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Elliott SA, Bialy L, Scott SD, Hartling L. Exploring methods for creating or adapting knowledge mobilization products for culturally and linguistically diverse audiences: a scoping review. Arch Public Health 2024; 82:111. [PMID: 39034399 PMCID: PMC11265177 DOI: 10.1186/s13690-024-01334-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/29/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Connecting end-users to research evidence has the power to improve patient knowledge and inform health decision-making. Differences in the culture and language of the end users may shape the effectiveness of knowledge mobilization (KMb). This scoping review set out to understand current approaches and methods when creating or adapting KMb products for culturally and linguistically diverse (CALD) audiences. METHODS We searched 3 databases (Ovid Medline, CINAHL via EBSCOhost, PsychINFO) from 2011 until August 2023. We included any literature about KMb product creation or adaptation processes serving CALD communities. A primary reviewer screened all identified publications and a second reviewer screened publications excluded by the primary. Data were extracted using a standardized form by one reviewer and verified by a second reviewer. Studies were categorized by type of adaptations ('surface' and/or 'deep' structure) and mapped based on type of stakeholder engagement used in the research approach (i2S model), and end-user involvement (content, design, evaluation and dissemination) in KMb product creation or adaptation. RESULTS Ten thousand two hundred ninety-nine unique titles and abstracts were reviewed, 670 full-text studies were retrieved and reviewed, and 78 studies were included in final data extraction and mapping. Twenty-four studies (31%) created or adapted exclusively text-based KMb products such as leaflets and pamphlets and 49 (63%) produced digital products such as videos (n = 16, 33%), mobile applications (n = 14, 29%), and eHealth websites (n = 7, 14%). Twenty-five studies (32%) reported following a framework or theory for their creation or adaptation efforts. Twenty-eight studies (36%) engaged stakeholders in the research approach. Nearly all (96%) involved end-users in creating or adapting the KMb products through involvement in content development (n = 64), design features (n = 52), evaluation (n = 44) and dissemination (n = 20). Thirty-two (41%) studies included reflections from the research teams on the processes for creating or adapting KMb products for CALD communities. CONCLUSION Included studies cited a variety of methods to create or adapt KMb products for CALD communities. Successful uptake of created or adapted KMb products was often the result of collaboration and involvement with end-users for more applicable, accessible and meaningful products. Further research developing guidance and best practices is needed to support the creation or adaptation of KMb products with CALD communities. REGISTRATION Protocol submitted to Open Science Framework on August 16, 2022 ( https://osf.io/9jcw4/ ).
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Affiliation(s)
- Sarah A Elliott
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada.
| | - Liza Bialy
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Shannon D Scott
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence (ARCHE), Faculty of Medicine and Dentistry, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton, AB, T6G 1C9, Canada
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LaMonica HM, Song YJC, Loblay V, Ekambareshwar M, Naderbagi A, Zahed IUM, Troy J, Hickie IB. Promoting social, emotional, and cognitive development in early childhood: A protocol for early valuation of a culturally adapted digital tool for supporting optimal childrearing practices. Digit Health 2024; 10:20552076241242559. [PMID: 38596404 PMCID: PMC11003334 DOI: 10.1177/20552076241242559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Objective The Thrive by Five app promotes positive interactions between children and parents, extended family, and trusted community members that support optimal socio-emotional and cognitive development in the early years. This article aims to describe the protocol for a prospective mixed-methods multi-site study evaluating Thrive by Five using surveys, interviews, workshops, audio diaries from citizen ethnographers and app usage data. Methods The study activities and timelines differ by site, with an extensive longitudinal evaluation being conducted at two sites and a basic evaluation being conducted at five sites. The learnings from the more comprehensive evaluations inform the iterative research and development processes while also ensuring ongoing evaluation of usability, acceptability and effectiveness of the app and its content across varying contexts. The study evaluates: (1) the impact of the Thrive by Five content on caregiver knowledge, behaviours, attitudes and confidence; (2) how the content changes relationships at the familial, community and system level; (3) how cultural and contextual factors influence content engagement and effectiveness and (4) the processes that facilitate or disrupt the success of the implementation and dissemination. Results All in-country partners have been identified and data collection has been completed in Indonesia, Malaysia, Afghanistan, Kyrgyzstan, Uzbekistan, Namibia and Cameroon. Conclusions Very few digital health solutions have been trialled for usability and effectiveness in diverse cultural contexts. By combining quantitative, qualitative, process and ethnographic methodologies, this innovative study informs the iterative and ongoing optimisation of the cultural and contextual sensitivity of the Thrive by Five content and the processes supporting implementation and dissemination.
