This application is in response to RFA EB-15-001, a special SBIR program to reduce health disparities by developing medical technologies that are effective, affordable, culturally acceptable, and easily accessible to those who need them. It is based on the well-established partnership between BrightOutcome and Dr. Ana Maria Lopez, Associate Vice President for Health Equity and Inclusion, University of Utah Health Sciences Center, and Director of Cancer Health Equity, Huntsman Cancer Institute. We propose co-development of Salud Juntos!, a bilingual high tech and high touch medical care support portal for Latinos, the most rapidly growing group in the U.S. By leveraging both e-health technologies and actual human connections. Salud Juntos!'s can expand to encompass health concerns comprehensively. Our target domain for this project will be the cancer care continuum, from cancer diagnosis/treatment though survivorship/palliation, with Phase I focusing on cancer symptom management. The high tech aspect of Salud Juntos! utilizes technology features such as mobile access, social media support, adaptive health status assessment, and individualized content deliveries to connect patients and families to care. The high touch aspect, a critical and unique component of Salud Juntos!, facilitates patient engagement through community health workers/promotoras who can personally deliver the requisite education and support to individuals and the community. Salud Juntos!'s high-tech features will be adapted for promotoras to use to manage their day-to-day tasks. The use of both high-tech and high-touch solutions ensures a broad reach across the digital divide and addresses health delivery barriers including knowledge, culture, and distance. The overarching goal of Salud Juntos! is to improve cancer patients' outcomes and self-efficacy by empowering cancer patients with self-management skills and bringing cancer care support directly to them at home via both promotoras and technology. Such supportive care, regardless whether delivered by promotoras or by technology, addresses both physical and psychosocial concerns and needs of cancer patients by offering timely patient education materials, engaging local/community support resources, facilitating patient-provider communication, and involving patients caregivers, friends and families. Phase I aims are to: 1) Collect input from stakeholders on expected system features, perceived usefulness/impacts, and potential adoption barriers via four focus groups of ten subjects each. Stakeholders include promotoras, supportive care professionals, Latino cancer patients, and their caregivers; 2) Design/develop the prototype Salud Juntos! by following a user-centered design process and leveraging the technical/functional foundations from our prior work; 3) Conduct two rounds of usability/usefulness tests with 32 subjects each, and a pilot study with 60 subjects randomized to receive usual care (control) and promotora support with Salud Juntos! (intervention) on a 1:1 ratio to conduct preliminary effectiveness evaluation and assess technical feasibility.
Latinos are now the largest and the fastest growing minority group in the U.S. However, the health disparities experienced by Latinos in the U.S. have been well documented. Based on the 2001-2005 AHRQ's Medical Expenditure Panel Survey data, the median healthcare expenditure for Latinos was 78.8% lower than that for White, non-Latinos. It is estimated that reducing the health disparities for Latinos would have saved the US economy a staggering $115 billion between 2006 and 2009. We propose to develop Salud Juntos!, a bilingual 'high tech and high touch' medical care support portal for Latinos by leveraging both e-health technology solutions and actual human connections via promotores to ensure a broad reach across the digital divide and addresses health delivery barriers including knowledge, culture, and distance.