Iterative Adaptation of a Maternal Nutrition Videos mHealth Intervention Across Countries Using Human-Centered Design: Qualitative Study

Abstract

BackgroundMobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso.ObjectiveThe objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings.MethodsGuided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors.ResultsWe propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted.ConclusionsDesign research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.

Innovative Digital Technologies for Purchasing and Consumption in Urban and Regional Agro-Food Systems: A Systematic Review

“…Almost half of studies on mobile phones and tablets focused on African countries and their use of SMS, voice messages or WhatsApp for agro-food sales or health advice [68,70,72,74]. Chang et al [68] assessed the existing ICT contribution in connecting farmers to the market in Senegal: mobile phones were the most widely available technology, but they were still not majorly used as a marketing tool by producers.…”

Design of a Planner-Based Intervention to Facilitate Diet Behaviour Change in Type 2 Diabetes

“…The use of HCD for enhancing chronic disease prevention was reviewed by Matheson et al (2015) and they reported on the positive effect of using the HCD approach in this domain [ 42 ]. The HCD process was used by other researchers to enhance mobile nutrition intervention content, by tailoring the intervention content to reflect the context of use and the needs of the full spectrum of users [ 43 ]. Another study reported on the use of a HCD approach in a diet app design and the authors recommended its use in the development of future diet-related apps [ 44 ].…”

Community Health Worker Use of Smart Devices for Health Promotion: Scoping Review

“…The included studies-all published between 2010 and 2021-were conducted in South Africa [29,30], Nigeria [31], Burkina Faso [32], Lesotho [33][34][35], and India [36][37][38][39][40] (Table 1). Among them, 9 (75%) studies were rural, 2 (17%) urban, and 1 (8%) both.…”

“…Finally, Isler et al [32] adapted a series of videos related to MCH and nutrition from 1 cultural setting (South Africa) to another (Burkina Faso). Animated videos with South African content and design received input from Burkanese CHWs and clients and were then modified to represent the Burkina Faso cultural, linguistic, and physical setting.…”

“…As a novel technology, mHealth use by CHWs may stimulate community interest [29][30][31][32][35][36][37]39]. Clients, bystanders, and neighbors were interested mHealth deliveries [29,39], as were CHWs not possessing electronic devices [35].…”