Cultural Adaptation of a Digital Overactive Bladder Behavioral Therapy for the U.S. Latina Population

ABSTRACT Overactive bladder (OAB) is a prevalent and costly health condition that poses a significant public health burden in the United States. It is well established that OAB disproportionately affects women. Studies have reported up to 43% of women over 40 and nearly 50% of women over 65 are affected by OAB across. Recent studies have focused on the bladder health disparities experienced by Hispanic/Latina women. These studies found that Hispanic women had the highest prevalence of OAB and urinary incontinence (UI) than other racial/ethnic groups. OAB behavioral therapy (BT) is a highly efficacious, low-risk treatment option that can significantly improve overall quality of life and is recommended by The American Urological Association as a first line therapy for OAB. However, OAB BT in clinical practice varies widely depending on insurance coverage, practice care management processes, and patient access/availability, especially in the Latin/Hispanic community. Remotely delivered culturally relevant and technology-supported preventive health interventions offer a viable technique for increasing OAB symptom awareness and self-management practices among Latina women. The CeCe App is a novel, conversational agent-based application for delivering validated, patient-centered education and coaching targeted to women with symptoms of OAB. CeCe allows its users to learn about their condition and manage their symptoms. A usable and accessible, evidence-based application like CeCe can be used to help U.S. Latina/e women overcome the barriers to OAB care that they face by educating them on how to improve their OAB symptoms. Therefore, in this study we seek to culturally adapt OAB CeCe for Latina women in the US to better address the specific obstacles faced in achieving positive OAB outcomes. To do this, we will need to assess the bladder and pelvic floor health understanding of Latina women through understanding the cultural challenges, nuances and specific language and voice necessary to adapt this product for Latina/e women (Aim 1). Then, the CeCe App will be culturally and linguistically adapted for US Latina/e women (Aim 2), and lastly, assessing early-stage acceptability of the culturally & linguistically adapted OAB CeCe App (Aim 3). This new version of the CeCe App will lead to increased accessibility & availability of OAB BT, improved patient adherence and improved OAB symptoms and quality of life among the Latin/Hispanic female community.