O Estado das Disparidades em Saúde dos Luso-Americanos

Pavão, Carlos A. O.; Gunn, Grayson E.; Golden, Rebecca G.

doi:10.20344/amp.15659

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Approximately 1.5 million people of Portuguese descent live in the U.S., with over 265,000 residing in Massachusetts, the second-highest concentration of Portuguese Americans [3]. Despite being one of the largest ethnic groups in Massachusetts and several other states, the health status, issues, and disparity among the Portuguese American population are not well-documented [4]. While the prevalence of diabetes among Portuguese Americans is not well documented, statistical data indicates a significantly higher prevalence of diabetes among numerous racial and ethnic minority populations in the U.S. relative to non-Hispanic White Americans [3].…”

Section: Introductionmentioning

confidence: 99%

A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study (Preprint)

LeSeure,

Chin,

Zhang

2024

Preprint

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BACKGROUND Background: Mobile applications (apps) have demonstrated effectiveness in supporting self-care in patients with type 2 diabetes. However, the absence of cultural relevance in these apps may diminish user engagement, especially among specific ethnic groups. Portuguese Americans, a unique population with specific needs in diabetes management, appear to be an understudied group in this regard, with a lack of published research on culturally tailored diabetes apps designed for their unique needs and preferences. OBJECTIVE Objective: This study aimed to develop a prototype app for Portuguese Americans with T2DM using the design thinking approach. METHODS Methods: The development process was guided by the five-step design thinking methodology, a rigorous approach suggested by the Hasso-Plattner Institute of Design at Stanford University. Phase 1 of this study involved the first two steps: empathize and define. Phase 2, the focus of this paper, comprised the following two steps: ideate and prototype, during which the prototype DiaFriend app (Version 1) was designed and developed. Phase 3, the fifth step, test, entails the ongoing evaluation of the app. RESULTS Results: The DiaFriend app (Version 1), meticulously designed with insights from Portuguese Americans with type 2 diabetes residing in Massachusetts, comprises five features: blood glucose monitoring, weight tracking, carbohydrate tracking, exercise log, and medication reminder. The carbohydrate tracking feature was explicitly tailored to correspond to Portuguese food culture. This paper details the app's development, the creation of the frontend interface, and the challenges faced during the backend development, which further underscores the meticulousness and dedication in the ideate processing and beginning creation of the prototype. CONCLUSIONS Conclusions: The research team firmly believes that the DiaFriend app (Version 1), with its unique and crucial cultural sensitivity, has the potential to significantly improve self-care among Portuguese Americans with type 2 diabetes. This innovative approach sets the stage for a more culturally tailored and effective approach to diabetes management, underscoring the importance of cultural relevance in healthcare technology.

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Section: Introductionmentioning

confidence: 99%

A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study (Preprint)

LeSeure,

Chin,

Zhang

2024

Preprint

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“…Unhealthy behaviors such as smoking and the lack of exercise and cancer screening are more prevalent when compared to other U.S residents (9). Socioeconomic disadvantages, language barriers, separation from family and friends, uninsurance and inadequate access to healthcare, discrimination, and fear of deportation are factors that contribute to health disparities (7,11,12,(16)(17)(18). Immigrants from Brazil work mostly with construction, house cleaning, and food services, being exposed to chemical, ergonomic, physical, and psychosocial job hazards (19).…”

