Marine biosecurity, the protection of the marine environment from impacts of non-indigenous species, has a high profile in New Zealand largely associated with a dependence on shipping. The Ministry of Fisheries is the lead agency for marine biosecurity and is tasked with managing the risks posed by pests and non-indigenous marine species. Much like the terrestrial environment, multiple pathways provide ample opportunities for new species to arrive. The Marine Biosecurity Team was established in 1998, and under the Biodiversity package delivered by government, has undertaken an ambitious programme to deliver biosecurity outcomes by reducing the knowledge gaps and establishing management frameworks. A Risk Management Framework aids decision-making and operational planning. Despite significant progress, a number of gaps have been identified in our knowledge base, capability, and capacity that require attention.

Background Many newly diagnosed cancers are associated with modifiable lifestyle behaviors, such as diet, exercise, smoking cessation, and maintaining a healthy weight. However, primary care providers rarely discuss cancer prevention behaviors with their patients. Objective This study aims to assess the usability, acceptability, and user engagement of the Healthier Together mobile app, which is designed to promote cancer prevention behaviors among non-Hispanic Black primary care patients, by using social networks and goal-setting theories of behavior change. Methods In an 8-week pilot study, we enrolled primary care patients (N=41) and provided them with a cancer prevention mobile app that allowed them to select, track, and share progress on cancer prevention goals with other users. App usability was assessed using the System Usability Scale. We assessed the app’s acceptability by qualitatively analyzing open-ended responses regarding participants’ overall experience with the app. We assessed participants’ engagement by analyzing the built-in data capture device, which included the number of times participants checked in (out of a maximum of 8) during the study. Results The mean age of the 41 participants was 51 years (SD 12), and 76% (31/41) were women. App use data were captured from all participants, and 83% (34/41) completed the exit survey and interview. The mean System Usability Scale score was 87 (SD 12; median 90; IQR 78-95). The analysis of open-ended responses revealed several key themes, and participants complemented the app’s ease of use and health behavior–promoting features while also commenting on the need for more feedback and social interactions through the app. On average, participants checked in 5.7 times (SD 2.7) out of 8 possible opportunities. Of the 41 participants, 76% (31/41) checked in during at least 4 of the 8 weeks. Secondary analyses revealed that participants often accomplished their set goals (mean 5.1, SD 2.7) for each week. The qualitative analysis of comments given by participants within the app after each weekly check-in revealed several themes on how the app assisted participants in behavioral change, highlighting that some participants created exercise programs, ate healthier foods, lost a significant amount of weight, and stopped smoking during this study. Conclusions The implementation of a mobile cancer prevention goal–setting app in a primary care setting was feasible, and the app achieved high usability, acceptability, and engagement among participants. User feedback revealed an influence on health behaviors. These findings suggest the promise of the Healthier Together app in facilitating behavioral change to reduce cancer risk among non-Hispanic Black primary care patients.

Background There remains a need to engage at-risk primary care populations in cancer prevention behaviors, yet primary care physicians often lack the time or resources to discuss these behaviors with their patients. Objective The objective of this study is to evaluate the content, usability, and acceptability of a mobile app that leverages insights from goal-setting and social network literature to facilitate cancer prevention goal setting, tracking, and sharing between non-Hispanic Black primary care patients and their social ties. Methods We recruited eligible non-Hispanic Black primary care patients (aged ≥18 years) from 2 practice sites in West Philadelphia, using nonprobabilistic purposive sampling. We conducted semistructured interviews with 5 to 7 participants over 3 weeks to solicit feedback on paper mock-ups of the app, iteratively adapting these mock-ups after each set of interviews. Thereafter, and informed by initial feedback, we created an electronic beta version of the app and sought acceptability and usability feedback from a different set of participants. Then, we conducted content analysis of all user responses to search for unifying themes on acceptability and usability of both the initial mock-ups and beta version of the app. We further assessed app usability using questions derived from the System Usability Scale. Results A total of 33 non-Hispanic Black primary care patients participated in this study. The mean age was 49 (SD 13) years, and 26 (79%) out of 33 participants identified as female. Semistructured interviews revealed three primary generalizable insights from our target population: the framing of each goal and its relevance to cancer impacted the likelihood that the goal would be chosen, participants thought that sharing health goals with others facilitates health behaviors, and most participants found it motivating to see other users’ goal progress, while still collaborating with these users on their health goals. An overarching insight that permeated across each theme was the participants’ desire to customize and personalize the app. Usability testing revealed that 100% (33/33) of participants found the app easy to use, and 76% (25/33) of participants reported that they would like to use this app frequently. Conclusions Cancer prevention in the modern era must include options that are accessible to all, but this does not mean that all options must be universal. This study’s iterative process led to the development of a cancer prevention mobile app that non-Hispanic Black primary care patients deemed usable and acceptable and yielded noteworthy insights about what intended end users value in setting and accomplishing health goals.

BACKGROUND There remains a need to engage at-risk primary care populations in cancer prevention behaviors, yet primary care physicians often lack the time or resources to discuss these behaviors with their patients. OBJECTIVE The objective of the study was to evaluate the content, usability, and acceptability of a mobile application that leverages insights from goal-setting and social networks literature to facilitate cancer prevention goal setting, tracking, and sharing between Non-Hispanic Black primary care patients and their social ties. METHODS We recruited participants from two primary care clinics in Philadelphia using non-probabilistic purposive sampling. We conducted semi-structured interviews with 5 to 7 participants over three weeks to solicit feedback on paper mock-ups of the application, iteratively adapting these mock-ups after each set of interviews. Thereafter, and informed by initial feedback, we created an electronic beta-version of the application and sought acceptability and usability feedback from a different set of participants. Then we conducted content analysis of all user responses to search for unifying themes on acceptability and usability of both the initial mock-ups and beta-version of the application. We further assessed application usability using questions derived from the System Usability Scale (SUS). RESULTS Thirty-three Non-Hispanic Black primary care patients participated in the study. The mean age was 49 (SD ± 13) and 79% identified as female. Semi-structured interviews revealed three primary generalizable insights from our target population: 1) the framing of each goal and its relevance to cancer impacted the likelihood the goal would be chosen; 2) participants thought that sharing health goals with others facilitates health behaviors; and 3) most participants found it motivating to see other users’ goal progress, while still collaborating with these users on their health goals. An overarching insight that permeated across each theme was the participants’ desire to customize and personalize the app. Usability testing revealed that 100% of participants found the application easy to use and 76% of participants reported they would like to use this application frequently. CONCLUSIONS Cancer prevention in the modern era must include options that are accessible to all, but this does not mean that all options must be universal. This study’s iterative process led to the development of a cancer prevention mobile application that Non-Hispanic Black primary care patients deemed usable and acceptable and yielded a number of noteworthy insights about what intended end-users value in setting and accomplishing health goals.

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