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Just-in-time adaptive interventions (JITAIs) are a novel approach to mobile health (mHealth) interventions, sending contextually tailored behavior change notifications to participants when they are more likely to engage, determined by data from wearable devices. We describe a community participatory approach to JITAI notification development for the myBPmyLife Project, a JITAI focused on decreasing sodium consumption and increasing physical activity to reduce blood pressure. Eighty-six participants were interviewed, 50 at a federally qualified health center (FQHC) and 36 at a university clinic. Participants were asked to provide encouraging physical activity and low-sodium diet notifications and provided feedback on researcher-generated notifications to inform revisions. Participant notifications were thematically analyzed using an inductive approach. Participants noted challenging vocabulary, phrasing, and culturally incongruent suggestions in some of the researcher-generated notifications. Community-generated notifications were more direct, used colloquial language, and contained themes of grace. The FQHC participants' notifications expressed more compassion, religiosity, and addressed health-related social needs. University clinic participants' notifications frequently focused on office environments. In summary, our participatory approach to notification development embedded a distinctive community voice within our notifications. Our approach may be generalizable to other communities and serve as a model to create tailored mHealth notifications to their focus population. [ABSTRACT FROM AUTHOR]

Health organizations and systems rely on increasingly sophisticated informatics infrastructure. Without anti-racist expertise, the field risks reifying and entrenching racism in information systems. We consider ways the informatics field can recognize institutional, systemic, and structural racism and propose the use of the Public Health Critical Race Praxis (PHCRP) to mitigate and dismantle racism in digital forms. We enumerate guiding questions for stakeholders along with a PHCRP-Informatics framework. By focusing on (1) critical self-reflection, (2) following the expertise of well-established scholars of racism, (3) centering the voices of affected individuals and communities, and (4) critically evaluating practice resulting from informatics systems, stakeholders can work to minimize the impacts of racism. Informatics, informed and guided by this proposed framework, will help realize the vision of health systems that are more fair, just, and equitable. [ABSTRACT FROM AUTHOR]

Stakeholders in biomedicine are evaluating how race corrections in clinical algorithms inequitably allocate health care resources on the basis of a misunderstanding of race-as-genetic difference. Ostensibly used to intervene on persistent disparities in health outcomes across different racial groups, these troubling corrections in risk assessments embed essentialist ideas of race as a biological reality, rather than a social and political construct that reproduces a racial hierarchy, into practice guidelines. This article explores the harms of such race corrections by considering how the technologies we use to account for disparities in health outcomes can actually innovate and amplify these harms. Focusing on the design of wearable digital health technologies that use photoplethysmographic sensors to detect atrial fibrillation, we argue that these devices, which are notoriously poor in accurately functioning on users with darker skin tones, embed a subtle form of race correction that presupposes the need for explicit adjustments in the clinical interpretation of their data outputs. We point to research on responsible innovation in health, and its commitment to being responsive in addressing inequities and harms, as a way forward for those invested in the elimination of race correction., Competing Interests: No competing financial interests exist., (© Beza Merid and Vanessa Volpe 2023; Published by Mary Ann Liebert, Inc.)