Browsing by Author "Gowan, Tayler M."

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    Co-Designing the MOSAIC mHealth App With Breast Cancer Survivors: User-Centered Design Approach
    (JMIR, 2024-12-09) Nuseibeh, Betsey Zenk; Johns, Shelley A.; Shih, Patrick C.; Lewis, Gregory F.; Gowan, Tayler M.; Jordan, Evan J.; Medicine, School of Medicine
    Background: Breast cancer is the world's most prevalent cancer. Although the 5-year survival rate for breast cancer in the United States is 91%, the stress and uncertainty of survivorship can often lead to symptoms of depression and anxiety. With nearly half of breast cancer survivors living with stress and symptoms of depression and anxiety, there are a significant number of unmet supportive care needs. New and potentially scalable approaches to meeting these supportive care needs are warranted. Objective: This study aimed to engage breast cancer survivors and acceptance and commitment therapy (ACT) content experts in user-centered design (UCD) to develop a mobile health app (MOSAIC [Mobile Acceptance and Commitment Therapy Stress Intervention]) using stress intervention strategies. Methods: We held 5 UCD sessions with 5 breast cancer survivors, 3 ACT content experts, 2 user experience design experts, and 1 stress expert facilitator over the course of 10 weeks. The sessions were developed to lead the 10 co-designers through the 5-step UCD process (eg, problem identification, solution generation, convergence, prototyping, and debriefing and evaluation). Following the fifth session, a prototype was generated and evaluated by the 5 breast cancer survivors and 3 ACT experts using the System Usability Scale, Acceptability E-scale, and a brief set of semistructured interview questions. Results: The 10 co-designers were present for each of the 5 co-design sessions. Co-designers identified 5 design characteristics: simple entry with use reminders (behavioral nudges), a manageable number of intervention choices, highly visual content, skill-building exercises, and social support. A total of 4 features were also identified as critical to the use of the tool: an ACT and breast cancer-specific onboarding process, clean navigation tools, clear organization of the interventions, and once-per-week behavioral nudges. These requirements created the foundation for the app prototype. The 5 breast cancer survivors and 3 ACT co-designers evaluated the app prototype for 1 week, using an Android smartphone. They rated the app as usable (mean 79.29, SD 19.83) on the System Usability Scale (a priori mean cutoff score=68) and acceptable (mean 24.28, SD 2.77) on the Acceptability E-scale (a priori mean cutoff score=24). Conclusions: Through the UCD process, we created an ACT app prototype with 5 breast cancer survivors, 3 ACT experts, and 2 UCD designers. The next step in our research is to continue the assessment and refining of the prototype with additional breast cancer survivors. Future work will pilot-test the app to examine the feasibility of a large-scale, randomized control trial. Studies will enroll increasingly diverse breast cancer survivors to broaden the generalizability of findings.
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    Effects of the COVID-19 Pandemic on Black Veterans’ Mental Health: A Qualitative Investigation
    (Johns Hopkins University Press, 2022-08) Matthias, Marianne S.; Adams, Jasma; Burgess, Diana J.; Daggy, Joanne; Gowan, Tayler M.; Perkins, Anthony J.; Eliancin, Johanne; Medicine, School of Medicine
    Although the disproportionate effects of the COVID-19 pandemic on Black Americans are well-documented, we know little about its effects on their day-to-day lives and sense of wellbeing, especially for those who have served in the military. We conducted qualitative interviews with 21 Black veterans to understand their experiences with the pandemic and administered questionnaires about mental health and pandemic impact. Questionnaires indicated mild depression, moderate anxiety and loneliness, and pandemic effects on social support and health care. Interviews revealed that heightened anxiety and stress were driven by not trusting others to take the pandemic seriously, workplace anxiety, comorbidities, and the pandemic's pronounced effects on Black communities. Participants shared insights into these effects, including lack of caution on the part of some and the role of systemic racism. Findings enhance our understanding of how Black veterans have experienced the pandemic and may have important implications for other underserved groups.
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    Management of Chronic Cough in Adult Primary Care: A Qualitative Study
    (Springer, 2021-09) Gowan, Tayler M.; Huffman, Monica; Weiner, Michael; Talib, Tasneem L.; Schelfhout, Jonathan; Weaver, Jessica; Griffith, Ashley; Doshi, Ishita; Dexter, Paul; Bali, Vishal; Medicine, School of Medicine
    This study is the first to describe, qualitatively, PCPs’ experiences evaluating and treating CC in adults. By interviewing clinicians, we sought to understand reasons for referrals, accessibility and use of clinical guidelines, confidence in evaluation and treatment, perceptions and attitudes, and desired resources. Findings may help in elucidating clinical decision-making and could indicate areas for improvement in dissemination and use of guidelines.