An mHealth Physical Activity Intervention for Latina Adolescents: Iterative Design of the Chicas Fuertes Study (Preprint)

Abstract

BACKGROUND Adolescent girls report the lowest levels of physical activity (PA) of any demographic group, with rates especially low for racial/ethnic minority girls. Only 3% of Latina teens meet national PA guidelines, and these habits appear to persist into adulthood. Developing effective interventions to increase PA in Latina teens is necessary for preventing disease and reducing disparities. OBJECTIVE The study objective was to develop a mHealth PA intervention for Latina adolescents using a multi-stage iterative process based on an adaptation of the IDEAS (Integrate, DEsign, Assess, Share) framework. METHODS Development of the intervention was accomplished through three iterations: 1) feedback from a previous web-based pilot study, Niñas Saludables; 2) conducting focus groups with the target population; and, 3) vetting the final materials with a youth advisory board (YAB) comprising Latina adolescents. Based on feedback from participants in the Niñas Saludables study, plans to improve the intervention included incorporating visual social media posts and text messaging, adding a commercial wearable tracker, and revising the existing website to be primarily visual; proposed procedures and material were then refined through focus groups. Participants for focus groups (N=50) were girls age 13-18 who could speak and read in English who were recruited from local high schools and after school programs serving a high proportion of Latinos. Facilitated discussions focused on experience with PA and social media apps, and specific feedback on intervention material prototypes and possible names and logos. Materials were refined based on their feedback, then were beta tested by the YAB. YAB members (N=4) were Latinas age 13-18 who were not regularly active and were recruited via word of mouth and selected through an application process. RESULTS The focus group discussions yielded the following findings: PA preferences included walking, running and group fitness classes, while the least popular activities were running, swimming, and biking. Most participants used some form of social media, with Instagram being the most favored. Participants preferred text messages be sent no more than once a day, be personalized, and be positively worded. Focus group participants preferred an intervention directly targeting Latinas, and social media posts that were brightly colored, included girls of all body types, and provided specific tips and information. Modified intervention materials were generally perceived favorably by the YAB members, who provided suggestions for further refinements including incorporation of some Spanish phrases. CONCLUSIONS Latina teens were generally enthusiastic about an mHealth PA intervention, provided the materials were targeted specifically to them and their preferences. Through multiple iterations of development and feedback with the target population, we gained insight into the needs of Latina teens and joined with industry partners to build a viable final product.