Mobile Health Technology Interventions to Improve the Health Status of Older Rural Women

Purpose: This dissertation explores obesity among older women living in the Appalachian region and how the use of mobile health technology can assist with behavioral change through the use of technology assisted self-care management.;Design: The concept of obesity was clarified using a dimensional analysis approach. Focus groups were used to collect qualitative data to explore social and contextual factors for influencing obesity. A cross-sectional survey was conducted to collect pilot data pertaining to the accessibility and usage of technology among older adults living in Western, North Carolina, and a feasibility study was used to test a mobile health Internet weight loss program.;Conclusions: Appalachian women are at a great risk for obesity and chronic disease due to limited access to healthcare. A solution to help decrease obesity among a population with limited healthcare access is the use of free mobile technology. This dissertation demonstrates the feasibility for high retention and adherence rates for the use of mobile technology providing group social support to older obese Appalachian women living in two different counties of Western, North Carolina. In addition, weight loss, improved glucose control, and improved minutes of reported weekly physical activity were observed among these women indicating preliminary efficacy of using a free mobile Internet technology for weight loss.;Clinical Relevance: Mobile technology appears to offer many features for improving health klowledge and communication among older Appalachian women and their healthcare providers.