scholarly journals Designing Effective eHealth Interventions for Underserved Groups: Five Lessons From a Decade of eHealth Intervention Design and Deployment

10.2196/25419 ◽  
2022 ◽  
Vol 24 (1) ◽  
pp. e25419
Author(s):  
Edmund WJ Lee ◽  
Rachel F McCloud ◽  
Kasisomayajula Viswanath
Keyword(s):  
Public Health ◽  
High Speed ◽  
Information Dissemination ◽  
Mobile Apps ◽  
Action Plan ◽  
Web Portals ◽  
Community Based ◽  
Health Apps ◽  
Ehealth Intervention ◽  
Underserved Groups

Despite the proliferation of eHealth interventions, such as web portals, for health information dissemination or the use of mobile apps and wearables for health monitoring, research has shown that underserved groups do not benefit proportionately from these eHealth interventions. This is largely because of usability issues and the lack of attention to the broader structural, physical, and psychosocial barriers to technology adoption and use. The objective of this paper is to draw lessons from a decade of experience in designing different user-centered eHealth interventions (eg, web portals and health apps) to inform future work in leveraging technology to address health disparities. We draw these lessons from a series of interventions from the work we have done over 15 years in the Viswanath laboratory at the Dana-Farber Cancer Institute and Harvard TH Chan School of Public Health, focusing on three projects that used web portals and health apps targeted toward underserved groups. The projects were the following: Click to Connect, which was a community-based eHealth intervention that aimed to improve internet skills and health literacy among underserved groups by providing home access to high-speed internet, computer, and internet training classes, as well as a dedicated health web portal with ongoing technical support; PLANET MassCONECT, which was a knowledge translation project that built capacity among community-based organizations in Boston, Lawrence, and Worcester in Massachusetts to adopt evidence-based health promotion programs; and Smartphone App for Public Health, which was a mobile health research that facilitated both participatory (eg, surveys) and passive data (eg, geolocations and web-browsing behaviors) collection for the purpose of understanding tobacco message exposure in individuals’ built environment. Through our work, we distilled five key principles for researchers aiming to design eHealth interventions for underserved groups. They are as follows: develop a strategic road map to address communication inequalities (ie, a concrete action plan to identify the barriers faced by underserved groups and customize specific solutions to each of them), engage multiple stakeholders from the beginning for the long haul, design with usability—readability and navigability—in mind, build privacy safeguards into eHealth interventions and communicate privacy–utility tradeoffs in simplicity, and strive for an optimal balance between open science aspirations and protection of underserved groups.

scholarly journals Designing Effective eHealth Interventions for Underserved Groups: Five Lessons From a Decade of eHealth Intervention Design and Deployment (Preprint)

2020 ◽  
Author(s):  
Edmund WJ Lee ◽  
Rachel F McCloud ◽  
Kasisomayajula Viswanath
Keyword(s):  
Public Health ◽  
High Speed ◽  
Information Dissemination ◽  
Mobile Apps ◽  
Action Plan ◽  
Web Portals ◽  
Community Based ◽  
Health Apps ◽  
Ehealth Intervention ◽  
Underserved Groups

