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Ba DM, Kayembe C, Littlejohn J, Van Scoy LJ, VanDyke E, Williams J, Katoch A, Shook NC, Zhang Y, Livelsberger C, McDonald AC, Muscat JE. Navigation-Based Telehealth Informed Decision-Making for Prostate Cancer Screening in Black Men. Curr Oncol 2024; 31:3698-3712. [PMID: 39057145 PMCID: PMC11275421 DOI: 10.3390/curroncol31070273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The rapid increase in telehealth has the potential to bring informed decision-making for prostate cancer screening (PCS) at the population level to high-risk individuals. We utilized a global technology platform of electronic health records data repositories (TriNetX) to determine its utility for Navigator-guided decision-making aid for PCS in Black men ages 45-79 years with no history of prostate cancer and PSA testing. Patients from Pennsylvania were invited to participate in a telehealth-delivered informed decision-making session for PCS. Focus groups, social learning theory, visual diagrams, and quantitative data on PCS risks and benefits were used to develop the content of the sessions, which included numerical discussions of risks vs. benefits in Black men. Participants completed several surveys, including baseline demographic and numeracy questionnaires, a one-on-one telehealth session with a trained Navigator, post-Navigation surveys, and an optional follow-up session with a urologist. Eighty-seven participants were consented and recruited. Although the mean numeracy score was only 1.9 out of 6, more than 90% rated as good or excellent that the sessions aided their PCS decision-making skills. This study indicates that Navigation by telehealth offers the ability to assist in informed decision-making for PCS at the population level.
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Affiliation(s)
- Djibril M. Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Chrispin Kayembe
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Joe Littlejohn
- Department of Urology, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Lauren J. Van Scoy
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Erika VanDyke
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - James Williams
- Pennsylvania Prostate Cancer Coalition, Harrisburg, PA 17120, USA;
| | - Avnish Katoch
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Neil C. Shook
- Center for Survey Research, Penn State Harrisburg, Harrisburg, PA 17057, USA;
| | - Yue Zhang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Craig Livelsberger
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Alicia C. McDonald
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Joshua E. Muscat
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
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White M, Malone S, Berhie G, Pizzetta C, Davidson E, Azevedo M, Hines A, Ikem F, Jones LM. Examining motivation factors for African American students' use of consumer wearables. Digit Health 2023; 9:20552076231203670. [PMID: 37928334 PMCID: PMC10624079 DOI: 10.1177/20552076231203670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/08/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose This study was initiated to examine factors that motivate African American students who use wearable devices at an HBCU in Mississippi. Method We conducted a correlational research study on undergraduate and graduate students from a southern USA university. The stratified random sample comprised a total of 239 students. The responses of the students were analyzed using the Fisher exact test to determine whether or not there was a significant association between the categorical demographic variables (age, gender, ethnicity, and student classification) and the students' motivation for using a wearable device. Results Students used wearables for one main reason, to help them increase their awareness of their health status because they understand the importance of tracking their health metrics to boost their health status and reduce risk factors for developing chronic diseases. Students also demonstrated that they understand the value of tracking health information, such as heart rate and blood pressure, as a way to reduce the prevalence and impact of risk factors that can lead to chronic diseases. Conclusions Wearables enable individuals to regularly observe, measure, and record their physical status and physiological measures, and facilitate medication adherence by enabling individuals to maintain their prescribed medication regimen adequately. The data collected and stored through these wearables can provide data that will be useful for medical personnel in their treatment of patients and in developing strategies for prevention and intervention for the larger community.
