BACKGROUND
Compared to national averages, rural Appalachians experience extremely elevated rates of premature morbidity and mortality. New opportunities, including approaches incorporating personal technology, may help improve lifestyles and overcome health inequities.
OBJECTIVE
The aim of this study was to assess the feasibility and acceptability of a healthy lifestyle intervention, including an app originally designed for urban users. This program, Make Better Choices 2 (MBC2), consists of personalized health coaching, smartphone application, accelerometer, and financial incentives.
METHODS
We convened four focus groups and 16 key informant interviews with diverse community stakeholders to assess perspectives on this novel, evidence-based diet and physical activity intervention. Participants were shown a slide presentation and asked open-ended follow up questions. The focus group and key informant interview sessions were audiotaped, transcribed, and subjected to thematic analysis.
RESULTS
The Appalachian residents in our study expressed extensive enthusiasm for and consider mHealth interventions feasible for three reasons: (1) increased availability and use of personal technology in rural areas; (2) changing interaction patterns that encourage the use of personal technology (e.g., more individualism, less group activity); and (3) enthusiasm for new approaches (i.e., apps, behavioral incentives) to lifestyle improvement. While viewed as a feasible and acceptable overall, lack of healthy lifestyle awareness, habitual behavior, and financial constraints may challenge the success of mHealth lifestyle interventions in Appalachia. Finally, participants described several minor elements that require modification, including expanding the upper age inclusion, providing extra coaching on technology use, emphasizing personal and supportive connections, employing local coaches, and ensuring adequate educational content for the program.
CONCLUSIONS
Blending health coaching and new technologies is not only acceptable, but may be essential to reach vulnerable rural residents.
CLINICALTRIAL
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