeza
Pozehl, Bunny
author_sort Rowland, Sheri
collection PubMed
description BACKGROUND: Mobile health (mHealth) technology using apps or devices to self-manage health behaviors is an effective strategy to improve lifestyle-related health problems such as hypertension, obesity, and diabetes. However, few studies have tested an mHealth intervention with Hispanic/Latino adults, and no studies were found testing mHealth with rural Hispanic/Latino adults, the fastest-growing population in rural areas. OBJECTIVE: The purpose of this study was to evaluate the feasibility, usability, and acceptability of an mHealth cardiovascular risk self-management intervention with rural Hispanic/Latino adults. METHODS: A descriptive study using quantitative and qualitative methods was used to evaluate the feasibility, usability, and acceptability of delivering a 12-week mHealth self-management intervention to reduce cardiovascular risk with rural Hispanic/Latino adults who were randomized to 1 of 2 groups. Both groups were asked to use MyFitnessPal to self-monitor daily steps, weight, and calories. The intervention group received support to download, initiate, and troubleshoot technology challenges with MyFitnessPal (Under Armour) and a smart scale, while the enhanced usual care group received only a general recommendation to use MyFitnessPal to support healthy behaviors. The usability of MyFitnessPal and the smart scale was measured using an adapted Health Information Technology Usability EvaluationScale (Health-ITUES). Adherence data in the intervention group (daily steps, weight, and calories) were downloaded from MyFitnessPal. Acceptability was evaluated using semistructured interviews in a subsample (n=5) of intervention group participants. RESULTS: A sample of 70 eligible participants (enhanced usual care group n=34; intervention group n=36) were enrolled between May and December 2019. The overall attrition was 28% at 12 weeks and 54% at 24 weeks. mHealth usability in the intervention group increased at each time point (6, 12, and 24 weeks). Adherence to self-monitoring using mHealth in the intervention group after week 1 was 55% for steps, 39% for calories, and 35% for weights; at the end of the 12-week intervention, the adherence to self-monitoring was 31% for steps, 11% for weight, and 8% for calories. Spikes in adherence coincided with scheduled in-person study visits. Structured interviews identified common technology challenges including scale and steps not syncing with the app and the need for additional technology support for those with limited mHealth experience. CONCLUSIONS: Recruitment of rural Hispanic/Latino adults into the mHealth study was feasible using provider and participant referrals. The use of MyFitnessPal, the smart scale, and SMS text messages to self-monitor daily steps, weights, and calories was acceptable and feasible if technology support was provided. Future research should evaluate and support participants’ baseline technology skill level, provide training if needed, and use a phone call or SMS text message follow-ups as a strategy to minimize attrition. A wearable device, separate from the smartphone app, is recommended for activity tracking.
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spelling pubmed-98235662023-01-08 Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study Rowland, Sheri Ramos, Athena K Trinidad, Natalia Quintero, Sophia Johnson Beller, Rebecca Struwe, Leeza Pozehl, Bunny JMIR Form Res Original Paper BACKGROUND: Mobile health (mHealth) technology using apps or devices to self-manage health behaviors is an effective strategy to improve lifestyle-related health problems such as hypertension, obesity, and diabetes. However, few studies have tested an mHealth intervention with Hispanic/Latino adults, and no studies were found testing mHealth with rural Hispanic/Latino adults, the fastest-growing population in rural areas. OBJECTIVE: The purpose of this study was to evaluate the feasibility, usability, and acceptability of an mHealth cardiovascular risk self-management intervention with rural Hispanic/Latino adults. METHODS: A descriptive study using quantitative and qualitative methods was used to evaluate the feasibility, usability, and acceptability of delivering a 12-week mHealth self-management intervention to reduce cardiovascular risk with rural Hispanic/Latino adults who were randomized to 1 of 2 groups. Both groups were asked to use MyFitnessPal to self-monitor daily steps, weight, and calories. The intervention group received support to download, initiate, and troubleshoot technology challenges with MyFitnessPal (Under Armour) and a smart scale, while the enhanced usual care group received only a general recommendation to use MyFitnessPal to support healthy behaviors. The usability of MyFitnessPal and the smart scale was measured using an adapted Health Information Technology Usability EvaluationScale (Health-ITUES). Adherence data in the intervention group (daily steps, weight, and calories) were downloaded from MyFitnessPal. Acceptability was evaluated using semistructured interviews in a subsample (n=5) of intervention group participants. RESULTS: A sample of 70 eligible participants (enhanced usual care group n=34; intervention group n=36) were enrolled between May and December 2019. The overall attrition was 28% at 12 weeks and 54% at 24 weeks. mHealth usability in the intervention group increased at each time point (6, 12, and 24 weeks). Adherence to self-monitoring using mHealth in the intervention group after week 1 was 55% for steps, 39% for calories, and 35% for weights; at the end of the 12-week intervention, the adherence to self-monitoring was 31% for steps, 11% for weight, and 8% for calories. Spikes in adherence coincided with scheduled in-person study visits. Structured interviews identified common technology challenges including scale and steps not syncing with the app and the need for additional technology support for those with limited mHealth experience. CONCLUSIONS: Recruitment of rural Hispanic/Latino adults into the mHealth study was feasible using provider and participant referrals. The use of MyFitnessPal, the smart scale, and SMS text messages to self-monitor daily steps, weights, and calories was acceptable and feasible if technology support was provided. Future research should evaluate and support participants’ baseline technology skill level, provide training if needed, and use a phone call or SMS text message follow-ups as a strategy to minimize attrition. A wearable device, separate from the smartphone app, is recommended for activity tracking. JMIR Publications 2022-12-23 /pmc/articles/PMC9823566/ /pubmed/36563025 http://dx.doi.org/10.2196/40379 Text en ©Sheri Rowland, Athena K Ramos, Natalia Trinidad, Sophia Quintero, Rebecca Johnson Beller, Leeza Struwe, Bunny Pozehl. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.12.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Rowland, Sheri
Ramos, Athena K
Trinidad, Natalia
Quintero, Sophia
Johnson Beller, Rebecca
Struwe, Leeza
Pozehl, Bunny
Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
title Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
title_full Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
title_fullStr Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
title_full_unstemmed Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
title_short Feasibility, Usability and Acceptability of a mHealth Intervention to Reduce Cardiovascular Risk in Rural Hispanic Adults: Descriptive Study
title_sort feasibility, usability and acceptability of a mhealth intervention to reduce cardiovascular risk in rural hispanic adults: descriptive study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9823566/
https://www.ncbi.nlm.nih.gov/pubmed/36563025
http://dx.doi.org/10.2196/40379
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