UNSTRUCTURED Despite the proliferation of eHealth interventions, such as web portals, for health information dissemination or the use of mobile apps and wearables for health monitoring, research has shown that underserved groups do not benefit proportionately from these eHealth interventions. This is largely because of usability issues and the lack of attention to the broader structural, physical, and psychosocial barriers to technology adoption and use. The objective of this paper is to draw lessons from a decade of experience in designing different user-centered eHealth interventions (eg, web portals and health apps) to inform future work in leveraging technology to address health disparities. We draw these lessons from a series of interventions from the work we have done over 15 years in the Viswanath laboratory at the Dana-Farber Cancer Institute and Harvard TH Chan School of Public Health, focusing on three projects that used web portals and health apps targeted toward underserved groups. The projects were the following: <i>Click to Connect</i>, which was a community-based eHealth intervention that aimed to improve internet skills and health literacy among underserved groups by providing home access to high-speed internet, computer, and internet training classes, as well as a dedicated health web portal with ongoing technical support; <i>PLANET MassCONECT</i>, which was a knowledge translation project that built capacity among community-based organizations in Boston, Lawrence, and Worcester in Massachusetts to adopt evidence-based health promotion programs; and <i>Smartphone App for Public Health</i>, which was a mobile health research that facilitated both participatory (eg, surveys) and passive data (eg, geolocations and web-browsing behaviors) collection for the purpose of understanding tobacco message exposure in individuals’ built environment. Through our work, we distilled five key principles for researchers aiming to design eHealth interventions for underserved groups. They are as follows: develop a strategic road map to address communication inequalities (ie, a concrete action plan to identify the barriers faced by underserved groups and customize specific solutions to each of them), engage multiple stakeholders from the beginning for the long haul, design with usability—readability and navigability—in mind, build privacy safeguards into eHealth interventions and communicate privacy–utility tradeoffs in simplicity, and strive for an optimal balance between open science aspirations and protection of underserved groups.

Community ready! Assessing and meeting the needs of parents in Arlington County, VA

2007 ◽  
Vol 5 (6) ◽  
pp. 53
Author(s):  
Marina S. Moses, DrPH, MS ◽  
Donna S. Caruso, RN, MSN ◽  
Timothy G. Otten, MPH ◽  
Sam Simmens, PhD ◽  
Tee L. Guidotti, MD, MPH
Keyword(s):  
Public Health ◽  
Emergency Preparedness ◽  
Information Dissemination ◽  
Spanish Speakers ◽  
English Speakers ◽  
Specific Information ◽  
Community Based ◽  
Public Health Preparedness ◽  
The Public ◽  
Public Health Emergency Preparedness

In March 2006, three elementary schools, composed of at least 50 percent Latino populations, were selected in Arlington, VA, to participate in a multitiered survey to evaluate parents’ emergency preparedness needs. This article describes how to identify vulnerable populations and tailor specific information and services to their public health needs. An oral survey was administered to parents in their preferred language, English or Spanish, regarding their questions, concerns, preferences, and needs pertaining to public health emergency preparedness. Major themes that emerged included the need for language and culturally sensitive preparedness information; the merit of using established community venues for parents to gather; and the importance of using group specific preferred modes of information dissemination. Significant differences were observed between English speakers and Spanish speakers’ perceived vulnerability, level of preparedness, and preferences for acquiring information. An important similarity that presented itself was that all parents surveyed regard the public school system as safe, trustworthy, and best suited for providing public health preparedness information to the community. Based on this study, an innovative model is being developed called Community Ready! which will be an all-hazards approach to public health preparedness outreach that will be reproducible in other municipalities and school districts.

Mobile Applications Leveraged in the COVID-19 Pandemic in East and South-East Asia: A Review and Content Analysis (Preprint)

2021 ◽  
Author(s):  
Bohee Lee ◽  
Siti Aishah Ibrahim ◽  
Tiying Zhang
Keyword(s):  
Public Health ◽  
Health Policy ◽  
East Asia ◽  
Mobile Applications ◽  
Public Health Policy ◽  
Information Dissemination ◽  
Mobile Apps ◽  
The Philippines ◽  
South East Asia ◽  
Credible Information