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Affiliation(s)
- Monique White
- Public Health, Informatics, and Technology, College of Health Sciences, Jackson State University, Jackson, MS, USA
| | - Shelia Malone
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Jackson State University, Jackson, MS, USA
| | - Girmay Berhie
- Public Health, Informatics, and Technology, College of Health Sciences, Jackson State University, Jackson, MS, USA
| | - Candis Pizzetta
- Department of English, Foreign Languages, and Speech Communication, College of Liberal Arts, Jackson State University, Jackson, MS, USA
| | - Edith Davidson
- Department of Business Administration, College of Business Administration, Jackson State University, Jackson, MS, USA
| | - Mario Azevedo
- Department of History and Philosophy, College of Liberal Arts, Jackson State University, Jackson, MS, USA
| | - Andre Hines
- Department of Public Policy & Administration, College of Liberal Arts, Jackson State University, Jackson, MS, USA
| | - Fidelis Ikem
- Department of Business Administration, College of Business Administration, Jackson State University, Jackson, MS, USA
| | - Lena M Jones
- Department of Public Policy & Administration, College of Liberal Arts, Jackson State University, Jackson, MS, USA
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Lewis MA, Harshbarger C, Bann C, Marconi VC, Somboonwit C, Piazza MD, Swaminathan S, Burrus O, Galindo C, Borkowf CB, Marks G, Karns S, Zulkiewicz B, Ortiz A, Abdallah I, Garner BR, Courtenay-Quirk C. Effectiveness of an Interactive, Highly Tailored "Video Doctor" Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial. J Acquir Immune Defic Syndr 2022; 91:58-67. [PMID: 35972854 PMCID: PMC9377499 DOI: 10.1097/qai.0000000000003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND To determine whether Positive Health Check, a highly tailored video doctor intervention, can improve viral suppression and retention in care. SETTING Four clinics that deliver HIV primary care. METHODS A hybrid type 1 effectiveness-implementation randomized trial design was used to test study hypotheses. Participants (N = 799) who were not virally suppressed, were new to care, or had fallen out of care were randomly assigned to receive Positive Health Check or the standard of care alone. The primary endpoint was viral load suppression, and the secondary endpoint was retention in care, both assessed at 12 months, using an intention-to-treat approach. A priori subgroup analyses based on sex assigned at birth and race were examined as well. RESULTS There were no statistically significant differences between Positive Health Check (N = 397) and standard of care (N = 402) for either endpoint. However, statistically significant group differences were identified from a priori subgroup analyses. Male participants receiving Positive Health Check were more likely to achieve suppression at 12 months than male participants receiving standard of care adjusted risk ratio [aRR] [95% confidence interval (CI)] = 1.14 (1.00 to 1.29), P = 0.046}. For retention in care, there was a statistically significant lower risk for a 6-month visit gap in the Positive Health Check arm for the youngest participants, 18-29 years old [aRR (95% CI) = 0.55 (0.33 to 0.92), P = 0.024] and the oldest participants, 60-81 years old [aRR (95% CI) = 0.49 (0.30 to 0.81), P = 0.006]. CONCLUSIONS Positive Health Check may help male participants with HIV achieve viral suppression, and younger and older patients consistently attend HIV care. REGISTRY NAME Positive Health Check Evaluation Trial. Trial ID: 1U18PS004967-01. URL: https://clinicaltrials.gov/ct2/show/NCT03292913.
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Affiliation(s)
| | - Camilla Harshbarger
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Vincent C. Marconi
- Division of Infectious Diseases, Emory University School of Medicine, Emory Vaccine Center, and Rollins School of Public Health, Atlanta, Georgia; VA Medical Center, Decatur, GA
| | | | | | | | | | - Carla Galindo
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Craig B. Borkowf
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gary Marks
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | | | | | - Cari Courtenay-Quirk
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Williams KDA, Wijaya C, Stamatis CA, Abbott G, Lattie EG. Insights Into Needs and Preferences for Mental Health Support on Social Media and Through Mobile Apps Among Black Male University Students: Exploratory Qualitative Study. JMIR Form Res 2022; 6:e38716. [PMID: 36044261 PMCID: PMC9475414 DOI: 10.2196/38716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/24/2022] [Accepted: 07/26/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Black college-aged men are less likely than their peers to use formal, therapeutic in-person services for mental health concerns. As the use of mobile technologies and social media platforms is steadily increasing, it is important to conduct work that examines the future utility of digital tools and technologies to improve access to and uptake of mental health services for Black men and Black men in college. OBJECTIVE The aim of this study was to identify and understand college-attending Black men's needs and preferences for using digital health technologies and social media for stress and mental health symptom management. METHODS Interviews were conducted with Black male students (N=11) from 2 racially diverse universities in the Midwestern United States. Participants were asked questions related to their current mental health needs and interest in using social media platforms and mobile-based apps for their mental health concerns. A thematic analysis was conducted. RESULTS Four themes emerged from the data: current stress relief strategies, technology-based support needs and preferences (subthemes: mobile-based support and social media-based support), resource information dissemination considerations (subthemes: information-learning expectations and preferences and information-sharing preferences and behaviors), and technology-based mental health support design considerations (subtheme: relatability and representation). Participants were interested in using social media and digital technologies for their mental health concerns and needs, for example, phone notifications and visual-based mental health advertisements that promote awareness. Relatability in the context of representation was emphasized as a key factor for participants interested in using digital mental health tools. Examples of methods for increasing relatability included having tools disseminated by minority-serving organizations and including components explicitly portraying Black men engaging in mental health support strategies. The men also discussed wanting to receive recommendations for stress relief that have been proven successful, particularly for Black men. CONCLUSIONS The findings from this study provide insights into design and dissemination considerations for future work geared toward developing mental health messaging and digital interventions for young Black men.
