Engaging Black Men in Digital Health to Improve Self-Management of Type 2 Diabetes: An Iterative Participatory Design Approach

摘要 帮助患者自我管理复杂的慢性病，如2型糖尿病(T2 DM)仍然是一项挑战 特别是对于少数族裔，特别是黑人男性，他们的发病率更高，更贫穷 健康结果。糖尿病需要严格的自我管理和监测血糖水平、体重、 坚持服药和生活方式行为，如饮食和锻炼。然而，黑人男性面临着更多的障碍 糖尿病患者的自我管理能力高于非西班牙裔白人，原因多种多样，包括在获取方面的差异 和提供护理、沟通和保健、识字障碍、性别角色、不信任和文化信仰 关于医疗系统的问题。由于智能手机和医疗仪表盘无处不在，数字 可以在不同的人群中利用这些技术来收集和监控与糖尿病相关的数据 患者的日常环境(即血糖、体重、服药依从性和生活方式行为)。 这些数据可以近乎实时地进行分析，为患者提供自我管理和 临床医生在就诊之间更全面地了解健康状况。然而，对数字健康的研究表明 在患有T2 DM的黑人男性中促进自我管理的人很少，特别是在涉及如何 适当地让患有T2 DM的黑人男性使用数字健康技术来改善自我管理。 虽然数字健康前景广阔，但我们还不知道如何开发相关和 专为需要自我管理糖尿病的黑人男性量身定做。 与国家护理研究所的战略计划一致，该战略计划旨在促进 利用技术创新改善慢性病患者的健康和生活质量 通过自我管理，这项研究旨在填补关于黑人男性的知识空白，以及如何有效地 定制数字健康技术，以促进T2 DM管理。这项研究的目的是调查 使用数字健康技术进行T2 DM自我管理的障碍、促进者和偏好 黑人。这项定性研究将使用焦点小组来探索40名黑人男性生活的视角 北卡罗来纳州的T2 DM患者。此外，我们将采用迭代参与式设计方法来开发和 完善医疗保健仪表盘，满足特定种族/民族和基于性别的需求和偏好。 这些知识对于满足日益增长的黑人男性的自我管理需求是必不可少的 患有糖尿病。这项研究的长期目标是为未来将开发和测试数字技术的研究提供信息 卫生技术，以改善符合种族/民族需求和基于性别的自我管理 患有2型糖尿病的黑人男性的偏好。

ABSTRACT Helping patients self-manage a complex chronic illness such as Type 2 Diabetes (T2DM) remains a challenge particularly for racial minorities especially for Black men, who experience higher rates of incidence and poorer health outcomes. Diabetes requires stringent self-management and monitoring of blood glucose levels, weight, medication adherence and lifestyle behaviors such as diet and exercise. Yet, Black men face more barriers to diabetes self-management than non-Hispanic whites for a variety of reasons, including disparities in access and delivery of care, communication and health literacy barriers, gender roles and, mistrust and cultural beliefs regarding the medical system. Due to the ubiquity of smartphones and healthcare dashboards, digital technologies can be leveraged across diverse populations to collect and monitor diabetes-related data from patients in their daily environments (i.e., blood glucose, weight, medication adherence, and lifestyle behaviors). These data can be analyzed and in near real-time to provide guidance to patients to self-manage and give clinicians a more complete picture of health in-between clinic visits. However, research on digital health that facilitates self-management among Black men with T2DM is scarce, particularly as it relates to how to appropriately engage Black men with T2DM in use of digital health technologies to improve self-management. While digital health holds great promise, we do not yet know how to develop technologies that are relevant and tailored for Black men who need to self-manage their diabetes. Congruent with the strategic plan of the National Institute of Nursing Research, which seeks to promote innovations using technology to improve health and improve quality of life for individuals with chronic illness through self-management, this study aims to fill a knowledge gap concerning Black men and how to effectively tailor digital health technologies to facilitate T2DM management. The purpose of this study is to investigate the barriers, facilitators, and preferences of using digital health technologies for T2DM self-management among Black men. This qualitative study will employ focus groups to explore the perspectives of 40 Black men living with T2DM in North Carolina. Further, we will employ an iterative participatory design approach to develop and refine a healthcare dashboard that addresses specific racial/ethnic and gender-based needs and preferences. This knowledge is essential for meeting the self-management needs of the growing population of Black men with diabetes. The long-term goal of this study is to inform future research that will develop and test digital health technologies to improve self-management that align with the racial/ethnic needs and gender-based preferences of Black men living with T2DM.