Community Engagement to Optimize the Use of Web-Based and Wearable Technology in a Cardiovascular Health and Needs Assessment Study: A Mixed Methods Approach.
BACKGROUND
Resource-limited communities in Washington, D.C. have high rates of obesity-related cardiovascular disease in addition to inadequate physical activity (PA) facilities and limited Internet access. Engaging community members in the design and implementation of studies to address these health disparities is essential to the success of community-based PA interventions.


OBJECTIVE
The objective of the study was to use qualitative and quantitative methods to evaluate the feasibility and acceptability of PA-monitoring wristbands and Web-based technology by predominantly African American, church-based populations in resource-limited Washington, D.C. neighborhoods.


METHODS
To address cardiovascular health in at-risk populations in Washington, D.C., we joined community leaders to establish a community advisory board, the D.C. Cardiovascular Health and Obesity Collaborative (D.C. CHOC). As their first initiative, the Washington, D.C. Cardiovascular Health and Needs Assessment intends to evaluate cardiovascular health, social determinants of health, and PA-monitoring technologies. At the recommendation of D.C. CHOC members, we conducted a focus group and piloted the proposed PA-monitoring system with community members representing churches that would be targeted by the Cardiovascular Health and Needs Assessment. Participants (n=8) agreed to wear a PA-monitoring wristband for two weeks and to log cardiovascular health factors on a secure Internet account. Wristbands collected accelerometer-based data that participants uploaded to a wireless hub at their church. Participants agreed to return after two weeks to participate in a moderated focus group to share experiences using this technology. Feasibility was measured by Internet account usage, wristband utilization, and objective PA data. Acceptability was evaluated through thematic analysis of verbatim focus group transcripts.


RESULTS
Study participants (5 males, 3 females) were African American and age 28-70 years. Participant wristbands recorded data on 10.1±1.6 days. Two participants logged cardiovascular health factors on the website. Focus group transcripts revealed that participants felt positively about incorporating the device into their church-based populations, given improvements were made to device training, hub accessibility, and device feedback.


CONCLUSIONS
PA-monitoring wristbands for objectively measuring PA appear to be a feasible and acceptable technology in Washington, D.C., resource-limited communities. User preferences include immediate device feedback, hands-on device training, explicit instructions, improved central hub accessibility, and designation of a church member as a trained point-of-contact. When implementing technology-based interventions in resource-limited communities, engaging the targeted community may aid in early identification of issues, suggestions, and preferences.


BACKGROUND



BACKGROUND
ClinicalTrials.gov NCT01927783; https://clinicaltrials.gov/ct2/show/NCT01927783 (Archived by WebCite at http://www.webcitation.org/6f8wL117u).
Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States.
Leah R
http://orcid.org/0000-0002-7851-690X
LR
Yingling
Alyssa T
http://orcid.org/0000-0001-6575-6464
AT
Brooks
Gwenyth R
http://orcid.org/0000-0001-7134-1636
GR
Wallen
Marlene
http://orcid.org/0000-0001-6241-5568
M
Peters-Lawrence
Michael
http://orcid.org/0000-0002-1867-4463
M
McClurkin
Rebecca
http://orcid.org/0000-0002-3659-5427
R
Cooper-McCann
Kenneth L
http://orcid.org/0000-0003-3243-8915
KL
Wiley
Valerie
http://orcid.org/0000-0002-9341-2535
V
Mitchell
Johnetta N
http://orcid.org/0000-0003-0599-0675
JN
Saygbe
Twanda D
http://orcid.org/0000-0001-6584-2549
TD
Johnson
Rev Kendrick E
http://orcid.org/0000-0001-6615-983X
RK
Curry
Allan A
http://orcid.org/0000-0002-4323-075X
AA
Johnson
Avis P
http://orcid.org/0000-0002-8647-5343
AP
Graham
Lennox A
http://orcid.org/0000-0002-6214-2448
LA
Graham
Tiffany M
http://orcid.org/0000-0001-9488-4131
TM
Powell-Wiley
African Americans; activity monitoring; community; community-based participatory research; focus groups; mHealth; obesity; physical activity; qualitative research