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There is considerable agreement on the importance
of developing and delivering health promotion interventions that are culturally
sensitive. Additionally, there is a growing body of literature to support that
targeted interventions are effective for increasing lifestyle exercise. However,
to build a targeted intervention, it is necessary to understand the cultural and
situation attributes specific to a target population. Little is known about
African Americans’ preferences for features of an electronic intervention to
increase lifestyle exercise.
In our project we plan to adapt the E-CHANGE
intervention to an African American population. Titled, Electronically Change Habits by Applying New Goals and Experiences (E-CHANGE), this
computer-based interactive intervention consists of a sequence of nurse-led
activities designed to increase cardiac patients’ expectancy-value,
self-efficacy, problem-solving and relapse prevention skills regarding exercise
maintenance. The content of the E-CHANGE intervention is based on a face-to-face
intervention, CHANGE, that we have recently tested in a randomized
trial and has shown to be effective. In E-CHANGE, individuals use
computer terminals in their homes, track and receive feedback on their exercise
behavior, and communicate with of a nurse “coach” by Internet access.
Thus, the aims of this pilot
study are to (1) examine the perceptions and experiences of African American
patients in incorporating exercise into their lifestyles following cardiac
events, (2) gain their views and experiences on the use of electronic health
information systems, and (3) obtain reactions to and suggestions for the
E-CHANGE intervention. Focus group interviews will be used to answer the
following research questions: 1.What are African Americans’ perceptions
of the problems/barriers to maintaining exercise following cardiac events?
2.What do African Americans perceive as the most helpful supports/enhancers for
exercise following cardiac events? 3.What are African Americans’ experiences
accessing/using electronic health information services? 4.What are African
Americans' reactions to specific features and content of E-CHANGE protoypes?
5.What suggestions do African Americans have for changing the E-CHANGE
intervention so that it is culturally sensitive?
Using four focus groups of 10
individuals each (n= 40), the perceptions and experiences of African American
women’s and men’s adoption and maintenance of exercise following cardiac
rehabilitation will be determined and their suggestions and reactions to an
electronic intervention to increase exercise will be sought. Two rounds of
interviews with the four focus groups will be conducted to obtain data on the
cultural content and design features needed for the E-CHANGE intervention. In
the first round, important information about subjects’ experiences of
incorporating exercise into their lives following a cardiac event will be sought
as well
their reactions to the E-CHANGE prototype. Results from the first round of focus
groups will be used to make modifications in the E-CHANGE intervention. In a
second round, these same individuals will be brought back and asked to respond
to a revised version of the E-CHANGE intervention.
This study is innovative in that it attempts to obtain data about both surface
and deep level cultural issues of African Americans regarding maintaining
exercise following cardiac events and their use of electronic health
interventions. It includes the recipients (target audience) of an electronic
healthcare delivery system as co-designers of the system.
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