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Affiliation(s)
- Kofoworola D A Williams
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Clarisa Wijaya
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Caitlin A Stamatis
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Gabriel Abbott
- Weinberg College of Arts & Sciences, Northwestern University, Chicago, IL, United States
| | - Emily G Lattie
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Senteio C, Murdock PJ. The Efficacy of Health Information Technology in Supporting Health Equity for Black and Hispanic Patients With Chronic Diseases: Systematic Review. J Med Internet Res 2022; 24:e22124. [PMID: 35377331 PMCID: PMC9016513 DOI: 10.2196/22124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/25/2020] [Accepted: 01/23/2022] [Indexed: 12/26/2022] Open
Abstract
Background Racial inequity persists for chronic disease outcomes amid the proliferation of health information technology (HIT) designed to support patients in following recommended chronic disease self-management behaviors (ie, medication behavior, physical activity, and dietary behavior and attending follow-up appointments). Numerous interventions that use consumer-oriented HIT to support self-management have been evaluated, and some of the related literature has focused on racial minorities who experience disparate chronic disease outcomes. However, little is known about the efficacy of these interventions. Objective This study aims to conduct a systematic review of the literature that describes the efficacy of consumer-oriented HIT interventions designed to support self-management involving African American and Hispanic patients with chronic diseases. Methods We followed an a priori protocol using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-Equity 2012 Extension guidelines for systematic reviews that focus on health equity. Themes of interest included the inclusion and exclusion criteria. We identified 7 electronic databases, created search strings, and conducted the searches. We initially screened results based on titles and abstracts and then performed full-text screening. We then resolved conflicts and extracted relevant data from the included articles. Results In total, there were 27 included articles. The mean sample size was 640 (SD 209.5), and 52% (14/27) of the articles focused on African American participants, 15% (4/27) of the articles focused on Hispanic participants, and 33% (9/27) included both. Most articles addressed 3 of the 4 self-management behaviors: medication (17/27, 63%), physical activity (17/27, 63%), and diet (16/27, 59%). Only 15% (4/27) of the studies focused on follow-up appointment attendance. All the articles investigated HIT for use at home, whereas 7% (2/27) included use in the hospital. Conclusions This study addresses a key gap in research that has not sufficiently examined what technology designs and capabilities may be effective for underserved populations in promoting health behavior in concordance with recommendations.
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Affiliation(s)
- Charles Senteio
- Department of Library and Information Science, School of Communication and Information, Rutgers University, New Brunswick, NJ, United States
| | - Paul Joseph Murdock
- Division of Health Sciences Informatics, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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Iyamu I, Gómez-Ramírez O, Xu AXT, Chang HJ, Watt S, Mckee G, Gilbert M. Challenges in the development of digital public health interventions and mapped solutions: Findings from a scoping review. Digit Health 2022; 8:20552076221102255. [PMID: 35656283 PMCID: PMC9152201 DOI: 10.1177/20552076221102255] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background “Digital public health” has emerged from an interest in integrating digital technologies into public health. However, significant challenges which limit the scale and extent of this digital integration in various public health domains have been described. We summarized the literature about these challenges and identified strategies to overcome them. Methods We adopted Arksey and O’Malley's framework (2005) integrating adaptations by Levac et al. (2010). OVID Medline, Embase, Google Scholar, and 14 government and intergovernmental agency websites were searched using terms related to “digital” and “public health.” We included conceptual and explicit descriptions of digital technologies in public health published in English between 2000 and June 2020. We excluded primary research articles about digital health interventions. Data were extracted using a codebook created using the European Public Health Association's conceptual framework for digital public health. Results and analysis Overall, 163 publications were included from 6953 retrieved articles with the majority (64%, n = 105) published between 2015 and June 2020. Nontechnical challenges to digital integration in public health concerned ethics, policy and governance, health equity, resource gaps, and quality of evidence. Technical challenges included fragmented and unsustainable systems, lack of clear standards, unreliability of available data, infrastructure gaps, and workforce capacity gaps. Identified strategies included securing political commitment, intersectoral collaboration, economic investments, standardized ethical, legal, and regulatory frameworks, adaptive research and evaluation, health workforce capacity building, and transparent communication and public engagement. Conclusion Developing and implementing digital public health interventions requires efforts that leverage identified strategies to overcome diverse challenges encountered in integrating digital technologies in public health.
