Cultural Adaptation of a mobile health application for Aboriginal and/or Torres Strait Islander mothers and families: A Qualitative Study (Preprint)

BACKGROUND Co-design ensures cultural safety of health interventions for Aboriginal and/or Torres Strait Islander communities. However, an intervention developed with one Indigenous community may not be suitable for another geographically and culturally distinct community. OBJECTIVE This study aimed to culturally adapt content and features of a mobile health (mHealth) application co-created by communities in one Australian state to better meet the needs of mothers and caregivers of Aboriginal and/or Torres Strait Islander children aged 0-18 years and health professionals in another state. METHODS The study followed the stages of the cultural adaptation stepwise model by Barrera et al. Mothers/caregivers of Aboriginal and/or Torres Strait Islander children aged 0-5 years and their health professionals were recruited from multiple community sites. Data were collected through culturally appropriate yarning circles or interviews facilitated by Aboriginal research staff. Qualitative data were transcribed and inductively analysed to generate themes. The feedback was translated into practical changes that were applied to the mHealth application. RESULTS Data saturation was achieved after yarning circles with 21 women and seven health professionals. Nine themes were generated from mothers/caregivers’ data: 1) cultural relevance and sensitivity, 2) linking with culturally appropriate services, 3) Use of lay language and more audio-visual content , 4) concerns with mobile data usage, 5) Perceptions about the current content of the Jarjums app, 6) raising children, 7) safety, 8) health and wellbeing of mothers and caregivers, and 9) coordinating health care. Four themes were generated from data collected from health professionals: 1) favourable features of the app, 2) potential barriers to the use of the app, 3) healthcare system access issues, and 4) recommended modifications. Based on feedback received, the mHealth application changes included the addition of information on healthy relationships and raising children, more visual content, and localized service directories for different categories of care and support. CONCLUSIONS A co-designed, culturally sensitive mHealth application is likely to support Aboriginal and/or Torres Strait Islander families facing health disparities due to disruption of Indigenous culture by a foundation for a potential clinical trial for effectiveness evaluation and wider implementation. INTERNATIONAL REGISTERED REPORT RR2-10.2196/53748