Abstract A08: Designing eHealth applications to support Hispanic cancer survivors
Authors: Banas Jennifer R. , Victorson David , Gutierrez Sandra , Cordero Evelyn , Flores Lucia 
Published: May 2015

Abstract
Background: Formative work was conducted with a Hispanic cancer survivor community toward the development of a tailored, literacy-friendly eHealth symptom management application. Ultimately, data will be used to create a symptom monitoring and support system.
Theoretical Framework: Cancer is the leading cause of death for Hispanics. Given the heterogeneity of sub-groups, designing appropriate health communications is challenging. Leveraging this population's increasing use of information and communication technology (ICT), there is potential to provide Hispanic cancer survivors with appropriately tailored eHealth communications.
Tailoring is a message design technique that incorporates formally assessed individual characteristics into message design, thus making the message personally relevant.1,2 Tailoring eliminates unessential information; what remains is more personally relevant. When information is relevant, it is more likely to be thoughtfully processed, and thus, more successful in guiding a person to make a suggested behavior change.1
Using a reliable and valid behavior model when designing health communications increases the likelihood for success. This study employed Fishbein's Integrative Model of Behavioral Prediction. This model has demonstrated to be effective in predicting intention, identifying key variables for intervention, and discriminating audience characteristics.3
Research Questions: Our research questions were as follows: (1) What are survivors' most common symptoms/side effects post treatment; (2) What strategies do they use to manage symptoms/side effects; (3) How do they use ICT for information or symptom support? (4) What suggestions do they have for the design of eHealth symptom support?
Methods: We conducted 3 mixed cancer patient focus groups (n=30). Trained Spanish-speaking facilitators lead the sessions using a moderator's guide grounded in the research questions. Recorded sessions were translated by a transcription service. Investigators and research assistants systematically examined transcriptions to generate a list of themes.
Results: Five key themes emerged: (1) Participants placed high importance on quality patient/medical professional communication; (2) When obtaining information or support, participants preferred to engage with a real person; (3) Participants are open to using various ICT, but recognize not all have access; (4) Depression and stress were the most common side effects; (5) The primary coping mechanism was social support; (6) Participants indicated a desire to connect with other cancer survivors.
Discussion: The ability to intervene with Hispanic cancer survivors in a culturally and personally relevant, literacy-friendly manner through an accessible symptom management eHealth application has great potential to address health disparities and contribute to improved health related quality of life with this population. It is critical such applications address the desire for personal communication and high quality relationships with a health professional. This application should also provide an opportunity to connect with similar others.
Conclusion: The ability to help Hispanic cancer survivors manage symptoms via a tailored, literacy-friendly manner eHealth application has potential to reduce health disparities among this population and to improve their health-related quality of life. Continued research will support the design of such eHealth applications.
(1) Kreuter M, Farrell D, Olevitch L, Brennan L. Tailoring Health Messages: Customizing Communication with Computer Technology. New Jersey: Lawrence Erlbaum Associates; 2000.
(2) Victorson D, Mendoza-Temple L, Takagishi C, Brendler C, Shevrin D, Cella D. Tailoring Supportive Care Interventions to Men Diagnosed with Prostate Cancer. Psychooncology. 2009; 18:S1-S58.
(3) Fishbein M. The Role of Theory in Developing Effecive Health Communications. Journal of Communication 56, s1-s17. 2006.
Citation Format: Jennifer R. Banas, David Victorson, Sandra Gutierrez, Evelyn Cordero, Lucia Flores. Designing eHealth applications to support Hispanic cancer survivors. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A08. doi:10.1158/1538-7755.DISP13-A08