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Affiliation(s)
- Ihoghosa Iyamu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Oralia Gómez-Ramírez
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Alice XT Xu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Hsiu-Ju Chang
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Sarah Watt
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Geoff Mckee
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Mark Gilbert
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Impact of a self-monitoring application on pediatric asthma disparities. Int J Med Inform 2020; 144:104294. [PMID: 33080504 DOI: 10.1016/j.ijmedinf.2020.104294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/27/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES We previously reported improved outcomes after implementing the electronic-AsthmaTracker (e-AT), a self-monitoring tool for children with asthma, at 11 ambulatory pediatric clinics. This study assesses e-AT adherence and impact across race/ethnicity subgroups. STUDY DESIGN Secondary data analysis of a prospective cohort study of children ages 2-17 years with persistent asthma, enrolled from January 2014 to December 2015 to use the e-AT for 1 year. Survival analysis was used to compare e-AT use adherence and generalized estimating equation models to compare outcomes pre- and post e-AT initiation, between race/ethnicity subgroups. RESULTS Data from 318 children with baseline measurements were analyzed: 76.4 % white, 11.3 % Hispanic, 7.8 % "other", and 4.4 % unknown race/ethnicity subgroups. Mean e-AT adherence was 82 % (95 %CI: 79-84 %, reference) for whites, 73 % (64-81 %, p = 0.025) for Hispanics, and 78 % (69-86 %, p = 0.373) for other minorities. Compared to whites, Cox proportional hazard ratio for study dropout risk was 2.14 (1.31-3.77, p = 0.001) for Hispanics and 0.95 (0.60-1.50, p = 0.834) for other minorities. Disparities existed at baseline, with lower QOL (74.9 vs 80.6; p = 0.025) and asthma control (18.4 vs 19.7; p = 0.027) among Hispanics, compared to whites. After e-AT initiation, disparities disappeared at 3 months for QOL (87.2 vs 90.5; p = 0.159) and asthma control (23.1 vs 22.4; p = 0.063), persisting until study end. Disparities also existed at baseline, with lower QOL (74.6 vs. 80.6; p = 0.042) and asthma control (18.2 vs. 19.7, p = 0.024) among "other" minorities, compared to whites, and disappeared at 3 months for QOL (92.7 vs. 90.5, p = 0.432) and asthma control (22.7 vs 22.4; p = 0.518), persisting until study end. Subgroup analysis was underpowered to detect a difference in oral steroid use or ED/hospital admissions. CONCLUSIONS Our study shows improved asthma control and QOL among minorities and disparity elimination after e-AT implementation. Future adequately powered studies will explore the impact on oral steroid and ED/hospital use disparities.
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Affiliation(s)
| | - Vanita Sood
- Andrew Weil Center for Integrative Medicine, University of Arizona, Tucson, Arizona
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Vizer LM, Eschler J, Koo BM, Ralston J, Pratt W, Munson S. "It's Not Just Technology, It's People": Constructing a Conceptual Model of Shared Health Informatics for Tracking in Chronic Illness Management. J Med Internet Res 2019; 21:e10830. [PMID: 31033452 PMCID: PMC6658298 DOI: 10.2196/10830] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 01/31/2019] [Accepted: 02/18/2019] [Indexed: 12/27/2022] Open
Abstract
Background For many people, tracking health indicators is central to managing a chronic illness. However, previous informatics research has largely viewed tracking as a solitary process that lacks the characteristics essential to tracking in support of chronic illness management. Objective To inform development of effective technologies that aid tracking of health indicators to support chronic illness management, this study aimed to construct a health informatics model that accurately describes the work and social context of that tracking work. Methods As part of a larger project, we conducted semistructured interviews with 40 adults concerning their chronic illness management practices, including tracking and communication. We also assembled transcripts of 30 publicly available videos of 24 adults discussing tracking processes for managing their own chronic illness. We used qualitative methods to analyze interviews and video transcripts through the lens of ongoing personal and health informatics research. Results We have described the people and work involved in tracking in support of chronic illness management and contributed a Conceptual Model of Shared Health Informatics (CoMSHI). Specifically, we identified the need for a health informatics model that (1) incorporates the ongoing nature of tracking work and (2) represents the social dimension of tracking for illness management. Our model depicts communication, information, collection, integration, reflection, and action work in the social context of the person with chronic illness, informal carers, health care providers, and community members. Conclusions The resulting CoMSHI yields a more detailed and nuanced viewpoint of tracking in support of chronic illness management and can inform technology design to improve tracking tools to support people in more confident and capable chronic illness management.
