Health-tech researcher + translator

DISSERTATION

Download available here.
As a public health doctoral student at the City University of New York School of Public Health I made a web-based sexual health app, GURHL Code, Guide to Understanding Reproductive Health for Ladeez, as the central component of my dissertation research.
Specific Aims

This feasibility and acceptability study building on a National Research Service Award (F31MH099924 Gonzalez, S.) randomized a non-probability sample of 110 young Black and Latina women (YBLW) aged 18 to 25 living in NYC and assigned half to a treatment arm (tailored app) and half to a control arm with standard of care, (SOC), condition (a static web-page with the name, address and phone number of local clinics). We recruited our sample via a social networking website, an on-line dating app, and traditional word-of-mouth techniques. Using analytics, quantitative and qualitative methods, this study:

Aim 1: Using recruitment data: 1) compare those who were eligible for the study and enrolled to those who were eligible and did not enroll in the GURHL Code study; and 2) drawing from self-report data, compare the cost per enrollee per recruitment source.

Aim 2: In comparison to the control arm, determine the tailored apps’ usability (e.g., ease of use, content, and design) through: a) analytics (e.g., number of times information was accessed and duration of page visits on respective modalities), b) process measures, and c) focus groups of the treatment and control arms.

Aim 3: Obtained preliminary estimates of the effectiveness of the app in the treatment versus control arm over 3-months to increase: a) sexual health knowledge, b) intention to connect to sexual and reproductive health clinical services, and c) self-report linkages to SRH services.

 

Project Development Details

making-gurhl-code-infographicThis project is an out-growth of  20 years of public health experience I have serving youth and young adults. From 2005 to 2009, I trained young people in New York City aged 14 to 24 years old to become peer sexual health educators, during which time I noticed how deeply connected these young people were to their cell phones – they were constantly on their phones. They were texting and playing games and it became clear that health educators, and public health more broadly, needed to find a way to reach young people where they were: on their mobile phones.

These experiences led to the pursuit of the Interactive Technology and Pedagogy (ITP) Certificate at the Graduate Center while earning a doctorate at the CUNY School of Public Health. Read more about usability testing and the ITP program here. In the second year, with support from the Graduate Center’s New Media Lab, I developed a web-based sexual health education mobile app. During the academic 2011 year, I collaboratively developed the concept of a sexual health education app for public health research, and presented early concepts of the app to various NYC-based community-based organizations. 

I am especially grateful to the Community Advisory Committee who helped get this project off the ground. Our intention is to have medically accurate sexual health info easily available for those oops moments when young women need it and just when they might want to know more about sex, sexuality or some basics like about your body. Input to make this comes from *lots* of New York City women. Some of them were women over 25 years old who have been working with teens and young adults. 

Special thanks goes to the young adult advisors and focus group participants who helped design the look of the app and helping decide what content to have in the app. Additional thanks to Joe & Marco at the New Media Lab and Digital Services Librarian, Stephen Klein, for technical support to bring this project to fruition. Tech specs: beta version of this project was designed using Balsamiq, developed using Ruby on Rails. The pilot is a WordPress mobile friendly site and was developed using html, css, php, and javascript.

After obtaining CUNY IRB approval (# 381039), community providers and young women were recruited to serve on the community advisory committee (CAC) and focus groups were conducted to explore possible app content and design. In spring 2013, I learned Ruby on Rails (RoR) to build a modest application at the New Media Lab. By summer 2013, participants were recruited for focus groups to gather input on the app design, content and to test beta versions of the wireframe and the app itself through rapid prototyping. By spring 2014, the focus group results were analyzed, and changes were integrated into the app with support from a Ruby on Rails (RoR) developer. The app was finalized and again pretested with CAC youth and advisors in summer 2014 prior to launching for the research project. The responsive web-based app was then shared with research participants for an acceptability and pilot research study in 2015.

Financial support to design and execute this project came from the Dean’s Dissertation Award from the CUNY School of Public Health, Ruth Kirschstein Natioanl Research Award (NIMH-F31), the New Media Lab at the Graduate Center, the Graduate Center’s Doctoral Student Research Grant, and others