CardioCare Quest is a digital telehealth game that aims to improve hypertension treatment outcomes among Navajo people. The game will accomplish this goal by celebrating the mundane everyday practices that lead to sustainable risk-reduction habits among several factors, including diet, exercise, taking medications as prescribed, measuring blood pressure, and education about hypertension. The game hosts a series of customizable and adaptive mini games that individually target these factors and will be designed using community-based, participatory practices. The game will also provide information to practitioners to help facilitate communication and data-driven decision making.

Project Aims:

1. Employ Research through Design (RtD) methodologies to co-create culturally grounded design problem statements prioritizing healthcare access disparities among Navajo Peoples.
2. Employ thematic analysis of codesigned minigame prototypes using (and contributing to) an emerging serious game theory.
3. Determine the impact of CardioCare Quest’s telehealth interventions through a mixed methods approach.

In Aim 1, we employ Participatory Design methodologies, including cultural probes, focus groups, and affinity diagramming, to foster collaboration with the Navajo Nation. This collaborative approach aims to develop culturally sensitive and relevant problem statements, addressing factors that contribute to and exacerbate high blood pressure. In Aim 2, thematic analysis is applied to codesigned minigame prototypes using an emerging serious game theory. Aim 3 involves using a mixed methods approach to determine the impact of CardioCare Quest’s telehealth interventions. The methodology of the CardioCare Quest project involves a participatory design approach that incorporates methods like bodystorming, brainstorming, and affinity diagramming that are tailored to the specific cultural and health needs of the Navajo Nation in Arizona.

Investigators

Tochukwu Ikwunne, PhD, Principal Investigator

Jared Duval, PhD, Co-Investigator

Over the last decade, reports of Onchocerca lupi infections in humans and canid reservoir species have increased globally. To date, there have been eight confirmed human O. lupi cases from the US, five of which were children on the Navajo Nation. Without appropriate mitigation strategies, the potential for dissemination and establishment of this parasite across the US and into Canada and Mexico continues to increase. The expanding endemic range of O. lupi in canines, coupled with the increase in incidence of both human and canine onchocercosis in the southwestern US, reinforces the need for additional resources to not only characterize but implement preventative policy to mitigate this threat. This is challenging in the absence of confirmed vector species. The objective of this study is to demonstrate vector competency of two putative vector species, black flies and biting midges, on Navajo Nation. To accomplish this objective, we will screen blackfly and biting midge species previously collected by the USGS as part of their community science insect monitoring project along the Colorado River where reported human, dog, and coyote infections overlap. Identifying O. lupi positive insect species from known collection points along the Colorado River will allow for targeted, live insect trapping. Vector competency will be demonstrated on freshly caught, live insects by implementing a modified, novel assay to isolate and quantify emerging third-stage O. lupi infectious. Determining O. lupi vector species will directly inform public health officials and vector control agencies to reduce transmission and identify at-risk populations.

Project Aims:

1. Determine hotspots of potential vector species of black flies and biting midges responsible for human and animal disease transmission along the Colorado River.
2. Demonstrate O. lupi vector competency in insect species.
3. Disseminate results to Navajo communities through Navajo veterinary services.

Our study investigating O. lupi vector competency will have a direct impact on human and animal health on the Navajo Nation by allowing for appropriate and effective implementation of vector control strategies based on confirmed vector species life cycles. It will have broad impacts for the O. lupi research community and will provide the necessary knowledge for O. lupi vector bite biomarker identification that will allow for fast and reliable identification of at-risk populations.

Investigator

Chandler Roe, PhD, Principal Investigator