Uptake of digital health interventions for cardiometabolic disease: A ‘Think Aloud’ Study with British South Asian individuals (Preprint)

Abstract

Digital health interventions (DHIs) could support prevention and management of cardiometabolic disease. However, those who may benefit most often experience barriers to awareness and adoption of these interventions.

Among South Asian individuals, we evaluated user experience of DHIs to prevent and manage cardiometabolic disease to understand barriers and facilitators to initial and ongoing use.

Among South Asian individuals recruited via primary care, community organisations, and snowball methods (n=18), we conducted “think-aloud” interviews using a reflective and reactive approach. Participants were asked to think aloud while completing a task they routinely do in a familiar DHI; and while setting up and completing a search task in a novel DHI, encouraging them to behave as if unobserved.

Participants included non-users, as well as those that used a range of DHIs as part of monitoring and improving their health. Lack of cultural specificity was highlighted as reducing relevance and usability, particularly relating to dietary change. Preferred features reflected individual health beliefs and behaviours, digital skills and trust in DHIs. For example, tracking blood glucose was considered by some to be positive, while for others it caused distress and anxiety. Similarly, some users found the novel DHI to be extremely simple to set up and use, and others grew frustrated navigating through initial interfaces. Many participants raised concerns about data privacy and needing to agree to terms and conditions which they did not understand. Participants expressed that with information and support from trusted sources, they would be interested in using DHIs as part of self-management.

DHIs may support South Asians to prevent and manage cardiometabolic disease, but it is important to consider the needs of specific user groups in DHI development, design, and implementation. Despite motivation to make health changes, digital barriers are common. Cultural appropriateness, and trusted sources (such as healthcare providers and community organisations) have roles in increasing awareness and enabling individuals to access and use DHIs.