Section: Introductionmentioning

confidence: 99%

Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study

et al. 2021

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Background: Portuguese-speaking immigrants are a growing underserved population in the Unites States who experience high levels of psychological distress and increased vulnerability to mental health disorders such as depression and anxiety. Current evidence shows that mindfulness-based interventions (MBIs) are effective to promote physical and mental health among educated English speakers; nonetheless, the lack of diversity in the mindfulness literature is a considerable limitation. To our knowledge, the feasibility and acceptability of MBIs among Portuguese-speaking immigrants have not yet been investigated.Methods: This single-arm pilot study (N = 30) explored the feasibility, acceptability, and cultural aspects of Mindfulness Training for Primary Care (MTPC)-Portuguese among Portuguese-speaking immigrants in the Boston area. MTPC is an 8-week, primary care-adapted, referral-based, insurance-reimbursable, trauma-informed MBI that is fully integrated into a healthcare system. The study also examined intervention preliminary effectiveness on mental health outcomes (depression and anxiety symptoms) and self-regulation (emotional regulation, mindfulness, self-compassion, interoceptive awareness), and initiation of health behavior was explored.Results: Primary care providers referred 129 patients from 2018 to 2020. Main DSM-5 primary diagnoses were depression (76.3%) and anxiety disorders (6.7%). Participants (N = 30) attended a mean of 6.1 (SD 1.92) sessions and reported a mean of 213.7 (SD = 124.3) min of practice per week. All survey finishers would recommend the program to a friend, found the program helpful, and rated the overall program as “very good” or “excellent,” and 93% would participate again, with satisfaction mean scores between 4.6 and 5 (Likert scale 0–5). Participants and group leaders provided feedback to refine MTPC-Portuguese culturally responsiveness regarding materials language, settings, time, food, and community building. Patients exhibited reductions in depression (d = 0.67; p < 0.001) and anxiety (d = 0.48; p = 0.011) symptoms, as well as enhanced emotional regulation (d = 0.45; p = 0.009), and among survey finishers, 50% initiated health behavior change through action plan initiation.Conclusion: This pilot study suggests that MTPC-Portuguese is feasible, acceptable, and culturally appropriate among Portuguese-speaking patients in the Boston area. Furthermore, the intervention might potentially decrease depression and anxiety symptoms, facilitate health behavior change, and improve emotional regulation. MTPC-Portuguese investigation with larger samples in controlled studies is warranted to support its dissemination and implementation in the healthcare system.Clinical Trial Registration: Identifier: NCT04268355.

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A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study

LeSeure,

Chin,

Zhang

2024

JMIR Diabetes

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Background Mobile apps designed with cultural sensitivity have demonstrated higher user acceptability and greater effectiveness in enhancing self-care skills. However, a significant gap exists in developing such apps for specific populations, such as Portuguese Americans living in southern Massachusetts, home to the second-largest Portuguese community in the United States. This group possesses unique cultural traditions, particularly in dietary practices, including a tendency toward high carbohydrate intake. Tailoring diabetes self-care apps to address these specific cultural requirements could substantially improve diabetes management within this population. Objective The aim of this app development project was to develop a prototype diabetes management app for Portuguese Americans with type 2 diabetes mellitus using the design thinking methodology, incorporating user-centered design principles and cultural sensitivity. This paper describes the phase-2 results, focusing on app design and development. Methods Phase 2 of this app development project adhered to the design thinking methodology delineated by the Hasso Plattner Institute of Design at Stanford University, focusing on 2 critical steps: ideation and prototyping. This phase started in March 2022 and continued until April 2024. The project was driven by a multidisciplinary team consisting of 2 nurse educators; an app development specialist; and 2 graduate research assistants from the university’s Computer and Information Sciences Department, both well-versed in mobile app development. Data collected during phase 1, which will be published separately, informed the app design and development process. Results The prototype of the DiaFriend app (version 1) was designed and developed. The app comprises five features: (1) blood glucose monitoring, (2) weight tracking, (3) carbohydrate tracking, (4) exercise log, and (5) medication reminder. The carbohydrate tracking feature was explicitly tailored to correspond to Portuguese food culture. This paper presents the front-end interface flowchart, demonstrating how the user navigates through each screen. It also discusses the challenges faced during the backend development, such as data not being able to be stored and retrieved. Conclusions The DiaFriend app (version 1) distinguishes itself from conventional diabetes self-care apps through its emphasis on cultural sensitivity. The development of this app underscores the importance of cultural considerations in health informatics. It establishes a foundation for future research in developing and evaluating culturally sensitive mobile health apps. The adaptation of such technologies has the potential to enhance self-care practices among Portuguese Americans with type 2 diabetes mellitus, with improved glycated hemoglobin levels as a potential outcome. The last step of the design thinking methodology, testing the app, will be conducted in phase 3 and the results will be published elsewhere.

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O Estado das Disparidades em Saúde dos Luso-Americanos

Abstract: N/a.

Cited by 3 publications

References 6 publications

A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study (Preprint)

A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study (Preprint)

Mindfulness Training for Primary Care for Portuguese-Speaking Immigrants: A Pilot Study

A Culturally Sensitive Mobile App (DiaFriend) to Improve Self-Care in Patients With Type 2 Diabetes: Development Study

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