Author: Sarah Perkes
Perkes, Sarah, 2024 Developing an mHealth program and respiratory measures with and for Aboriginal and Torres Strait Islander women caring for young children, Flinders University, College of Medicine and Public Health
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Aboriginal and Torres Strait Islander women have great strength and influence in their communities. Health promotion programs targeting women’s health inevitably have important positive impacts for children and other community members. Mobile health (mHealth) programs are an opportunity to improve access to culturally appropriate health information in real time. The aim of this thesis was to use co-design approaches to develop an mHealth program (Growin’ Up Healthy Jarjums) and robust culturally sensitive measures for a research trial with Aboriginal and Torres Strait Islander mothers of young children.
As many co-design research projects do, this research changed direction substantially from beginning to end. Initially this thesis was focused child respiratory health, including the development of an mHealth tool to capture respiratory health outcomes of infants participating in a research trial. However, once we got talking to women it became clear that they wanted a tool that provided them with knowledge and support on a wide range of health topics. The focus of this thesis then shifted to co-designing an mHealth program with multiple health topics.
This thesis includes four linked studies: a cross-sectional survey to determine access to and interest in mHealth among Aboriginal and Torres Strait Islander women (Chapter 8); a co-design study to develop a prototype mHealth program for women’s and children’s health (Chapter 9); a pilot study to examine acceptability and engagement of a prototype mHealth program (Chapter 10); and a Delphi study to gain consensus on the most relevant and acceptable respiratory and birth measures for Aboriginal and Torres Strait Islander infants participating in a research trial (Chapter 11).
The cross-sectional survey (Chapter 8) confirmed that Aboriginal and Torres Strait Islander women were high users of smart phones and have a strong interest in mHealth. In the co-design study (Chapter 9) an mHealth prototype was developed covering 12 health topics. A 4-week pilot study (Chapter 10) identified that the program was perceived as useful and culturally appropriate, SMS had the highest engagement, and areas for technical and engagement-related improvements to the app were identified. In the final study (Chapter 11), relevant and acceptable measures for child respiratory health for use in a research trial were identified including 15 measures for birth, 17 measures from 1 to 6 months of age and 3 questionnaires for use at 6 months of age.
This thesis has generated knowledge on the access to, interest in and preferences for mHealth among Aboriginal and Torres Strait Islander women of reproductive age, an area where there has been limited data to date. Furthermore, a co-designed mHealth program that aimed to improve health knowledge and health behaviours among Aboriginal and Torres Strait Islander mothers has been developed and pilot tested. This work provides a solid foundation to further develop this mHealth program, and test it for effectiveness. The measures identified and developed in Chapter 11 may be used to measure respiratory health outcomes of the Growin’ Up Healthy Jarjums mHealth program, though additional outcome measures will need to be identified to capture other outcomes. If effective, the Growin’ Up Healthy Jarjums mHealth program would be provided to the same communities that co-designed it.
Keywords: mHealth, Aboriginal and Torres Strait Islander
Subject: Public Health thesis
Thesis type: Doctor of Philosophy
Completed: 2024
School: College of Medicine and Public Health
Supervisor: Professor Billie Bonevski