BACKGROUND The COVID-19 pandemic led to increased attention to digital tools to support governmental public health policies in East and South-East Asia. Mobile applications (or apps) related to COVID-19 continue to emerge and evolve with a wide variety of characteristics and functions. However, there is a paucity of studies evaluating such apps, with most of the available studies conducted in the early days of the pandemic. OBJECTIVE This study aimed to examine free apps developed or supported by governments in East and South-East Asian region and highlight their key characteristics and functions. Also, we aimed to interpret how other COVID-19 policies were associated with the introduction of these apps. METHODS We systematically searched for mobile apps in Apple App Store and Google Play Store and analysed the contents of eligible apps. The mobile apps released or updated between 1 March 2020 and 7 May 2021 in Singapore, Taiwan, South Korea, China, Japan, Thailand, Hong Kong, Vietnam, Malaysia, Indonesia and the Philippines were included. The CoronaNet Research Project database was also examined to examine the timeline of public health policy commencement dates to the release dates of the included apps. RESULTS Of the 1,943 mobile apps initially identified, 46 were eligible, with almost 70% of the mobile apps being intended for the general public. The most common function was health monitoring, followed by raising public health awareness through education and information dissemination. Significantly, most apps for quarantine monitoring were mandatory for the target users or a population subset. Most mobile apps emerged close to the public health policy commencement dates in the early stages of the pandemic. Mobile apps with functions related to COVID-19 vaccines began to appear parallel to vaccination rollout. CONCLUSIONS In East and South-East Asia, most governments employed mobile health apps as adjuncts to public health measures in this pandemic for tracking COVID-19 cases and delivering credible information.

Risk Attitudes and Behavior Among Norwegian Adolescents

2005 ◽  
Vol 10 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Hilde Iversen ◽  
Torbjørn Rundmo ◽  
Hroar Klempe
Keyword(s):  
Public Health ◽  
Traffic Safety ◽  
Behavior Modification ◽  
Health Programs ◽  
Risk Attitudes ◽  
Community Based ◽  
Public Health Programs ◽  
The Core ◽  
And Behavior ◽  
Attitudes And Behavior

Abstract. The core aim of the present study is to compare the effects of a safety campaign and a behavior modification program on traffic safety. As is the case in community-based health promotion, the present study's approach of the attitude campaign was based on active participation of the group of recipients. One of the reasons why many attitude campaigns conducted previously have failed may be that they have been society-based public health programs. Both the interventions were carried out simultaneously among students aged 18-19 years in two Norwegian high schools (n = 342). At the first high school the intervention was behavior modification, at the second school a community-based attitude campaign was carried out. Baseline and posttest data on attitudes toward traffic safety and self-reported risk behavior were collected. The results showed that there was a significant total effect of the interventions although the effect depended on the type of intervention. There were significant differences in attitude and behavior only in the sample where the attitude campaign was carried out and no significant changes were found in the group of recipients of behavior modification.

Assessment and Prediction of Privacy Concerns on Health Apps (Preprint)

2020 ◽  
Author(s):  
Reham AlTamime ◽  
Vincent Marmion ◽  
Wendy Hall
Keyword(s):  
Data Sharing ◽  
Mobile Applications ◽  
Retention Rate ◽  
Mobile Apps ◽  
Third Party ◽  
Privacy Concerns ◽  
Health Apps ◽  
Mobile Health Apps ◽  
Specific Factors ◽  
And Control

BACKGROUND Mobile apps and IoT-enabled smartphones technologies facilitate collecting, sharing, and inferring from a vast amount of data about individuals’ location, health conditions, mobility status, and other factors. The use of such technology highlights the importance of understanding individuals’ privacy concerns to design applications that integrate their privacy expectations and requirements. OBJECTIVE This paper explores, assesses, and predicts individuals’ privacy concerns in relation to collecting and disclosing data on mobile health apps. METHODS We designed a questionnaire to identify participants’ privacy concerns pertaining to a set of 432 mobile apps’ data collection and sharing scenarios. Participants were presented with 27 scenarios that varied across three categorical factors: (1) type of data collected (e.g. health, demographic, behavioral, and location); (2) data sharing (e.g., whether it is shared, and for what purpose); and, (3) retention rate (e.g., forever, until the purpose is satisfied, unspecified, week, or year). RESULTS Our findings show that type of data, data sharing, and retention rate are all factors that affect individuals’ privacy concerns. However, specific factors such as collecting and disclosing health data to a third-party tracker play a larger role than other factors in triggering privacy concerns. CONCLUSIONS Our findings suggest that it is possible to predict privacy concerns based on these three factors. We propose design approaches that can improve users’ awareness and control of their data on mobile applications

scholarly journals Linkage to primary-care public health facilities for cardiovascular disease prevention: a community-based cohort study from urban slums in India

