A Physical Activity Just-in-time Adaptive Intervention Designed in Partnership With a Predominantly Black Community: Virtual, Community-Based Participatory Design Approach

Maria Cielito Robles, Mark W. Newman, Aalap Doshi, Sarah Bailey, Linde Huang, Soo Ji Choi, Chris Kurien, Beza Merid, Joan Cowdery, Jessica R. Golbus, Christopher Huang, Michael P. Dorsch, Brahmajee Nallamothu, Lesli E. Skolarus

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Black people are disproportionally impacted by hypertension. New approaches for encouraging healthy lifestyles are needed to reduce hypertension and promote health equity in Black communities. Objective: In this report, we describe the early-stage, virtual design of a just-in-time adaptive intervention (JITAI) to increase physical activity in partnership with members of a low-income, predominantly Black community. Methods: The hallmark of JITAIs is highly contextualized mobile app push notifications. Thus, understanding participants' context and determinants of physical activity are critical. During the height of the COVID-19 pandemic, we conducted virtual discovery interviews and analysis guided by the Behavior Change Wheel (which focuses on participants' capacity, opportunity, and motivation to engage in physical activity), as well as empathy mapping. We then formed a community-academic participatory design team that partnered in the design sprint, storyboarding, and paper prototyping. Results: For this study, 5 community members participated in the discovery interviews, 12 stakeholders participated in the empathy mapping, 3 community members represented the community on the design team, and 10 community members provided storyboard or paper prototyping feedback. Only one community member had used videoconferencing prior to partnering with the academic team, and none had design experience. A set of 5 community-academic partner design principles were created: (1) keep users front and center, (2) tailor to the individual, (3) draw on existing motivation, (4) make physical activity feel approachable, and (5) make data collection transparent yet unobtrusive. To address community-specific barriers, the community-academic design team decided that mobile app push notifications will be tailored to participants' baseline mobility level and community resources (eg, local parks and events). Push notifications will also be tailored based on the day (weekday versus weekend), time of day, and weather. Motivation will be enhanced via adaptive goal setting with supportive feedback and social support via community-generated notifications. Conclusions: We completed early-stage virtual design of a JITAI in partnership with community participants and a community design team with limited design and videoconferencing experience. We found that designing JITAIs with the community enables these interventions to address community-specific needs, which may lead to a more meaningful impact on users' health.

Original languageEnglish (US)
Article numbere33087
JournalJMIR Formative Research
Issue number3
StatePublished - Mar 2022
Externally publishedYes


  • blood pressure
  • community participatory design
  • design
  • health equity
  • healthy lifestyle
  • hypertension
  • just-in-time adaptive intervention
  • physical activity

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Informatics


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