Evaluation of an mHealth Intervention (Growin’ Up Healthy Jarjums) Designed With and for Aboriginal and Torres Strait Islander Mothers: Engagement and Acceptability Study (Preprint)

Abstract

BACKGROUND Aboriginal and Torres Strait Islander women have access to, and interest in, mobile health (mHealth), though there are few culturally relevant, evidence-based mHealth programs available. We co-developed a mHealth program (Growin’ up Healthy Jarjums) with Aboriginal and Torres Strait Islander women focusing on women’s health behaviours and psychosocial wellbeing. OBJECTIVE The aims of this study were to assess the engagement and acceptability of the Growin’ Up Healthy Jarjums program with mothers caring for Aboriginal and Torres Strait islander children aged under 5 years, and assess the acceptability of the program with professionals. METHODS A single group post-test only acceptability trial was conducted. Women were given access to Growin’ Healthy Jarjums - a web-based app, Facebook page, and SMS (text messages) for 4 weeks. Short videos were tested within the app and on the Facebook page. Engagement with the app was evaluated by examining number of logins, page views, and links used on the app. Engagement with the Facebook page was examined by likes and follows, comments and reach of posts. Engagement with the SMS were examined by the number of women that opted out, and with videos by the number of plays, videos watched, and duration of video watched. Acceptability of the program was examined by post-test interviews with mothers, and focus groups with professionals. RESULTS A total of 47 participants joined the study; 41 women and 6 health professionals; 32 women and 6 health professionals completed post-test interviews. Thirty-one (76%) women accessed the app; 13 scrolled the main page only and 18 clicked into other pages. There were 48 plays, and 6 finishes of the 12 videos. The Facebook page received 49 page likes and 51 followers. The post with the most reach was a supportive and affirming cultural post which reached 308 people and had 17 reactions, comments or shares. No participants opted out of SMS. Almost all women (30/32; 94%) reported that Growin’ Up Healthy Jarjums was useful and all women ) reported that the program was culturally appropriate and easy to use. Most women (27/32; 90%) reported that the program was relevant to them and their family. Twenty-two (71%) women reported that the program had an overall positive impact but there were six women (19%) who reported technical problems accessing the app. Fourteen women suggested improvements to the app including building a native app (rather than web based app), single log in, easier to navigate, and more interactive. All women reported that they would recommend the program to other families. CONCLUSIONS This study demonstrates that the Growin’ up Healthy Jarjums program was perceived to be useful, and culturally appropriate. SMS had the highest engagement followed by the Facebook page, and then the app. This study identified areas for technical and engagement improvements to the app. A powered trial is needed to assess the effectiveness of the Growin’ up Healthy Jarjums program at improving health outcomes.