The Feasibility and Design of a Culturally Appropriate Health Promotion App for Black People in England: A Mixed-Methods Approach.

Gai, Basiru (2026) The Feasibility and Design of a Culturally Appropriate Health Promotion App for Black People in England: A Mixed-Methods Approach. Doctoral thesis, Birmingham City University.

Preview

Text Basiru Gai PhD Thesis_Final Version_Final Award June 2026.pdf - Accepted Version Download (2MB)

Abstract

Background: Black people in England experience significant health inequalities, including disproportionate higher prevalence of hypertension, type 2 diabetes mellitus, and maternal mortality. Smartphone health apps offer potential to address these inequalities, but limited research has explored their feasibility in this population. This study aimed to: (1) assess the feasibility of a culturally appropriate health promotion app for Black people in England focusing on its demand, acceptance, and implementation. (2) explore a design framework to guide understanding and development of a culturally appropriate app for Black people in England.

Methods: An explanatory sequential mixed-methods study design, combining quantitative cross-sectional survey data with qualitative focus group discussions, was employed. The quantitative component assessed the feasibility of the proposed app looking at previous health app adoption patterns, technology trust, preference of culturally appropriate app over contemporary ones, and self-reported perceived health status in relation to health app adoption. The qualitative component was designed integrating the Health Belief Model’s constructs and explored perceptions on culturally appropriate health promotion apps: perceived benefits, motivation for use, anticipated barriers, and perception on access to information on illness susceptibility and severity and it perceived impact. Data was analysed statistically with SPSS for the quantitative part, and framework analysis for the qualitative aspect.

Key Findings: The findings revealed moderate previous health app adoption (54.8% prior use), but high discontinuation rates (70.9%), mainly due to loss of interest. Only 40.3% of respondents had been recommended a health app by a healthcare provider. Prior health app experience significantly predicted preference of a culturally appropriate health promotion app (x 2 = 33.9, p < .001). Female respondents were significantly more likely to download and use health apps (x 2 = 9.3, p < .002), whilst age showed no significant relationship with adoption. Notably, perceived wellness was not associated with app download and use, suggesting that subjective health status does not drive adoption. Black African respondents reported substantially better self-reported health (67%) compared to Black Caribbean respondents (31%), indicating the Black community in England is not monolithic and may require ethnically tailored approaches. Three key perceived benefits of a culturally appropriate health promotion app were revealed: addressing health needs specific to Black people, providing access to healthcare information, and fostering trustworthiness. Participants articulated several motivations that would encourage them to continue using an app. The App should: fulfilling user expectations, providing informative and current content, and incorporating gamification features. However, significant barriers emerged, particularly concerns about data security, confidentiality, and information credibility. Participants expressed concerns about illness susceptibility and severity, especially regarding an App's ability to provide accurate diagnoses and quality mental health information. A critical trust paradox revealed that trust is essential to app adoption yet building trust requires demonstration of trustworthiness through use.

Conclusion: A culturally appropriate health promotion app is a feasible means of providing health education for Black people in England. However, success requires genuine community empowerment and sustained participation in the design, development, and implementation processes.

Item Type:	Thesis (Doctoral)
Dates:	Date Event 8 June 2026 Accepted
Uncontrolled Keywords:	Health inequalities, culturally appropriate interventions, health promotion, User-centred design, participatory approach, Black community empowerment. Health Belief Model
Subjects:	CAH04 - psychology > CAH04-01 - psychology > CAH04-01-01 - psychology (non-specific) CAH04 - psychology > CAH04-01 - psychology > CAH04-01-04 - psychology and health CAH04 - psychology > CAH04-01 - psychology > CAH04-01-05 - others in psychology CAH11 - computing > CAH11-01 - computing > CAH11-01-04 - software engineering CAH11 - computing > CAH11-01 - computing > CAH11-01-08 - others in computing
Divisions:	Doctoral Research College > Doctoral Theses Collection Life and Health Sciences > Psychology
Depositing User:	Louise Muldowney
Date Deposited:	09 Jun 2026 14:23
Last Modified:	09 Jun 2026 14:23
URI:	https://www.open-access.bcu.ac.uk/id/eprint/17072

Actions (login required)

View Item