Objective To evaluate the validity and acceptability of the Ava bracelet for collecting heart rate, sleep, mood, and physical activity data among reproductive-aged women (pregnant and nonpregnant) under free-living conditions. Methods Thirty-three participants wore the Ava bracelet on their non-dominant wrist and reported mood and physical activity in the Ava mobile application for seven nights. Criterion validity was determined by comparing the Ava bracelet heart rate and sleep duration measures to criterion measures from the Polar chest strap and ActiGraph GTX3 + accelerometer. Construct validity was determined by comparing self-report measures and the heart rate variability ratio collected in the Ava mobile application to previously validated measures. Acceptability was evaluated using the modified Acceptability of Health Apps among Adolescents Scale. Results Mean absolute percentage error was 11.4% for heart rate and 8.5% for sleep duration. There was no meaningful difference between the Ava bracelet, ActiGraph, and construct a measure of sleep quality. Compared to construct measures, Ava bracelet heart rate variability had a significant low negative correlation ( r:−0.28), mood had a significant low positive correlation ( r : 0.39), and physical activity level had a significant low ( rlevel of physical activity: 0.56) to moderate positive correlation ( rMET−minutes/week: 0.71). The acceptability of the Ava bracelet was high for fertility and low for pregnancy tracking. Conclusion Preliminary evidence suggests the Ava bracelet and mobile application estimates of sleep and heart rate are not equivalent to criterion measures in free-living conditions. Further research is needed to establish its utility for collecting prospective, subjective data throughout periods of preconception and pregnancy.

Background. It is challenging for junior public health investigators who identify as Black, Indigenous, or People of Color (BIPOC) to secure funding for projects and research. We used a narrative inquiry approach to understand and present the funding cascade from the perspectives of female, junior BIPOC researchers and provide funders with actionable recommendations to advance their antiracist goals. Approach. We applied a Critical Race Theory (CRT) framework to guide our narrative inquiry approach. The participants were the four co-authors and we each drafted individual narratives around our experience with the funding cascade and subsequently the five stages of narrative analysis. Results. We created a visual representation of key activities for funders and applicants organized by our perceived magnitude of inequities in a journey map, an interpreter table that describes common phrases and barriers encountered, and a composite counternarrative presented as a group text message conversation, elevating common themes including feeling pressured to have our research agendas conform to funders’ interests and receiving limited key information and support in the funding process. Discussion. We discussed how our findings represented manifestations of White supremacy characteristics like power hoarding and paternalism. Implications for practice. We offered specific antidotes for funding organizations to make their processes more antiracist and invited leaders of public health funding organizations to join us to further identify antidotes and share lessons learned in Fall 2023.

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Background The acceptability of health interventions is centrally important to achieving their desired health outcomes. The construct of acceptability of mobile health interventions among adolescents is neither well-defined nor consistently operationalized. Objectives Building on the theoretical framework of acceptability, these two studies developed and assessed the reliability and validity of a new scale to measure the acceptability of mobile health applications (“apps”) among adolescents. Methods We followed a structured scale development process including exploratory factor analyses (EFAs), confirmatory factor analyses (CFAs), and employed structural equation modeling (SEM) to assess the relationship between the scale and app usage. Adolescent participants used the Fooducate healthy eating app and completed the acceptability scale at baseline and one-week follow-up. Results EFA ( n = 182) determined that the acceptability of health apps was a multidimensional construct with six latent factors: affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, and self-efficacy. CFA ( n = 161) from the second sample affirmed the six-factor structure and the unidimensional structures for each of the six subscales. However, CFA did not confirm the higher-order latent factor model suggesting that the six subscales reflect unique aspects of acceptability. SEM indicated that two of the subscales—ethicality and self-efficacy—were predictive of health app usage at one-week follow-up. Conclusions These results highlight the importance of ethicality and self-efficacy for health app acceptability. Future research testing and adapting this new acceptability scale will enhance measurement tools in the fields of mobile health and adolescent health.

Background Human-centered design, or design thinking, offers an extensive toolkit of methods and strategies for user-centered engagement that lends itself well to intervention development and implementation. These methods can be applied to the fields of public health and medicine to design interventions that may be more feasible and viable in real-world contexts than those developed with different methods. Objective The design team aimed to develop approaches to building food skills among caregivers of children aged 0-5 years who are eligible for a federal food assistance program while they were in the grocery store. Methods They applied 3 specific human-centered design methods—Extremes and Mainstreams, Journey Mapping, and Co-Creation Sessions—to collaboratively develop intervention approaches to enhance Supplemental Nutrition Assistance Program Education (SNAP-Ed) reach and impact across food retail settings. Extremes and Mainstreams is a specific kind of purposive sampling that selects individuals based on characteristics beyond demographics. Journey Mapping is a visual tool that asks individuals to identify key moments and decision points during an experience. Co-Creation Sessions are choreographed opportunities for individuals to explicitly contribute to the design of a solution alongside research or design team members. Results Ten caregivers with diverse lived experiences were selected to participate in remote design thinking workshops and create individual journey maps to depict their grocery store experiences. Common happy points and pain points were identified. Nine stakeholders, including caregivers, SNAP-Ed staff, and grocery store dieticians, cocreated 2 potential intervention approaches informed by caregivers’ experiences and needs: a rewards program and a meal box option. Conclusions These 3 human-centered design methods led to a meaningful co-design process where proposed interventions aligned with caregivers’ wants and needs. This case study provides other public health practitioners with specific examples of how to use these methods in program development and stakeholder engagement as well as lessons learned when adapting these methods to remote settings.