Center for Digital Health

Community-Based Interventions and the Future of Digital Health Research

By implementing digital health interventions on a community level, researchers may be able to improve both outcomes and equity. (Originally posted January 31st, 2020 on https://brownedhi.org)

space launchMany of the digital health programs that have been rolled out in recent years are designed to be used by an individual-yet research has shown that focusing on an individual level can have less of an impact on the health behaviors of vulnerable populations (1).  While creating digital health interventions for the individual may seem like the most common-sense means to evoke behavioral change, researchers have often neglected to recognize the importance of community-level factors in health habits. Community members have a shared identity, which leads to a collective effort of organizing, cooperation, and social support.  Constructing an intervention at the community level necessarily takes into account the structural issues that affect vulnerable populations, such as geographic, economic, and social disparities. Therefore, designing a digital health intervention that collectively engages communities may not only have a stronger impact on health behaviors, but also promote health equity within research.

Researchers in the field have already seen the positive effects of community-based health interventions, like Dr. Andrea Grimes Parker’s “Spaceship Launch” program, an exergame that converts participants’ physical activity metrics into points on a computer game.  Dr. Parker, a computer and health sciences professor at Northeastern University, has focused much of her work on exploring how computer technology can aid in reducing racial and economic health disparities (2).  The “Spaceship Launch” program was designed to help families in lower income neighborhoods, which experience disproportionately higher levels of obesity, visualize and take ownership of their physical activity in a collaborative way.  Participant families received FitBit and KidPower watches that tracked their daily physical activity; this data was then translated into “fuel” that powered a virtual spaceship game. Every Saturday, families went to their local community center and used a digital touch screen to play the game together and visualize the amount of fuel they accumulated throughout the week based on their level of physical activity-the higher the activity for the week, the more fuel they would have to play the game (3).

One major takeaway from the study was that the competition between families in the community led to higher interactions and engagements between groups, and deeper connections within their own neighborhoods.  The families would all come together on Saturday afternoons to play the game, collaborate, and challenge each other to win even more fuel for the next week.  It not only built up a sense of anticipation for the kids and parents, but also drove collective participation within a community space.

The study also highlighted the importance of data visceralization within digital health interventions; the participants had their activity levels brought to life through the game, rather than just reading steps taken or calories burned. It allowed them to interact with their metrics and have a deeper understanding of their physical activity, which in turn motivated them to achieve higher metrics for the next week.  Overall, Spaceship Launch demonstrated the effectiveness of community-based health interventions in promoting physical activity within families.  Future digital health projects that strive for health equity should consider focusing on the collective community, rather than the individual.

References:

(1) Elizabeth Stowell, Mercedes C. Lyson, Herman Saksono, Reneé C. Wurth, Holly Jimison, Misha Pavel, and Andrea G. Parker. 2018. Designing and Evaluating mHealth Interventions for Vulnerable Populations: A Systematic Review. In Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems (CHI ’18). Association for Computing Machinery, New York, NY, USA, Paper 15, 1–17.https://doi.org/10.1145/3173574.3173589

(2) Bio: Andrea Grimes Parker; Khoury College of Computer Sciences.  Retrieved January 29, 2020, https://www.khoury.northeastern.edu/people/andrea-grimes-parker/

(3) Herman Saksono, Ashwini Ranade, Geeta Kamarthi, Carmen Castaneda-Sceppa, Jessica A. Hoffman, Cathy Wirth, and Andrea G. Parker. 2015. Spaceship Launch: Designing a Collaborative Exergame for Families. In Proceedings of the 18th ACM Conference on Computer Supported Cooperative Work & Social Computing (CSCW ’15). Association for Computing Machinery, New York, NY, USA, 1776–1787. DOI:https://doi.org/10.1145/2675133.2675159