The Role of Cultural Competency in the Development of mHealth Technology to Address Childhood Obesity Amongst Female African-American Adolescents

BACKGROUND: Research has indicated that African-American (AA) youth are consistently disproportionately affected by the childhood obesity epidemic, especially amongst AA females. The prevalence of childhood obesity in the United States has increased from 13.4% to 24.4% amongst AA adolescents, while the prevalence of obesity in all adolescents in this age bracket rose from 10.5% to 18.1%. By 2014, 42.5% of African-American (AA) girls were obese; the highest prevalence of any age group by gender, race or ethnicity. With statistics indicating 80% of obese adolescents will become obese adults, these AA females are on a trajectory towards worsening health outcome. There is a paucity of resources available to target obesity and mHealth technology has shown promises to create positive healthy behavior changes. OBJECTIVE/PURPOSE: Create a culturally competent mHealth technology that will address obesity in AA female adolescents. METHODS: Six focus groups were conducted amongst D.C. pediatric providers, AA female adolescents and their mothers. These groups discussed current strategies and barriers in addressing childhood obesity, specifically amongst AA female adolescents. RESULTS: In collecting data to inform the development of the software, there were key cultural nuances identified that should be considered. First, tools currently used to manage obesity need to be seen as applicable to this patient population. Many providers voiced that their patients’ parents were resistant to the BMI growth chart due to the inaccurate portrayal of their body type. Second, perceptions about health and weight are key influencers in health behaviors. Body image development occurs in a cultural context. Female AA adolescents noted their perceived ideal size was significantly larger in comparison to the standard norm for adolescent BMIs. Third, language and representation are very important in successfully targeting this population for weight intervention. Pediatric providers, adolescents and their parents agreed that having avatars that shared similar external characteristics was crucial to user engagement and adherence. CONCLUSION: Our findings indicate the need for more culturally appropriate tools when creating interventions. Specifically, these results are important in the development of our mHealth technology targeting behavior change in AA female adolescents in order to achieve healthier lifestyles