MiTia

The Hispanic community often lacks health equity and access to the healthcare system. As a result, they turn to family or friends for advice, often older women who are referred to as la tia, or aunt. Unfortunately, las tias can proliferate old wives’ tales that lead to poor health decisions such as the belief that insulin causes blindness.

MiTia is a hyper-local social networking platform that meets the community where it’s at, harnessing the influential power of las tias to disseminate better health information within the community. It allows las tias to provide advice while also introducing accompanying content that plants seeds of doubt in incorrect health beliefs and presents alternative, evidence-based beliefs.

While currently focused on Hispanic-Americans, MiTia could be expanded globally as the informal, relationship-based healthcare model is prevalent. By aligning with cultural norms, MiTia could improve the quality of health information shared in communities around the world.

According to the World Health Organization, half of the world lacks access to essential health services. Rural communities, especially lack access to healthcare professionals. In many cases, there is also a lack of trust in the formal healthcare system. This is certainly the case in the US Hispanic community. As a result, these communities turn to family or friends for health information. In the Hispanic community, these are often older women who are referred to as la tia, or aunt.

Receiving useful, credible health information is critical to improving health equity among communities globally. While las tias fill a large gap for their community, they can also proliferate old wives’ tales that lead to poor health decisions such as the belief that insulin causes blindness or that diabetes is caused by susto, or fright. The National Institute on Minority Health and Health Disparities recently published a supplement highlighting the importance of improving health information to address health disparities. Many published research articles note myriad issues with health communication in the Latin communities in the US as well as communities globally, especially rural communities or communities where the members are not comfortable with the predominant language spoken in the healthcare system.

We believe that in order to shift health beliefs, you must first meet people where they are at.

We are working with Hispanic-American populations to develop a solution that can effectively provide access to more accurate information in a culturally-sensitive way.

We believe la tia is central to influencing health beliefs. While she may be part of the problem in proliferating inaccurate health information, we also believe she is central to the solution. Ultimately, la tia is key to providing a social vaccine to the community’s unhealthy cultural health beliefs. A social vaccine is a concept from social epidemiology that implies that social influences can shift health beliefs and improve health outcomes.

To ensure our solution is culturally-sensitive and valued by all of these key stakeholders, we are conducting focus groups with tias, community members, church leaders and self-insured employers.

As stated, we have been focused on the Hispanic-American community. The reason we are applying to MIT Solve is to get help exploring the business model for a global solution. In the US, we will leverage the self-insured employers. However, we do not believe that model will work globally and need connections to key stakeholders to perform customer discovery.

MiTia is a hyper-local social networking platform that provides user-generated content from influential tias in the Hispanic community. This provides a digital, more anonymous outlet for those in the Hispanic community to get health information in a way that is more aligned with cultural norms.

MiTia is a mobile platform where tias are invited to use the app based off of recommendation from leaders within places of worship and schools. Initial content is focused on the most important topics within the community. Invited tias are asked to answer several questions and paid for their time in order to seed the platform. Only those tias are allowed to invited other tias in order to make the platform have an air of exclusivity among the tias. Through word of mouth, church leaders, and potentially local radio stations, the community will be exposed to the MiTia app. Users can search for topics and a “news feed” appears with answers from the tias. If the topic has common misconceptions in the culture, additional content will appear in the news feed that plant seeds of doubt into those misconceptions and introduces alternative views that are evidence-based. This can not only begin to shift views and increase trust in the healthcare system but it also allows health information to be provided to individuals including children with mobile access without depending on the parents. MiTia also uses AI to serve up content based on popularly searched content in that geographic area or local social network. 

The ability to speak to a live (and trained) tia is also possible. This could be via video conferencing or via text messaging. Eventually, the text-based interface could be in the form of a chatbot. All tias who provide live consults would have an appropriate level of training. They would make some amount of money by providing the support either paid for by subscriptions, by self-insured employers, or by the formal healthcare system.

