A qualitative analysis to optimize a telemonitoring intervention for heart failure patients from disparity communities

BMC Medical Informatics and Decision Making

Research Article

L. Murray¹  G. McKenzie¹  R. Pekmezaris²  P. DiMarzio²  C. N. Nouryan²  R. M. Schwartz³  L. Bauer⁴  D. Ahern⁴  S. Castillo⁴  A.N. Makaryus⁵  T. Orona⁶  K. Pecinka⁶  T. N. Taylor⁷ 

[1] Community Advisory Board, Northwell Health, 175 Community Drive, 11021, Great Neck, NY, USA;Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA;Department of Occupational Medicine, Epidemiology, and Prevention, Hofstra Northwell School of Medicine, 175 Community Drive, 11021, Great Neck, NY, USA;Northwell Health, 175 Community Drive, 11021, Great Neck, NY, USA;Department of Occupational Medicine, Epidemiology, and Prevention, Hofstra Northwell School of Medicine, 175 Community Drive, 11021, Great Neck, NY, USA;Northwell Health, 175 Community Drive, 11021, Great Neck, NY, USA;Nassau University Medical Center, 2201 Hempstead Tpke, 11554, East Meadow, NY, USA;Nassau University Medical Center, 2201 Hempstead Tpke, 11554, East Meadow, NY, USA;Department of Cardiology, Hofstra Northwell School of Medicine, Manhasset, NY, USA;Northwell Health, 175 Community Drive, 11021, Great Neck, NY, USA;SUNY Downstate School of Medicine, 450 Clarkson Ave, 11203, Brooklyn, NY, USA;

关键词: Focus Group;    Heart Failure Patient;    Focus Group Discussion;    Community Advisory Board;    Target Patient Population;   

DOI  :  10.1186/s12911-016-0300-9

 received in 2015-12-04, accepted in 2016-05-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe use of telemonitoring is a promising approach to optimizing outcomes in the treatment of heart failure (HF) for patients living in the community. HF telemonitoring interventions, however, have not been tested for use with individuals residing in disparity communities.MethodsThe current study describes the results of a community based participatory research approach to adapting a telemonitoring HF intervention so that it is acceptable and feasible for use with a lower-income, Black and Hispanic patient population. The study uses the ADAPT-ITT framework to engage key community stakeholders in the process of adapting the intervention in the context of two consecutive focus groups. In addition, data from a third focus group involving HF telemonitoring patient participants was also conducted. All three focus group discussions were audio recorded and professionally transcribed and lasted approximately two hours each. Structural coding was used to mark responses to topical questions in the interview guide.ResultsThis is the first study to describe the formative process of a community-based participatory research study aimed at optimizing telehealth utilization among African-American and Latino patients from disparity communities. Two major themes emerged from qualitative analyses of the focus group data. The first theme that arose involved suggested changes to the equipment that would maximize usability. Subthemes identified included issues that reflect the patient populations targeted, such as Spanish translation, font size and medical jargon. The second theme that arose involved suggested changes to the RCT study structure in order to maximize participant engagement. Subthemes also identified issues that reflect concerns of the targeted patient populations, such as the provision of reassurances regarding identity protection to undocumented patients in implementing an intervention that utilizes a camera, and that their involvement in telehealth monitoring would not replace their clinic care, which for many disparity patients is their only connection to medical care.ConclusionsThe adaptation, based on the analysis of the data from the three focus groups, resulted in an intervention that is acceptable and feasible for HF patients residing in disparity communities.Trial registrationNCT02196922; ClinicalTrials.gov (US National Institutes of Health).

【 授权许可】

CC BY   
© The Author(s). 2016