TY  - JOUR
AU  - Vilendrer, Stacie
AU  - Amano, Alexis
AU  - Brown Johnson, Cati G
AU  - Favet, Marissa
AU  - Safaeinili, Nadia
AU  - Villasenor, Jacqueline
AU  - Shaw, Jonathan G
AU  - Hertelendy, Attila J
AU  - Asch, Steven M
AU  - Mahoney, Megan
PY  - 2021
DA  - 2021/5/20
TI  - An App-Based Intervention to Support First Responders and Essential Workers During the COVID-19 Pandemic: Needs Assessment and Mixed Methods Implementation Study
JO  - J Med Internet Res
SP  - e26573
VL  - 23
IS  - 5
KW  - COVID-19
KW  - pandemic
KW  - health literacy
KW  - social media
KW  - quality improvement
KW  - police
KW  - emergency responders
KW  - physicians
KW  - disasters
KW  - natural disasters
KW  - health behavior
KW  - literacy
KW  - app
KW  - intervention
KW  - adoption
KW  - accessibility
KW  - usability
KW  - support
KW  - testing
AB  - Background: The COVID-19 pandemic has created unprecedented challenges for first responders (eg, police, fire, and emergency medical services) and nonmedical essential workers (eg, workers in food, transportation, and other industries). Health systems may be uniquely suited to support these workers given their medical expertise, and mobile apps can reach local communities despite social distancing requirements. Formal evaluation of real-world mobile app–based interventions is lacking. Objective: We aimed to evaluate the adoption, acceptability, and appropriateness of an academic medical center–sponsored app-based intervention (COVID-19 Guide App) designed to support access of first responders and essential workers to COVID-19 information and testing services. We also sought to better understand the COVID-19–related needs of these workers early in the pandemic. Methods: To understand overall community adoption, views and download data of the COVID-19 Guide App were described. To understand the adoption, appropriateness, and acceptability of the app and the unmet needs of workers, semistructured qualitative interviews were conducted by telephone, by video, and in person with first responders and essential workers in the San Francisco Bay Area who were recruited through purposive, convenience, and snowball sampling. Interview transcripts and field notes were qualitatively analyzed and presented using an implementation outcomes framework. Results: From its launch in April 2020 to September 2020, the app received 8262 views from unique devices and 6640 downloads (80.4% conversion rate, 0.61% adoption rate across the Bay Area). App acceptability was mixed among the 17 first responders interviewed and high among the 10 essential workers interviewed. Select themes included the need for personalized and accurate information, access to testing, and securing personal safety. First responders faced additional challenges related to interprofessional coordination and a “culture of heroism” that could both protect against and exacerbate health vulnerability. Conclusions: First responders and essential workers both reported challenges related to obtaining accurate information, testing services, and other resources. A mobile app intervention has the potential to combat these challenges through the provision of disease-specific information and access to testing services but may be most effective if delivered as part of a larger ecosystem of support. Differentiated interventions that acknowledge and address the divergent needs between first responders and non–first responder essential workers may optimize acceptance and adoption. 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/5/e26573
UR  - https://doi.org/10.2196/26573
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33878023
DO  - 10.2196/26573
ID  - info:doi/10.2196/26573
ER  -