Harris KM, Mayo Gamble T, Yoo MG, Spell LA, Minor TN, Jones H, Lynch D. Leveraging mHealth to Mitigate the Impact of COVID-19 in Black American Communities: Qualitative Analysis.
JMIR Hum Factors 2023;
10:e47294. [PMID:
37874735 PMCID:
PMC10770780 DOI:
10.2196/47294]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/30/2023] [Accepted: 10/23/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND
COVID-19 remains an ongoing public health crisis. Black Americans remain underrepresented among those vaccinated and overrepresented in both COVID-19 morbidity and mortality. Medical misinformation, specifically related to COVID-19, has exacerbated the impact of the disease in Black American communities. Communication tools and strategies to build relationships and disseminate credible and trustworthy diagnostic and preventative health information are necessary to improve outcomes and equity for historically oppressed populations.
OBJECTIVE
As the initial phase of a larger mixed methods project to develop, pilot, and evaluate a mobile health (mHealth) intervention among a population at high risk for COVID-19 and cardiovascular comorbidities, this study sought to explore COVID-19 information behavior among Black Americans. Specifically, this study examined (1) preferences for COVID-19 education via mHealth, (2) barriers and facilitators to COVID-19 education and diagnostic testing and routine care for associated cardiovascular and respiratory comorbidities in the local community, and (3) key content for inclusion in a COVID-19 mHealth app.
METHODS
This qualitative study used principles of community-based participatory research and information systems research to conduct 7 focus groups across 3 sites. Focus groups were audio recorded and transcribed for thematic analysis using an abductive approach.
RESULTS
The study sample included 54 individuals across sites with a mean age of 50.24 (SD 11.76; range 20-71) years. Participants were primarily female (n=42, 78%) and Black (n=54, 100%) with varied education levels. Over half (n=29, 54%) of the participants were employed full-time, and nearly three-fourths (n=40, 74%) had household incomes
CONCLUSIONS
Increasing transparency and building trust are 2 key strategies that may improve the impact of health information messaging in Black communities. Focusing on content over context fails in the provision of critical health information and perpetuates health inequities by reinforcing systemic and structural racism. COVID-19 messaging must consider contextual information, patient needs and preferences, and patient information-seeking and information-search behaviors to establish trust and credibility, positively impact patient health outcomes, and improve health equity.
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Affiliation(s)
- Kelly M Harris
- School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
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- Tilicia Mayo Gamble
- Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA, United States
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- Madelyn G Yoo
- School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
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- Lindsay A Spell
- School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
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- Timira N Minor
- School of Medicine, Washington University in St. Louis, Saint Louis, MO, United States
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- Holly Jones
- Martha S Pitzer Center for Women, Children, and Youth, College of Nursing, Ohio State University, Columbus, OH, United States
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- Donald Lynch
- Division of Cardiovascular Health and Disease, Department of Medicine, University of Cincinnati, Cincinnati, OH, United States
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