Through the use of MiTia, communities can access better health information. There is an age-old saying that Knowledge is Power. Research has shown that better information leads to better choices. By increasing access to more accurate health information, MiTia increases the likelihood of community members making better health decisions and by extension improving their health.

The solution is innovative because it is designed in a manner that is culturally-sensitive and leverages people within the community to help others. Specifically, it supports health promotion using a psychosocial approach.  In a way, it leverages trust capital at the micro-level (between two individuals) to forge a pathway towards greater confidence at the meso-level (between individual and western healthcare system).   In some cases, it may serve to actually lend credibility and legitimize the system and its model for disease causation and evidence-based practices.Current products on the market present health information in a clinical manner. By leveraging members of the community, MiTia delivers content to users in a way that better aligns with their cultural norms of receiving health information.

MiTia is a smart phone application. The technologies leveraged for MiTia are standard mobile development languages (e.g. React Native) and AWS to run the application. We feel that this is appropriate given that the penetration of smart phone usage in the US is expected to be 92.8% by 2020 (internetinnovation.org) and globally is expected to grow to 40%-48% by 2021 (venturebeat.com and statistica.com). The application also leverages machine learning for topic recommendations according to geographic regions and other factors, which ensures information is as contextually relevant as possible. The chat bot functionality would also leverage AI.

We believe our solution will address the problem because it is grounded by theoretical models and fields of study including the Health Belief Model, Socio-Technical Systems Theory, Social Epidemiology, and the Trans-theoretical Model for Health Behavior Change. Our subject matter expert and product manager have both previously worked as social research scientists for over a decade. They are well-versed in contextual technology design, always taking a user-centered and socio-technical systems approach to understanding a problem and thinking through the design of a technological solution.

• Currently served: 0 (the product has not yet been released)
• Serving within one year: 40,000 (this includes Spanish-speaking employees and their families)
• Serving within five years: 500,000 (this includes communities all over the US and across the world)

Within the next year, Thrust Interactive seeks to release MiTia and sign up its first customers (self-insured employers), who would deploy MiTia to its employee population. Through that, we hope to show effectiveness of MiTia in improving health outcomes and engaging its users. Through participation in programs such as MIT Solve, we also hope to have a deeper understanding of the global healthcare landscape.

With the success and knowledge gained in the first year, we expect to be prepared to attempt global expansion, targeting a diverse array of communities across the globe in order to pilot and learn what works and what does not in various communities. Within five years, we hope to have learned enough to have developed a generalized platform that could be deployed virtually anywhere in the world. Our goal would be to have an instance of MiTia operating in at least 20 countries in the world.

The greatest barriers to our goals are connections to people who understand the global healthcare landscape and financial resources to execute the implementation of MiTia at a quicker pace.

We hope that participation in MIT Solve will help to address these barriers. Barring that, we will continue to leverage internal funds, apply to more accelerators, and leverage our network to make the connections we need to get a deeper understanding of the global landscape and identify potential sources of funding for MiTia.

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Thrust Interactive (maker of MiTia) employs 16 full-time and 3 part-time staff. MiTia is currently leveraging the time of 3 full-time staff on a part-time basis as well as time volunteered by our subject matter expert.

Thrust Interactive has developed over 100 products over the past 10 years. We are experts in consumer engagement, having developed engaging games for big brands such as AT&T, the Cartoon Network, PBS Kids, the NFL, among others. We leverage game science and behavioral science to create those engaging experiences. We take a user-centered design approach and an agile development approach in all of our work. Lastly, we have all of the key personnel needed to deliver on the product.

We have a diverse team that includes a product manager, a creative director, a full-stack developer and a subject matter expert. Our product manager has a unique background in technology (BSEE), business (MBA) and design (MS-HCI) and has designed and managed mobile products for over a decade. He has a passion for empathic design, behavioral design, and data science. Our subject matter expert has a social science background and spent years as a health educator for her local Spanish-speaking community in Georgia.

