"We Have to Be Advocates for Ourselves": A Social-Ecological Approach to Mobile Health Design with Black Older Adults Living with Diabetes

Even well-intentioned researchers may engage in health equity tourism (HET). We describe our two-year engagement with under-resourced community sites to provide insights into fostering genuine commitments to remedying health disparities. To explore implications for mobile health (mHealth) design for Black older adults with low income, we employed reflexive, qualitative methods based on outreach activity and semi-structured interviews with 25 community members. Our analysis highlights the importance of accessible self-learning opportunities to nurture technological interest. Our findings also suggest varying loci of control in health, and that mistrust motivates informal support networks and mHealth usage. Based on our work, we provide actionable recommendations for HCI researchers to mitigate HET. In addition, we reframe our findings through a social-ecological perspective to better understand the interplays between technology and health, and generate insights into how mHealth design can better serve under-resourced communities.