Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points
Background: Tobacco use has a disproportionate impact on older, medically underserved adults. Mobile health (mHealth) tools hold promise for increasing reach of treatment options, yet introduce new barriers to access and use. Research Question: How can investigators incorporate patient and community...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | CHEST Pulmonary |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S294978922400093X |
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| author | Joanna L. Hart, MD Tamar Klaiman, PhD, MPH Michael Scott, BS George M. Fernandez Dorothy Sheu, MPH Aerielle Belk, BS Jasmine A. Silvestri, MPH Jannie Kim, MPH Scott D. Halpern, MD, PhD Nsenga Farrell, EdD, MA |
| author_facet | Joanna L. Hart, MD Tamar Klaiman, PhD, MPH Michael Scott, BS George M. Fernandez Dorothy Sheu, MPH Aerielle Belk, BS Jasmine A. Silvestri, MPH Jannie Kim, MPH Scott D. Halpern, MD, PhD Nsenga Farrell, EdD, MA |
| author_sort | Joanna L. Hart, MD |
| collection | DOAJ |
| description | Background: Tobacco use has a disproportionate impact on older, medically underserved adults. Mobile health (mHealth) tools hold promise for increasing reach of treatment options, yet introduce new barriers to access and use. Research Question: How can investigators incorporate patient and community input into the design and testing of accessible, scalable, and equity-promoting mHealth tobacco treatment tools? Study Design and Methods: We present a model for mHealth tobacco treatment tool development using a longitudinal community-partnered design process. We iteratively developed and refined tools used in a large, pragmatic trial. First, a stakeholder advisory committee (SAC) convened with members including individual patients and representatives from patient and health equity advocacy groups, community and government public health services, clinical program leads, and health system and insurance leaders. Second, we conducted a patient needs assessment to confirm or expand on SAC recommendations using semistructured interviews among patients meeting ≥ 1 medically underserved criteria who smoked tobacco daily. Transcribed interviews were coded and analyzed for patterns of patients’ desired design elements. Results: The SAC recommended key strategies to promote cultural relevance of the tools, maximize engagement of participants, and prevent attrition, which were incorporated into the intervention and trial design. To further refine the approach, we completed interviews with 39 patients from November 2020 to September 2021. Many respondents used telemedicine tools with their clinicians yet were skeptical of their use for tobacco treatment due to lack of facility with mobile technologies. Patients recommended direct support options, avoidance of novel smartphone applications, and customizable features. Interpretation: We provide a model for patient-centered design that incorporates community engagement through longitudinal advisors and wider representation of patients. Longitudinal community engagement that incorporates broad patient perspectives facilitates effective development and deployment of mHealth tools to maximize responsiveness to patient and community needs. |
| format | Article |
| id | doaj-art-14a8b27e30c84c3a809382fdf1c100d8 |
| institution | OA Journals |
| issn | 2949-7892 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | CHEST Pulmonary |
| spelling | doaj-art-14a8b27e30c84c3a809382fdf1c100d82025-08-20T02:18:48ZengElsevierCHEST Pulmonary2949-78922025-03-013110012710.1016/j.chpulm.2024.100127Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home PointsJoanna L. Hart, MD0Tamar Klaiman, PhD, MPH1Michael Scott, BS2George M. Fernandez3Dorothy Sheu, MPH4Aerielle Belk, BS5Jasmine A. Silvestri, MPH6Jannie Kim, MPH7Scott D. Halpern, MD, PhD8Nsenga Farrell, EdD, MA9Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA; Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA; Michael J. Crescenz VA Medical Center, Philadelphia, PA; CORRESPONDENCE TO: Joanna L. Hart, MDPalliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PACenter for Black Health and Equity, Durham, NCLatino Connection, Color and Culture, Harrisburg, PAPalliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PAPalliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PAPalliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PACHDI Foundation, New York, NYPalliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PA; Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PAPalliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, PABackground: Tobacco use has a disproportionate impact on older, medically underserved adults. Mobile health (mHealth) tools hold promise for increasing reach of treatment options, yet introduce new barriers to access and use. Research Question: How can investigators incorporate patient and community input into the design and testing of accessible, scalable, and equity-promoting mHealth tobacco treatment tools? Study Design and Methods: We present a model for mHealth tobacco treatment tool development using a longitudinal community-partnered design process. We iteratively developed and refined tools used in a large, pragmatic trial. First, a stakeholder advisory committee (SAC) convened with members including individual patients and representatives from patient and health equity advocacy groups, community and government public health services, clinical program leads, and health system and insurance leaders. Second, we conducted a patient needs assessment to confirm or expand on SAC recommendations using semistructured interviews among patients meeting ≥ 1 medically underserved criteria who smoked tobacco daily. Transcribed interviews were coded and analyzed for patterns of patients’ desired design elements. Results: The SAC recommended key strategies to promote cultural relevance of the tools, maximize engagement of participants, and prevent attrition, which were incorporated into the intervention and trial design. To further refine the approach, we completed interviews with 39 patients from November 2020 to September 2021. Many respondents used telemedicine tools with their clinicians yet were skeptical of their use for tobacco treatment due to lack of facility with mobile technologies. Patients recommended direct support options, avoidance of novel smartphone applications, and customizable features. Interpretation: We provide a model for patient-centered design that incorporates community engagement through longitudinal advisors and wider representation of patients. Longitudinal community engagement that incorporates broad patient perspectives facilitates effective development and deployment of mHealth tools to maximize responsiveness to patient and community needs.http://www.sciencedirect.com/science/article/pii/S294978922400093Xcommunity engagementhealth equitypatient-centered designtobacco use disorder |
| spellingShingle | Joanna L. Hart, MD Tamar Klaiman, PhD, MPH Michael Scott, BS George M. Fernandez Dorothy Sheu, MPH Aerielle Belk, BS Jasmine A. Silvestri, MPH Jannie Kim, MPH Scott D. Halpern, MD, PhD Nsenga Farrell, EdD, MA Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points CHEST Pulmonary community engagement health equity patient-centered design tobacco use disorder |
| title | Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points |
| title_full | Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points |
| title_fullStr | Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points |
| title_full_unstemmed | Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points |
| title_short | Community-Engaged Development of Equitable and Scalable Mobile Health Tools for Tobacco TreatmentTake-Home Points |
| title_sort | community engaged development of equitable and scalable mobile health tools for tobacco treatmenttake home points |
| topic | community engagement health equity patient-centered design tobacco use disorder |
| url | http://www.sciencedirect.com/science/article/pii/S294978922400093X |
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