MiTia currently has the following partnerships for support in business model development and product strategy for the Hispanic-American community.

• Health Information Management Systems Society (HIMSS)
• Children's Healthcare of Los Angeles (CHLA) Innovation Studio

Partnership discussions with local organizations are in progress for collecting community insight and piloting:

• A local self-insured employer
• A local health system
• A local church

The value proposition for MiTia varies depending on the stakeholder. For community users, MiTia gives users on-demand access to more culturally-sensitive (i.e. trusted) health information and where desired can do so anonymously. For customers such as self-insured employers, it provides a means of effectively reaching a part of their employee population that generally has higher healthcare costs. For tias, MiTia is additional source of income and a way of increasing their sense of value and influence in their community.

Each of these stakeholders are reached in a different way. For the B2B2C model, which is the primary model in the US, users would be reached through their employer. For the B2C model, users would be reached via word of mouth, the church or radio stations. As mentioned below, revenue streams would come from self-insured employers who pay for subscriptions for their employees or who pay a license to use MiTia.

From a cost perspective, costs would be incurred for development and technical operations costs as well as through payments provided to tias for their health consultant services.

We will leverage internal funds generated from revenues from the entertainment side of Thrust Interactive's business and grant funding through applying to SBIR grants and challenges such as MIT Solve. This allows time to refine the product and establish a customer base. It is expected that MiTia will be a subscription or license model, where those targeted organizations will pay for subscriptions for their members or pay for a license to allow their members to access the full array of services that MiTia offers.

Additional revenue models we plan to explore are direct-to-consumer subscription, pay per consult, public health agency funded, or ads-based.

Thrust Interactive (maker of MiTia) is looking for connections, mentorship, and funding acceleration. We believe that MiTia can have a profound impact on the world, and we know we cannot do it alone. We need people who have a deeper understanding of the global healthcare landscape. We need people who can provide mentorship on the global product strategy for MiTia. Finally, we need funding to accelerate the development of MiTia. As mentioned, MiTia is being funding internally by leveraging revenues generated by the entertainment side of Thrust Interactive’s business. Therefore, the speed of product release is limited by cash flow. Receiving funding or connections to potential investors would be immensely helpful in accelerating that product release.

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To reach the goals mentioned above, Thrust Interactive (maker of MiTia) seeks partnerships with organizations that better understand the healthcare landscape in other countries, particularly in Latin America to better develop the MiTia business model for those areas.

In order to provide the most contextually relevant information to a user of MiTia, AI is critical. MiTia will take into account whatever data can be reasonably collected from a cultural acceptance perspective such as location, time, social network connections, and topics searched and leverage AI to determine the most appropriate content to display or recommendations to provide. It is also envisioned that AI can be leveraged to support tias in better understanding the user seeking advice and providing suggested recommendations for the tias to provide. Lastly, in the long-term, a chatbot functionality is envisioned that would leverage AI to support a user.

Every aspect of MiTia is being designed and implemented via community engagement. Initial designs were developed by a team member who spent years as a health educator for her local Spanish-speaking community in Georgia. The team has since conducted several interviews with influential tias and are actively engaging a self-insured employer, a church, and the health system within that community to understand the needs of those stakeholders as well as allow the team to get access to more tias and other members of the community who would be users of MiTia. Participatory design sessions are planned beginning in July 2019. Funding from MIT Solve and Together for Health Cities would support broader customer discovery to ensure the product meets the needs of communities that share the informal, relationship-based health information sharing paradigm.

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MiTia makes visible the influence and value of women within their culture. As mentioned throughout the application, in much of the world, strong and intelligent women are central to providing health information that informs healthcare decisions, especially in areas of low health access. MiTia supports those women by creating a platform that amplifies their voices to impact even more members of their community while also by providing financial support for the work they provide.

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