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There are reminder apps for people who frequently forget to take their medication, but what about for those who don’t think they need the medication in the first place?

“Culturally bound, negative beliefs about medications, and a preference to replace medications with natural remedies, are common in disadvantaged Latino communities,” states a recent grant proposal, “but are rarely discussed with health providers due to language barriers, low health literacy and cultural distance.” The proposal comes from two UCI researchers, Sergio Gago-Masague and John Billimek, who are working to address this issue.

Gago-Masague is an assistant professor of teaching in the Department of Computer Science and director of the Engaging Technology and Application Design (ETAD) Lab at the California Institute for Telecommunications and Information Technology (Calit2). Billimek is the director for community engagement and administrative affairs for the Program in Medical Education for the Latino Community (PRIME-LC). Their collaboration has resulted in the grant, “Mi Propio Camino (My Own Way): Addressing Negative Beliefs about Medication to Improve Adherence among Hispanic Adults with Hypertension,” which was recently awarded $1.8 million by the National Institutes of Health (NIH) through its National Heart, Lung and Blood Institute (NHLBI).

The goal is to “test an intervention driven by an IoT system focused on addressing negative beliefs about medication in a large, high-risk population — Latino adults with diabetes and uncontrolled hypertension,” says Gago-Masague. “We will test a conceptual framework that will inform future development of novel interventions tailored for other at-risk populations.”

Gago-Masague is in charge of the technical side, including software implementation, data collection and data visualization, while Billimek is leading the clinical side, recruiting and interviewing patients and conducting follow-up visits. “I’ve worked with Dr. Billimek for the last four years building a prototype for this project,” says Gago-Masague. “We have mostly worked with students at UCI through the Calit2 Multidisciplinary Design Program for the past few years, who helped with the app design.”

For the study, during three group medical visit (GMV) sessions, discussions of strategies to lower blood pressure will incorporate not only medication but also culturally bound perspectives on lifestyle and natural remedies. Then, patients will participate in two brief instances of home monitoring with mHealth devices, prompting patients to discuss their individual experiences with a regimen. The hope is to identify a way to promote medication adherence. Otherwise, as noted in the proposal, “failing to meet this need will likely lead to continued disparities in adherence to evidence-based antihypertensive therapies and in preventable complications among the 2.5 million Latino adults with comorbid diabetes and hypertension.”

Shani Murray