There is considerable agreement on the importance of developing and delivering health promotion interventions that are culturally sensitive. Additionally, there is a growing body of literature to support that targeted interventions are effective for increasing lifestyle exercise. However, to build a targeted intervention, it is necessary to understand the cultural and situation attributes specific to a target population. Little is known about urban African Americans' preferences for features of an electronic intervention to increase exercise. We plan to adapt an electronic intervention, E-CHANGE, to an urban African American population. Thus, the aims of this pilot study are to (1) examine the perceptions and experiences of African American patients in incorporating and maintaining exercise in their lifestyles following cardiac events, (2) gain their views and experiences on the use of electronic health information systems, and (3) obtain reactions to and suggestions for the E-CHANGE intervention. Two rounds of interviews with four focus groups of 10 individuals each (n=40) will be conducted to obtain data on the cultural adaptations needed for the E-CHANGE intervention. In the first round, important information about subjects' experiences of incorporating exercise into their lives following a cardiac event will be sought as well their opinions of the E-CHANGE prototype. Results from the first round of focus groups will be used to make adaptations in the design of the E-CHANGE intervention. In a second round, these same individuals will return and be asked to respond to a revised version of the E-CHANGE intervention. Data will be analyzed using Atlas.ti software and data interpretation will be conducted by a study team that consists of nurses, an anthropologist and a systems engineer. This study is innovative in that it attempts to obtain data about both surface and deep level cultural issues of African Americans regarding maintaining exercise following cardiac events and their use of electronic health interventions. It includes the recipients (target audience) of an electronic healthcare delivery system as co-designers of the system. Information learned in this study will be used to develop communication practices that are appropriate and affirming of other cultures, values and identities.
