Related Experiment Video
Updated: Oct 7, 2025
Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies
Published on: February 3, 2023
An Open-Source Privacy-Preserving Large-Scale Mobile Framework for Cardiovascular Health Monitoring and Intervention
Gari Clifford1,2, Tony Nguyen1, Corey Shaw1
1Department of Biomedical Informatics, Emory University, Atlanta, GA, United States.
Insights
The MOYO mobile platform was co-designed with young African Americans to address cardiovascular disease (CVD) disparities. This system monitors health and environmental exposures, promoting early intervention in at-risk communities.
Area of Science:
- Public Health
- Health Informatics
- Cardiovascular Disease Research
Background:
- Cardiovascular diseases (CVDs) disproportionately affect young African Americans in the Southern US due to social determinants of health and health inequities.
- Early detection and intervention are crucial for preventing race-based disparities in adult diseases, but young adults are hard to engage.
- Existing health trajectories are impacted by early-life factors, necessitating interventions in younger populations.
Purpose of the Study:
- To develop a system design for the MOYO mobile platform.
- To address primordial prevention challenges in a young, at-risk population of Southern-urban African Americans.
Main Methods:
- Co-design sessions with 505 urban African Americans (aged 18-29) to develop MOYO prototypes.
- Qualitative analysis of 297 prototype screens using grounded theory and open-coding.
- Development of a cross-platform app using an agile design process and a HIPAA-compliant cloud infrastructure.
Main Results:
- Nine dominant design requirements emerged: customization, incentives, social engagement, awareness, education, behavior tracking, location services, health professional access, data agreements, and health assessment.
- The MOYO app collects health surveys, narratives, environmental data (pollution, weather, food deserts), physical activity, social networks, and physiological data.
- Integration with wearables and electronic health records was implemented via fast healthcare interoperability resources.
Conclusions:
- The MOYO mobile platform offers a comprehensive health and exposure monitoring system.
- Findings underscore the importance of involving African Americans in designing technologies to improve CVD outcomes.
- The platform supports both passive monitoring and active self-reporting for broad compliance.
Background:
Cardiovascular diseases (CVDs) are the leading cause of death worldwide and are increasingly affecting younger populations, particularly African Americans in the southern United States. Access to preventive and therapeutic services, biological factors, and social determinants of health (ie, structural racism, resource limitation, residential segregation, and discriminatory practices) all combine to exacerbate health inequities and their resultant disparities in morbidity and mortality. These factors manifest early in life and have been shown to impact health trajectories into adulthood. Early detection of and intervention in emerging risk offers the best hope for preventing race-based differences in adult diseases. However, young-adult populations are notoriously difficult to recruit and retain, often because of a lack of knowledge of personal risk and a low level of concern for long-term health outcomes.
Objective:
This study aims to develop a system design for the MOYO mobile platform. Further, we seek to addresses the challenge of primordial prevention in a young, at-risk population (ie, Southern-urban African Americans).
Methods:
Urban African Americans, aged 18 to 29 years (n=505), participated in a series of co-design sessions to develop MOYO prototypes (ie, HealthTech Events). During the sessions, participants were orientated to the issues of CVD risk health disparities and then tasked with wireframing prototype screens depicting app features that they considered desirable. All 297 prototype screens were subsequently analyzed using NVivo 12 (QSR International), a qualitative analysis software. Using the grounded theory approach, an open-coding method was applied to a subset of data, approximately 20% (5/25), or 5 complete prototypes, to identify the dominant themes among the prototypes. To ensure intercoder reliability, 2 research team members analyzed the same subset of data.
Results:
Overall, 9 dominant design requirements emerged from the qualitative analysis: customization, incentive motivation, social engagement, awareness, education, or recommendations, behavior tracking, location services, access to health professionals, data user agreements, and health assessment. This led to the development of a cross-platform app through an agile design process to collect standardized health surveys, narratives, geolocated pollution, weather, food desert exposure data, physical activity, social networks, and physiology through point-of-care devices. A Health Insurance Portability and Accountability Act-compliant cloud infrastructure was developed to collect, process, and review data, as well as generate alerts to allow automated signal processing and machine learning on the data to produce critical alerts. Integration with wearables and electronic health records via fast health care interoperability resources was implemented.
Conclusions:
The MOYO mobile platform provides a comprehensive health and exposure monitoring system that allows for a broad range of compliance, from passive background monitoring to active self-reporting. These study findings support the notion that African Americans should be meaningfully involved in designing technologies that are developed to improve CVD outcomes in African American communities.
