Improving Materials for a Technology-Based Childhood Obesity Intervention for Hispanic/Latino Families in Rural Nebraska: A Mixed-Method Usability Test (Preprint)

BACKGROUND Childhood obesity remains a public health concern in the United States, disproportionately affecting Hispanic/Latino (H/L) and rural populations. Despite this disparity, there is a lack of culturally relevant programs specifically designed to reach this population. To address this gap, our team culturally adapted a technology-based childhood obesity intervention, Hispanic Family Connections, targeting H/L families living in rural areas. The intervention comprises two main components: interactive voice response (IVR) calls and a workbook with at-home activities to promote family engagement. OBJECTIVE To 1) evaluate the usability of the IVR calls and workbook included in the Hispanic Family Connections intervention; and 2) document and plan adaptations to these components using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). METHODS We conducted five mixed-method, task-based usability tests (UT) using the think-aloud procedure. All five participants were women, self-identified as H/L, and were Spanish literate. Each participant completed three think-aloud tasks designed to evaluate the usability of the IVR calls and workbook chapters. Usability was assessed using the After Scenario Questionnaire (ASQ) at the end of each task and the System Usability Scale (SUS) at the end of the UT session. All sessions were recorded, and data were organized into two primary categories: 1) quantitative results (ASQ and SUS), and 2) qualitative data (participants' comments and researchers' observational). Findings were compiled and analyzed following the eight main domains of FRAME. RESULTS For the workbook, ASQ scores showed a high level of ease in task completion (1.1 ± 0.32), satisfaction with completion time (1.0 ± 0.00), and satisfaction with support information (1.5 ± 0.97). For the IVR calls, participants reported a higher level of ease in task completion (1.0 ± 0.00), satisfaction with completion time (1.0 ± 0.00), and satisfaction with support information (1.2 ± 0.45). SUS results were positive for 80% of participants, with an average usability score above the benchmark (75.5 ± 15.04). Using FRAME, we identified and documented 30 suggestions for adaptations and improvements of the workbook and IVR calls. The majority of suggestions were content-related (86.67%), with most focusing on tailoring/tweaking, or refining existing materials. CONCLUSIONS The usability test results, combined with the systematic documentation using FRAME, allowed us to identify and prioritize the adaptations needed to improve the intervention materials. These refinements will prepare the Hispanic Family Connections intervention for implementation in a subsequent feasibility study. CLINICALTRIAL Identifier: NCT04731506