A community engagement strategy for health promotion through co-created digital solutions, the BIBOPP project

Historically, professionals developed strategies to promote health with little or no input from the targeted populations. Recently, community engagement is gaining importance as a strategy to work together to achieve positive health impact and outcomes. In this light, we developed the digital solution, BIBOPP. BIBOPP offers adults an evidence-based risk analysis for chronic diseases, allowing them to evaluate their health and lifestyle. Results can be shared in the E-health record, notifying their general practitioner (GP) in case of excessive risk and involving the latter in followup. People receive an overview of activities, primary care providers, ... in their community, tailored to their personal risk profile and preferences. Aggregated data, collected with consent from the citizens, yield insights on the self-reported lifestyle and health, relevant for population health management in local health care and policymaking. During the development process, we set up multiple co-creation sessions with citizens, primary caregivers and local policymakers. Design: In the pilot phase, BIBOPP was tested in 7 Flemish municipalities through local advertising and social media. Descriptive statistics were performed on the survey data from citizens that consented to this. After the launch, we organized surveys, and focus groups on the acceptance and efficacy of the tool with different target groups of citizens, including those with expected limited digital literacy skills, e.g., older adults and people with no or low formal educational background. We set up a workshop with primary care providers and local policymakers, and we conducted interviews with informal carers. Results: We recruited over 5000 citizens to complete the survey, of these, 1300 consented to having their data analyzed. This sample had an age range from 20 till 80 years. Overall health was good, with less than 10% smoking, over 60% performing daily exercise (30 minutes of average physical activity per day), over 50% consuming fruit and vegetables daily, and less than 1% suffering from a chronic disease. From the qualitative research, we learned that in general citizens experienced a positive feeling of self-efficacy with BIBOPP, but especially people with complex care needs expressed the need for human support. For motivation in using BIBOPP in daily life, they mentioned they trusted their GP to indicate whether they needed this. Primary care providers and local policymakers also confirmed that in their perspective, disease prevention is not a major concern for citizens and health promotion should be introduced through bottom-up initiatives. As far as the GP in the referral role, they indicated that this stakeholder is already overloaded with care tasks and that multiple stakeholders should be involved, and that data sharing, and integrated technology and software solutions would be helpful in that. Interviews with informal carers are still ongoing at the time of writing this abstract. Conclusion: The digital solution BIBOPP, co-designed with all stakeholders, delivers personalized services, and population health management. However, BIBOPP now reaches mostly healthy adults. Perspectives from citizens, as well as care providers and policymakers, clearly illustrates the need and will to implement an integrated and community engagement strategy for health promotion.