Reach Out Emergency Department: Partnering With an Economically Disadvantaged Community in the Development of a...

Area of Science:

• Public Health
• Health Behavior Theory
• Mobile Health Interventions

Background:

• Hypertension impacts nearly 30% of U.S. adults, disproportionately affecting underserved communities.
• Mobile health interventions, particularly text messaging, show promise for chronic disease management.
• The Reach Out intervention targets hypertension management in African Americans within a safety net setting.

Purpose of the Study:

• To describe the development and refinement process of text messages for the Reach Out mHealth intervention.
• To outline a framework for creating culturally relevant and theory-based health promotion messages.
• To inform the design of future text-messaging interventions for vulnerable populations.

Main Methods:

• A five-step framework was employed: literature review, community formative research, theoretical framework development, message drafting, and community feedback/revision.
• Community input was integral throughout the development process to ensure relevance and acceptability.
• Messages were designed based on health behavior theories and evidence-based practices.

Main Results:

• A total of 333 text messages (generic and segmented) were created.
• Messages cover key hypertension management areas: diet, physical activity, medication adherence, and blood pressure monitoring.
• The development process resulted in a community-centered health behavior theory framework.

Conclusions:

• A community-centered, theory-based approach is crucial for developing effective text message interventions.
• Partnership with the local community ensures the acceptability and relevance of health promotion programs.
• The described five-step framework can guide future mHealth efforts for vulnerable populations.