Community-Based Participatory Research and User-Centered Design in a Diabetes Medication Information and Decision Tool

Henderson, Vida; Barr, Kathryn L.C.; An, Lawrence C.; Guajardo, Claudia; Newhouse, William; Mase, Rebecca; Heisler, Michele

doi:10.1353/cpr.2013.0024

Cited by 55 publications

(41 citation statements)

References 53 publications

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“…An ancillary randomized control trial compared a participant group that received the iDecido program on the tablet versus a group exposed to the same educational material in print form. 48 While both groups demonstrated improved self-efficacy, medication adherence, and HbA1c, additional benefits reported by the iDecido group included higher satisfaction with medication information and improvements in diabetes distress. It is possible that by delivering material via an interactive platform that incorporated patients' specific goals and barriers to diabetes self-management, community health workers were able to more clearly convey information and behavior problem solving skills.…”

Section: Deployment Of Tablet Technology and The Community Health Wormentioning

confidence: 92%

“…22 Differences in how health information is perceived affects the attention given to that information, with low saliency leading to health knowledge gaps, poor health behaviors and lower participation in health interventions. 48,56 To enhance saliency of messages it is important to consider how the content is framed, especially among individuals with low general and health literacy. For example, gain-framed messages emphasize the benefits associated with adopting a health behavior while loss-framed messages focus on the costs of not adopting.…”

Section: Tailoring Ehealth Interventions For Latino Populationsmentioning

confidence: 99%

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Eliminating disparities among Latinos with type 2 diabetes: Effective eHealth strategies

López

Tan‐McGrory

Horner

et al. 2016

Journal of Diabetes and its Complications

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Latinos are at increased risk for obesity and type 2 diabetes (T2D). Well-designed information technology (IT) interventions have been shown to be generally efficacious in improving diabetes self-management. However, there are very few published IT intervention studies focused on Latinos. With the documented close of the digital divide, Latinos stand to benefit from such advances. There are limited studies on how best to address the unique socio-cultural-linguistic characteristics that would optimize adoption, use and benefit among Latinos. Successful e-health programs involve frequent communication, bidirectionality including feedback, and multimodal delivery of the intervention. The use of community health workers (CHWs) has been shown consistently to improve T2D outcomes in Latinos. Incorporating CHWs into eHealth interventions is likely to address barriers with technology literacy and improve patient activation, satisfaction and adherence. Additionally, tailored interventions are more successful in improving patient activation. It is important to note that tailoring is more than linguistic translation; tailoring interventions to the Latino population will need to address educational, language, literacy and acculturation levels, along with unique illness beliefs and attitudes about T2D found among Latinos. Interventions will need to go beyond the lone participant and include shared decision making models that incorporate family members and friends.

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Section: Deployment Of Tablet Technology and The Community Health Wormentioning

confidence: 92%

Section: Tailoring Ehealth Interventions For Latino Populationsmentioning

confidence: 99%

Eliminating disparities among Latinos with type 2 diabetes: Effective eHealth strategies

López

Tan‐McGrory

Horner

et al. 2016

Journal of Diabetes and its Complications

View full text Add to dashboard Cite

show abstract

“…The development process and content of the iDecide program have been described in detail elsewhere (32). Briefly, we used CBPR and User Centered Design (UCD) (33, 34) principles to iteratively develop and refine the iDecide tool.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Community Health Worker–Led Diabetes Medication Decision-Making Support for Low-Income Latino and African American Adults With Diabetes Using E-Health Tools Versus Print Materials

et al. 2014

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Background Health care centers serving low-income communities have scarce resources to support medication decision-making among patients with poorly controlled diabetes. Objective We compared outcomes between community health worker (CHW) use of a tailored, interactive web-based tablet-delivered tool (iDecide) versus use of print educational materials. Design A randomized two-arm trial from 2011-2013. Trial Registration NCT01427660. Setting Community health center in Detroit serving a Latino and African American low-income population. Participants 188 adults with a hemoglobinA1c >7.5% (55%) or who reported questions, concerns, or difficulty taking diabetes medications Primary Funding Sources Agency for Health Care Quality and Research (1R18HS019256-01) and P30DK092926 (MCDTR) Measurements Primary outcomes were changes in knowledge about anti-hyperglycemic medications, patient-reported medication decisional conflict, and satisfaction with anti-hyperglycemic medication information. We also examined changes in diabetes distress, self-efficacy, medication adherence, and A1c. Intervention Participants were randomized to receive a 1-2 hour session with a CHW using either iDecide or printed educational materials and two follow-up calls. Results 94% of participants completed three-month follow-up. Both groups improved across most measures. iDecide participants reported greater improvements in satisfaction with medication information (helpfulness, p=.007; clarity, p=.03) and in diabetes distress compared to the print materials group (p<0.001). There were no differences between groups in other outcomes. Limitations The study was conducted at one health center over a short period, and the CHWs were experienced in behavioral counseling, thus possibly mitigating the need for additional support tools. Conclusions Most outcomes were similarly improved among participants receiving both types of diabetes medication decision-making support. Longer-term evaluations are necessary to determine whether the greater improvements in satisfaction with medication information and diabetes distress achieved in the iDecide group at three months translate into better longer-term diabetes outcomes.

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“…The evaluation process can improve transparency, reveal potential facilitators and barriers to participation, and improve the robustness of research, helping researchers to gain a better understanding of patient and community interests and priorities. 2,3,18,19 …”

Section: Introductionmentioning

confidence: 99%

Facilitating Meaningful Engagement on Community Advisory Committees in Patient-Centered Outcome Research

Kelly¹,

Wang²,

Lucas³

et al. 2017

Progress in Community Health Partnerships

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Background Reflecting on the processes and practices used to engage community stakeholders in patient-centered outcome research strengthens participation at the project level and contributes more broadly to developing knowledge about effective participatory processes and methods. Objectives We conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision-aid for older women with early-stage breast cancer. Methods In-depth qualitative interviews were conducted with PAC members to obtain their input on the effectiveness of the project’s participatory approach and identify barriers to participation. Results and lessons learned Although there was general support for the aims of the study, patient knowledge gaps and meeting facilitation style limited participation. Members made suggestions on improving collaboration within the group, that, when implemented, resulted in increased participation and revitalized interest in the project. Conclusion Results suggest that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers’ capacity to engage meaningfully with stakeholders.

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Community-Based Participatory Research and User-Centered Design in a Diabetes Medication Information and Decision Tool

Cited by 55 publications

References 53 publications

Eliminating disparities among Latinos with type 2 diabetes: Effective eHealth strategies

Eliminating disparities among Latinos with type 2 diabetes: Effective eHealth strategies

Comparison of Community Health Worker–Led Diabetes Medication Decision-Making Support for Low-Income Latino and African American Adults With Diabetes Using E-Health Tools Versus Print Materials

Facilitating Meaningful Engagement on Community Advisory Committees in Patient-Centered Outcome Research

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