iMedicalApps and JMIR Publications have partnered to help disseminate interesting & innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.

Community Engagement to Optimize the Use of Web-based and Wearable Technology in a Cardiovascular Health and Needs Assessment Study: A Mixed Methods Approach

1. What was the motivation behind your study?

Resource-limited communities in Washington D.C. have high rates of obesity and cardiovascular (CV) disease and inadequate physical activity (PA) levels. In designing a technology-based behavioral intervention to target PA within these communities, we sought to understand potential facilitators and barriers to use of proposed monitoring tools from the targeted community members. By engaging community leaders and members in a partnership, we hoped to leverage the collaboration to design and implement a technology-based intervention that was both feasible and acceptable to the targeted community.

2. Describe your study.

The Washington D.C. Cardiovascular Health and Needs Assessment evaluated CV health and tested PA-monitoring technologies as intervention tools among an African-American, church-based population. At the recommendation of our community partners, the proposed PA-monitoring system was first piloted with community members representing our targeted group. Participants logged CV health factors online and wore a PA-monitoring wristband, uploading data to a church-based wireless hub weekly. After 2 weeks, we conducted a moderated focus group to assess feasibility and acceptability of the technology.

3. What were the results of the study?

Study participants (n=8) were African-American and aged 28-70 years. Of 13 possible days of PA-monitoring readings, wristbands provided readings for 10.1 ± 1.6 days. Most participants (67.5%) had ≥10 days of PA data. Two participants logged cardiovascular health factors on the online account. Focus group transcripts revealed that participants felt positively about incorporating the device into their church-based populations in the larger Washington D.C. Cardiovascular Health and Needs Assessment given improvements were made to device training, hub accessibility, and device feedback.

4. What is the main point that readers should take away from this study?

Our findings highlighted the critical need for community-based participatory research (CBPR) methods when integrating technology in similar resource-limited settings. While the study’s PA-monitoring system appeared to be feasible and acceptable for use in larger-scaled studies in similar community-based settings, we found that CBPR methods, particularly community advisory boards and focus groups, play a necessary role in identifying issues, suggestions and preferences during development and implementation of technology-based health behavior studies.

5. What was the most surprising finding from your study?

We were surprised by the low levels of online account engagement. Participants found the online account to be burdensome for viewing and entering data and preferred a smartphone application. Our hub-based system had the benefit of community-wide accessibility, making uploading PA data possible for all participants regardless of device ownership or access. Their preference for multiple syncing options highlighted the need for accessible options for syncing and viewing data so that the technology is optimized for all participants, regardless of device ownership.

6. What are the next steps? How do you envision this work ultimately translating into clinical practice or affect R&D?

In this study, strengths and weaknesses of the proposed PA-monitoring system were identified. Based on suggestions, changes were made to implementation of the PA-monitoring system in our larger-scaled study, the Washington D.C. Cardiovascular Health and Needs Assessment. Objective measures gathered by the wearable PA monitors in our larger study are being used to evaluate PA levels in this population and will ultimately inform the technology component of a future community-based, tailored behavioral change intervention targeting inadequate PA in these resource-limited communities.