Background Patients are increasingly using mobile health (mHealth) apps to monitor their health and educate themselves about medical issues. Despite the increasing popularity of such apps, poor design and usability often lead to suboptimal continued use of these apps and subsequently to poor adherence to the behavior changes at which they are aimed. One solution to these design problems is for app developers to use user-centered design (UCD) principles to consider the context and needs of users during the development process. Objective This study aimed to present a case study on the design and development process for an mHealth app that uses virtual human technology (VHT) to encourage colorectal cancer (CRC) screening among patients aged 50 years and above. Methods We have first provided an overview of the project and discussed its utilization of VHT. We have then reviewed UCD principles and how they can be incorporated into the development of health apps. We have described how we used UCD processes during the app’s development. We have then discussed the unique roles played by communication researchers, computer scientists, clinicians, and community participants in creating an mHealth app that is credible, usable, effective, and accessible to its target audience. Results The principles of UCD were woven throughout the project development, with researchers collecting feedback from patients and providers at all stages and using that feedback to improve the credibility, usability, effectiveness, and accessibility of the mHealth app. The app was designed in an iterative process, which encouraged feedback and improvement of the app and allowed teams from different fields to revisit topics and troubleshoot problems. Conclusions Implementing a UCD process contributed to the development of an app, which not only reflected cross-disciplinary expertise but also the needs, wants, and concerns of patients.

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This study examined the effect of message source credibility on e-cigarette harm perceptions among U.S. young adults. An online experimental study was conducted where young adults (n = 302, Mage = 23.7) were randomized to an e-cigarette public health education message from an expert or a peer young adult. Then, participants answered questions about their perceptions about the message source and e-cigarettes. Results suggest that young adults rated experts as a more credible source (vs. peer) (b = −0.39, SE = 0.15, 95% CI [−0.67, −0.10], p < 0.01). Young adults reported greater perceived credibility of the expert message (vs. peer), which was associated with increased e-cigarette harm perceptions. Increased perceived source credibility mediated the association of increased e-cigarette absolute harm perceptions from viewing an expert message (b = −0.11, SE = 0.04, 95% CI: −0.20, −0.02). Source credibility should be considered when designing e-cigarette education messages for young adults.

Recent changes in the global economy make it imperative for U.S. recycling programs to reduce contamination, however, little is known about how local municipalities are responding to this need. The implementation of the Chinese National Sword policy banned most U.S. imported solid waste in 2018, but there has been an increased focus on implementing recycling education campaigns. To date, there has been little empirical attention on how these campaigns are being developed and whether they are effective for increasing recycling and reducing contamination. The goal of the current study is to understand how recycling communication campaigns are being developed and implemented at the municipal level. To accomplish this, we conducted in depth-interviews with recycling coordinators, representing 30 counties within a large and diverse state to identifying the current message development and distribution strategies. Counties were selected to ensure the balanced representation of geographical (urban/rural) and recycling participation (low/middle/high). Findings illustrate six distinct types of recycling communication patterns employed in municipal solid waste county governments. We compare and contrast the benefits and challenges associated with communicating about recycling. The implications of these findings for developing a communication training to advance current campaign efforts in the local context are discussed.

Introduction: How families function and provide support plays a central role in patients' self-management of Type 2 diabetes (T2DM) and prediabetes (preDM). Families would benefit from communication training, which is rarely incorporated into diabetes self-management education (DSME). Mothers are especially in need of this support. Women are at a higher risk of T2DM, and when mothers are patients, they can prioritize their family role and family's well-being over their personal needs as a patient. Method: To identify family communication that affects mothers' ability to self-manage T2DM/preDM, we interviewed 17 mothers aged 36 -64 (M ϭ 56). Transcripts were thematically analyzed. Results: Women described four family communication experiences affecting self-care: (a) family-of-origin communication (e.g., weight/diet messages during childhood), (b) communal coping communication (e.g., adopting healthy behaviors as a family), (c) communication inhibiting communal coping (e.g., negative response to mothers' lifestyle changes), and (d) mothers taking the lead (e.g., leading conversations or communicating control over family's lifestyle decisions). Discussion: Findings highlight the need for a family systems approach to DSME. Communication from multiple bonds (e.g., spouse, children) and past familyof-origin experiences impact self-care. Communal coping (appraising diabetes as "our" problem) was critical to self-management as mothers struggled to balance their needs with family members' preferences/attitudes. When not supported, mothers who took the lead communicatively could facilitate communal coping or prioritize self-care needs. Findings can inform a family-centered approach to DSME that highlights the importance of communal coping, provides all members communication skills training, and addresses the need for mothers to prioritize personal well-being.