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Affiliation(s)
- Lisa M Vizer
- Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Bon Mi Koo
- Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - James Ralston
- Kaiser Permanente Washington, Seattle, WA, United States
| | - Wanda Pratt
- University of Washington, Seattle, WA, United States
| | - Sean Munson
- University of Washington, Seattle, WA, United States
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Sherman LD, Grande SW. Building Better Clinical Relationships With Patients: An Argument for Digital Health Solutions With Black Men. Health Serv Insights 2019; 12:1178632919834315. [PMID: 30886522 PMCID: PMC6415479 DOI: 10.1177/1178632919834315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/31/2019] [Indexed: 11/17/2022] Open
Abstract
There is a rapid evolution of care delivery taking place across the globe in response to an explosion of novel health technologies. Growing in parallel to this expansion is the anticipation of mHealth technologies to drive patient-centered care into the future. Despite this hope, continuing reports of health inequities and lived experiences of substandard care fill national, state, and community health reports. The impact of these inequities is particularly pernicious on Black men and their long-term health status. As decades of robust evidence substantiates needed interventions, current progress is not seeing expected gains. In this commentary, we argue that at the heart of these inequities are issues of access, health literacy, institutional racism, and growing social distance between clinicians and Black men. To address these inequities, we suggest that digital interventions, designed to support decision-making, information exchange, and shared accountability have the best hope to overcome current inequities by promoting authentic relationships that ultimately drive better communication between Black men and their clinicians.
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Affiliation(s)
- Ledric D Sherman
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, USA
| | - Stuart W Grande
- Division of Health Policy & Management, School of Public Health, The University of Minnesota, Minneapolis, MN, USA
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Tan JYR, Nguyen TT, Tabrisky A, Siedle-Khan R, Napoles AM. Mobile Technology for Healthy Aging Among Older HIV-Positive Black Men Who Have Sex with Men: Qualitative Study. JMIR Aging 2018; 1:e11723. [PMID: 31518233 PMCID: PMC6715097 DOI: 10.2196/11723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 01/16/2023] Open
Abstract
Background People living with HIV are living longer in the United States as a result of antiretroviral therapy. Black men who have sex with men (MSM) are disproportionally affected by HIV and have low rates of engagement in HIV care and treatment. Mobile technology holds promise as an intervention platform; however, little is known regarding its use among older black MSM living with HIV. Objective The goal of this study was to explore mobile technology use and narratives of aging with HIV among older black MSM to inform mobile health intervention development. Methods A total of 12 black MSM living with HIV, aged 50 years or older, completed in-person, semistructured interviews exploring the issues of aging, HIV care engagement, and mobile technology use. The interviews were audiotaped, transcribed, and analyzed using qualitative research methods. Results Men appreciated having survived the AIDS epidemic, but some expressed discomfort and ambivalence toward aging. Men described various levels of engagement in HIV care and treatment; challenges included social isolation and need for support that was not focused on HIV. Almost all described using mobile technology to engage in health care, whereas some referenced important barriers and challenges to technology use. Conclusions Findings highlighted a high level of interest toward a mobile technology–based intervention targeting older black men but also identified barriers and challenges to using mobile technology for health care engagement. Mobile technology is well incorporated into older black MSM’s lives and shows potential as an intervention platform for addressing aging issues to enhance engagement in HIV care and treatment.
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Affiliation(s)
- Judy You Rong Tan
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Tung T Nguyen
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Alyssa Tabrisky
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Robert Siedle-Khan
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Anna Maria Napoles
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, DC, United States
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