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Affiliation(s)
- Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Yun J. C. Song
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Victoria Loblay
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- The Australian Prevention Partnership Centre, Sydney, Australia
| | | | - Aila Naderbagi
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | | | - Jakelin Troy
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
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LaMonica HM, Crouse JJ, Song YJC, Alam M, Wilson CE, Hindmarsh G, Yoon A, Boulton KA, Ekambareshwar M, Loblay V, Troy J, Torwali M, Guastella AJ, Banati RB, Hickie IB. Developing Culturally Appropriate Content for a Child-Rearing App to Support Young Children's Socioemotional and Cognitive Development in Afghanistan: Co-Design Study. JMIR Form Res 2023; 7:e44267. [PMID: 37610805 PMCID: PMC10483291 DOI: 10.2196/44267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/24/2023] [Accepted: 07/23/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Optimal child-rearing practices can help mitigate the consequences of detrimental social determinants of health in early childhood. Given the ubiquity of personal digital technologies worldwide, the direct delivery of evidence-based information about early childhood development holds great promise. However, to make the content of these novel systems effective, it is crucial to incorporate place-based cultural beliefs, traditions, circumstances, and value systems of end users. OBJECTIVE This paper describes the iterative approach used to develop the Thrive by Five child-rearing app in collaboration with Afghan parents, caregivers (eg, grandparents, aunts, and nannies), and subject matter experts (SMEs). We outline how co-design methodologies informed the development and cultural contextualization of content to meet the specific needs of Afghan parents and the content was tested and refined in collaboration with key Afghan stakeholders. METHODS The preliminary content was developed based on a comprehensive literature review of the historical and sociocultural contexts in Afghanistan, including factors that influence child-rearing practices and early childhood development. After an initial review and refinement based on feedback from SMEs, this content was populated into a beta app for testing. Overall, 8 co-design workshops were conducted in July and August 2021 and February 2022 with 39 Afghan parents and caregivers and 6 SMEs to collect their feedback on the app and its content. The workshops were audio recorded and transcribed; detailed field notes were taken by 2 scribes. A theoretical thematic analysis using semantic codes was conducted to inform the refinement of existing content and development of new content to fulfill the needs identified by participants. RESULTS The following 4 primary themes were identified: child-rearing in the Afghan sociocultural context, safety concerns, emotion and behavior management, and physical health and nutrition. Overall, participants agreed that the app had the potential to deliver valuable information to Afghan parents; however, owing to the volatility in the country, participants recommended including more activities that could be safely done indoors, as mothers and children are required to spend most of their time at home. Additionally, restrictions on public engagement in music required the removal of activities referencing singing that might be performed outside the home. Further, activities to help parents reduce their children's screen time, promote empathy, manage emotions, regulate behavior, and improve physical health and nutrition were requested. CONCLUSIONS Direct engagement with Afghan parents, caregivers, and SMEs through co-design workshops enabled the development and refinement of evidence-based, localized, and contextually relevant child-rearing activities promoting healthy social, emotional, and cognitive development during the first 5 years of children's lives. Importantly, the content was adapted for the ongoing conflict in Afghanistan with the aim of empowering Afghan parents and caregivers to support their children's developmental potential despite the security concerns and situational stressors.
