Dietary Approaches to Stop Hypertension: Lessons Learned From a Case Study on the Development of an mHealth Behavior Change System

Abstract

BackgroundEvidence-based solutions for changing health behaviors exist but problems with feasibility, sustainability, and dissemination limit their impact on population-based behavior change and maintenance.ObjectiveOur goal was to overcome the limitations of an established behavior change program by using the inherent capabilities of smartphones and wireless sensors to develop a next generation mobile health (mHealth) intervention that has the potential to be more feasible.MethodsIn response to the clinical need and the growing capabilities of smartphones, our study team decided to develop a behavioral hypertension reduction mHealth system inspired by Dietary Approaches to Stop Hypertension (DASH), a lifestyle modification program. We outline the key design and development decisions that molded the project including decisions about behavior change best practices, coaching features, platform, multimedia content, wireless devices, data security, integration of systems, rapid prototyping, usability, funding mechanisms, and how all of these issues intersect with clinical research and behavioral trials.ResultsOver the 12 months, our study team faced many challenges to developing our prototype intervention. We describe 10 lessons learned that will ultimately stimulate more effective and sustainable approaches.ConclusionsThe experiences presented in this case study can be used as a reference for others developing mHealth behavioral intervention development projects by highlighting the benefits and challenges facing mHealth research.

Hypertension in Blacks

“…The feasibility and long-term sustainability of these community-based outreach programs, some of which require intense resources is unclear. 73 The inclusion of technology-based or mobile health (mHealth) interventions 74, 75 should be considered to test whether they can enhance culturally-appropriate community-based programs. This can include telephone-delivered hypertension management programs 76, 77 in conjunction with HBPM, or ABPM and/or mobile phone text messaging to support medication adherence.…”

“…78, 79 Smartphone technology can also be used to facilitate data collection, including ecological momentary assessments among JHS participants between study visits and deliver or re-emphasize healthcare education 80 and lifestyle interventions. 73, 81 …”

The mediating role of self-efficacy in the relationship between premotivational cognitions and engagement in multiple health behaviors: a theory-based cross-sectional study among township residents in South Africa

“…However, problems such as feasibility, sustainability and dissemination limit the impact of evidence-based solutions on advocacy, social mobilization and behavioral and social changes among individuals 14. One study has shown that perceptions of illness influence the way patients cope and self-manage the illness.…”

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“…[1,6,7] In order to achieve patient engagement in the ED, a number of research have suggested using health information technology (HIT), an electronic dashboard, mobile application, and tablet PC. [8][9][10][11][12][13] At present, however, the potential of HIT has not been reached fully owing to the deficiency of design and implementation. [14][15] To reach the potential of HIT, we developed the "Talking Pole" using the core principles of the Human-Centered Design (HCD) approach, such as the iterative process which is well-suited for the development of HIT.…”