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Multivariate Analysis ◽  
Urban Slum ◽  
Primary Care Providers ◽  
Health Facilities ◽  
Care Providers ◽  
Community Based ◽  
Public Health Facilities ◽  
Care Facilities

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

scholarly journals 31.C. Workshop: Development and implementation of action plans on health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
Action Plan ◽  
Knowledge Society ◽  
Implementation Strategies ◽  
Social Consequences ◽  
Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

scholarly journals Population subgroup differences in the use of a COVID-19 chatbot

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Laura C. Schubel ◽  
Deliya B. Wesley ◽  
Ethan Booker ◽  
John Lock ◽  
Raj M. Ratwani
Keyword(s):  
Public Health ◽  
Information Dissemination ◽  
Subgroup Differences ◽  
Symptom Screening ◽  
Population Subgroup

AbstractCOVID-19 chatbots are widely used to screen for symptoms and disseminate information about the virus, yet little is known about the population subgroups that interact with this technology and the specific features that are used. An analysis of 1,000,740 patients invited to use a COVID-19 chatbot, 69,451 (6.94%) of which agreed to participate, shows differences in chatbot feature use by gender, race, and age. These results can inform future public health COVID-19 symptom screening and information dissemination strategies.

Measuring the Efficacy of a Pilot Public Health Intervention for Engaging Communities of Puerto Rico to Rapidly Write Hurricane Protection Plans

2020 ◽  
pp. 1-10
Author(s):  
Mark E. Keim ◽  
Laura A. Runnels ◽  
Alexander P. Lovallo ◽  
Margarita Pagan Medina ◽  
Eduardo Roman Rosa ◽  
...  
Keyword(s):  
Public Health ◽  
Puerto Rico ◽  
User Satisfaction ◽  
National Guard ◽  
Rapid Development ◽  
Public Health Intervention ◽  
Health Intervention ◽  
Project Work ◽  
Community Members ◽  
Community Based

Abstract Objective: The efficacy is measured for a public health intervention related to community-based planning for population protection measures (PPMs; ie, shelter-in-place and evacuation). Design: This is a mixed (qualitative and quantitative) prospective study of intervention efficacy, measured in terms of usability related to effectiveness, efficiency, satisfaction, and degree of community engagement. Setting: Two municipalities in the Commonwealth of Puerto Rico are included. Participants: Community members consisting of individuals; traditional leaders; federal, territorial, and municipal emergency managers; municipal mayors; National Guard; territorial departments of education, health, housing, public works, and transportation; health care; police; Emergency Medical Services; faith-based organizations; nongovernmental organizations (NGOs); and the private sector. Intervention: The intervention included four community convenings: one for risk communication; two for plan-writing; and one tabletop exercise (TTX). This study analyzed data collected from the project work plan; participant rosters; participant surveys; workshop outputs; and focus group interviews. Main Outcome Measures: Efficacy was measured in terms of ISO 9241-11, an international standard for usability that includes effectiveness, efficiency, user satisfaction, and “freedom from risk” among users. Degree of engagement was considered an indicator of “freedom from risk,” measurable through workshop attendance. Results: Two separate communities drafted and exercised ~60-page-long population protection plans, each within 14.5 hours. Plan-writing workshops completed 100% of plan objectives and activities. Efficiency rates were nearly the same in both communities. Interviews and surveys indicated high degrees of community satisfaction. Engagement was consistent among community members and variable among governmental officials. Conclusions: Frontline communities have successfully demonstrated the ability to understand the environmental health hazards in their own community; rapidly write consensus-based plans for PPMs; participate in an objective-based TTX; and perform these activities in a bi-lingual setting. This intervention appears to be efficacious for public use in the rapid development of community-based PPMs.

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