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Affiliation(s)
- Haley M LaMonica
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Jacob J Crouse
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Yun J C Song
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Mafruha Alam
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Chloe E Wilson
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Gabrielle Hindmarsh
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Adam Yoon
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Kelsie A Boulton
- Clinic for Autism and Neurodevelopment Research, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Mahalakshmi Ekambareshwar
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Victoria Loblay
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
- The Australian Prevention Partnership Centre, Sydney, Australia
| | - Jakelin Troy
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, Australia
| | - Mujahid Torwali
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, Australia
| | - Adam J Guastella
- Clinic for Autism and Neurodevelopment Research, Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Richard B Banati
- Medical Imaging Sciences, Faculty of Medicine and Health, Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Australian Nuclear Science and Technology Organisation, Sydney, Australia
| | - Ian B Hickie
- Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Alam M, Hickie IB, Poulsen A, Ekambareshwar M, Loblay V, Crouse J, Hindmarsh G, Song YJC, Yoon A, Cha G, Wilson C, Sweeney-Nash M, Troy J, LaMonica HM. Parenting app to support socio-emotional and cognitive development in early childhood: iterative codesign learnings from nine low-income and middle-income countries. BMJ Open 2023; 13:e071232. [PMID: 37192801 DOI: 10.1136/bmjopen-2022-071232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE Many children in low-income and middle-income countries are disadvantaged in achieving early developmental potential in childhood as they lack the necessary support from their surroundings, including from parents and caregivers. Digital technologies, such as smartphone apps, coupled with iterative codesign to engage end-users in the technology-delivered content development stages, can help overcome gaps in early child development (ECD). We describe the iterative codesign and quality improvement process that informs the development of content for the Thrive by Five International Program, localised for nine countries in Asia and Africa. DESIGN Between 2021 and 2022, an average of six codesign workshops in each country were conducted in Afghanistan, Indonesia, Kyrgyzstan, Uzbekistan, Cameroon, the Democratic Republic of the Congo, Ethiopia, Kenya and Namibia.ParticipantsA total of 174 parents and caregivers and 58 in-country subject matter experts participated and provided feedback to refine and inform the cultural appropriateness of the Thrive by Five app and its content. Detailed notes from the workshops and written feedback were coded and analysed using established thematic techniques. RESULTS Four themes emerged from the codesign workshops: local realities, barriers to positive parenting, child development and lessons learnt about the cultural context. These themes, as well as various subthemes, informed content development and refinement. For example, childrearing activities were requested and developed to promote inclusion of families from diverse backgrounds, encourage best parenting practices, increase engagement of fathers in ECD, address parents' mental well-being, educate children about cultural values and help bereaved children with grief and loss. Also, content that did not align with the laws or culture of any country were removed. CONCLUSIONS The iterative codesign process informed the development of a culturally relevant app for parents and caregivers of children in the early years. Further evaluation is required to assess user experience and impact in real world settings.
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Affiliation(s)
- Mafruha Alam
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam Poulsen
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Victoria Loblay
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Jacob Crouse
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Gabrielle Hindmarsh
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Yun J C Song
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Adam Yoon
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Grace Cha
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Chloe Wilson
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Jakelin Troy
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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Loblay V, Ekambareshwar M, Naderbagi A, Song YJC, Ford M, Zahed I, Yoon A, Hickie IB, LaMonica HM. Enhancing equitable engagement for digital health promotion: Lessons from evaluating a childrearing app in Indonesia. Digit Health 2023; 9:20552076231222112. [PMID: 38152442 PMCID: PMC10752113 DOI: 10.1177/20552076231222112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023] Open
Abstract
Part of the appeal of digital health interventions, including mHealth, is the potential for greater reach in places where conventional health promotion is hampered by geographical, financial or social barriers. Yet, 'engagement' - typically understood as user experience and interactions with technology - remains a persistent challenge, particularly in places where technology access or familiarity with technology is limited. We undertook an evaluation of a childrearing app to promote socioemotional and cognitive development in early childhood across the world. In this article, we present findings from qualitative research on app rollout in Indonesia, the first of numerous low- and middle-income countries targeted by the app. We draw on systems theory and complexity thinking to broaden the lens of 'engagement' beyond individual users to encompass collective systems (families and communities), exploring how the intervention was harnessed to meet local contextual needs. The qualitative research involved semi-structured interviews, workshops and audio diaries with 57 diverse stakeholders, including Indonesian parents, caregivers, and collaborators involved in funding, development, and dissemination of the app. We observed the importance of social connection, sense-making, and interactive learning for enhancing engagement with the app and its messages. Enthusiastic users, strongly linked across community networks (e.g. kindergarten teachers), improvised dissemination strategies to facilitate uptake. Interactive learning that tapped into familiar social structures (e.g. intergenerational hierarchies) was crucial for engagement. Understanding ways the app failed to tap into structures of social connection served to highlight the need to embed strategies to support collective engagement.
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Affiliation(s)
- Victoria Loblay
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | | | - Aila Naderbagi
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | - Yun JC Song
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | - Michele Ford
- Faculty of Arts and Social Sciences, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | - Iqthyer Zahed
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | - Adam Yoon
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
| | - Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Gadigal country, Sydney, NSW Australia
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