# Developing, Refining, and Testing a Mobile Health Question Prompt List in Gastroesophageal Reflux Disease

> **NIH NIH K23** · STANFORD UNIVERSITY · 2023 · $192,996

## Abstract

Project Summary
Up to 42% of Americans with gastroesophageal reflux disease (GERD) experience uncontrolled, chronic
symptoms that reduce health-related quality of life and heighten the risk of long-term complications. My long-
term goal is to improve health outcomes for patients with esophageal disorders. This proposal aims to improve
health outcomes for patients with GERD, by harnessing patient activation and motivating behavioral change as
a framework for a mobile health (mHealth) Question Prompt List (QPL) intervention. Patient activation
emphasizes patients’ knowledge, skills, and confidence in managing their health care and predicts patients’
level of health success. However, almost half of patients with GERD demonstrate low patient activation scores.
Low patient activation leads to poor adherence to medical therapy. Remarkably, very little research has
focused on developing an intervention to improve patient activation and motivate behavior change in GERD.
Emerging evidence suggests effective patient-physician communication interventions, such as disease-specific
QPLs, increase patient activation. The objective of this proposal is to apply a 5-step user-centered Design
Thinking model to develop, refine, and test a mobile app based QPL specific for GERD patients titled
“Esophagus-Qs.” The central hypothesis is that Esophagus-Qs will be usable and has potential to harness
patient activation and motivate behavior change. Our specific aims include: 1) Develop the design of
Esophagus-Qs by empathizing, defining the problems patients face, and ideating to generate solutions; 2)
Refine the design of Esophagus-Qs by prototyping and testing usability; and 3) Collect preliminary data on
Esophagus-Qs in a randomized controlled pilot study to estimate the effect size of the intervention. We will
pursue these aims using an innovative combination of qualitative and quantitative methodologies and
implementation science to inform app development. The proposed research is significant, because it has
potential to harness patient activation and motivate behavior change, that can translate into improved health
outcomes. It is also significant because it will develop a platform that can be extended to develop mHealth
QPLs in other esophageal disorders. The proximate expected outcome of this work is to develop a usable
Esophagus-Qs and collect preliminary data on differences in patient activation over time, medication
adherence, health-related quality of life, and GERD symptom severity between Esophagus-Qs and standard of
care. Pilot data from this career development award will be the foundation for an R01-funded clinical trial to
rigorously test the efficacy of Esophagus-Qs among a large, diverse population.

## Key facts

- **NIH application ID:** 10739903
- **Project number:** 1K23DK133664-01A1
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Afrin Kamal Rahman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $192,996
- **Award type:** 1
- **Project period:** 2023-09-01 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10739903

## Citation

> US National Institutes of Health, RePORTER application 10739903, Developing, Refining, and Testing a Mobile Health Question Prompt List in Gastroesophageal Reflux Disease (1K23DK133664-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10739903. Licensed CC0.

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