Abstract

Digital health technologies are increasingly promoted as scalable strategies for addressing persistent disparities in chronic disease prevention and management. Yet limited research has examined how historically underserved populations interpret and evaluate culturally tailored digital environments. This study examined how African American women engaged with and assessed a culturally tailored nutrition and physical activity portal. A cross sectional mixed methods design was used with 206 African American women who completed structured survey measures and open ended responses after reviewing the portal. Quantitative analyses included descriptive statistics, Pearson correlations, and backward stepwise multiple regression to identify predictors of portal evaluation, while qualitative responses were analyzed using inductive thematic analysis. Regression analyses indicated that lower educational attainment, higher self perceived weight status, and stronger endorsement of the importance of website design features were associated with more favorable portal evaluations, although the model explained a modest proportion of variance. Qualitative findings identified five interrelated themes: trust through clarity and tone, representation as relatability, usability as respect, cultural alignment beyond imagery, and desire for expanded functionality with cultural integrity. Participants evaluated the portal not only on informational content but also on whether the design conveyed recognition of lived realities, avoided stigmatizing language, and reflected culturally relevant contexts. Findings suggest that engagement with digital health resources among African American women is shaped by interpretive processes involving trust, representation, and contextual relevance rather than access alone, indicating that culturally grounded digital design may serve as an important mechanism for supporting equitable engagement and sustained health behavior change.

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