Acceptability and Feasibility of a Self-Directed Health Priorities Program for Southern Older African Americans

TL;DR

A web-based health program for older African Americans was found acceptable but needs improvements in usability and cultural relevance.

Contribution

The study evaluates the acceptability and feasibility of a culturally tailored health priorities program for Southern older African Americans.

Findings

Patients rated the program's usability as good (75.3 ± 14.6), while caregivers rated it as poor (30.1 ± 4.3).

Participants suggested optimizing mobile functionality and using culturally adapted avatars.

The program was acceptable to patients but faced navigation challenges on non-computer devices.

Abstract

Acceptability and feasibility of a self-directed health priorities program for Southern older African Americans were assessed in a mixed-methods formative evaluation (NIH Stage 1a). The study explored patient and family caregiver (FCG) experiences with the “My Health Priorities” (MHP) web-based program, a component of the Patient Priorities Care Approach. Fifteen older African Americans (≥65 years, ≥2 chronic conditions) and their adult African American FCGs (≥18 years) from a southeastern U.S. primary care clinic participated. Thematic analysis of interviews and usability assessments via the System Usability Scale (SUS) were conducted. Patients generally found the program acceptable but faced navigation challenges on non-computer devices. Recommendations included culturally adapting avatars, optimizing mobile functionality, and providing strategies for patient-clinician interactions. Patients rated usability at 75.3 ± 14.6 (good), whereas FCGs rated it at 30.1 ± 4.3 (poor). Study measures took 30 minutes to complete, while the intervention took 60 minutes, with 81% of study measures completed. Findings suggest that web-based programs may be acceptable for African American patients and caregivers, but usability and cultural relevance require improvement. Differences in patient and caregiver usability ratings highlight the need for tailored design considerations.