Developing Culturally Sensitive mHealth Apps for Caribbean Immigrant Women to Use During Pregnancy: Focus Group Study

Abstract

BackgroundA valuable addition to the mobile health (mHealth) space is an exploration of the context of minorities in developed countries. The transition period postmigration, culture, and socioeconomic uniqueness of migratory groups can shed light on the problems with existing prenatal mHealth apps.ObjectiveThe objectives of this study were to (1) use the theoretical concept of pregnancy ecology to understand the emotional, physical, information, and social challenges affecting low-income Caribbean immigrant women’s prenatal well-being practices and (2) develop a deep understanding of challenges worthy of consideration in mHealth design for these women.MethodsThis qualitative interpretive approach using analytical induction presents the findings of 3 focus group sessions with 12 Caribbean immigrant women living in South Florida in the United States. The study took place from April to September 2015.ResultsThe participants revealed problematic tiers and support needs within the pregnancy ecology including emotional stressors caused by family separation, physical challenges, information gaps, and longing for social support.ConclusionsmHealth interventions for low-income Caribbean immigrant women must be designed beyond the conventional way of focusing on the events surrounding the unborn child. It can be tailored to the needs of the expecting mother. Pregnancy information should be customized on the basis of the variability of lifestyle, cultural practices, socioeconomic status, and social ties while still being able to deliver appropriate guidelines and clear cultural misconceptions.

Transnationalism and care of migrant families during pregnancy, postpartum and early-childhood: an integrative review

“…Eleven papers focused on a specific maternity service or intervention (see Tables 3 and 4). Ten of these were directed towards migrant mothers including doula support [46,47], a mobile health application to enhance pregnancy well-being for women from the Caribbean (by providing health information and social support) [48,49], a nurse-practitioner led prenatal program for migrant farm-workers [57], a support group to enhance prenatal and postnatal education [41], a prenatal training course [75], a community-based antenatal service [86], a group pregnancy care initiative for Karen women from Burma [92] and a specialized antenatal clinic for refugee women [100]. One paper examined a culturally tailored prenatal health education video series that was developed for both mothers and fathers from Somalia [68].…”

“… AlJaberi 2018 [ 48 ] To develop a comprehensive understanding of the pregnancy health and social needs of low-income Caribbean immigrants towards informing the development of a mHealth intervention United States Pregnancy mobile health intervention Qualitative descriptive 12 mothers Caribbean Focus groups Immigrant 4. AlJaberi 2018 [ 49 ] To understand the emotional, physical, information and social challenges affecting low-income women’s prenatal well-being practices towards developing a mHealth intervention for these women United States Pregnancy mobile health intervention Qualitative descriptive 12 mothers Caribbean Focus groups Immigrant 5. Almeida 2014 [ 50 ] To verify whether there are differences regarding women’s perceptions of quality and appropriateness of care received between immigrant and native women during pregnancy and postpartum Portugal Healthcare during pregnancy and postpartum Qualitative descriptive 31 mothers African countries (Portuguese-speaking), Brazil, Eastern European countries Interviews LOT: 2 to 20 years Immigrant, undocumented 6.…”

“…This may then affect care-providers' relationships with migrant families and/or the effectiveness of their health and social care interventions. Although the review did not shed much light on how exactly these forms of transnational ties should be addressed in care, it did show that inquiring about family members back home could be used to build rapport [90,110], and that technology could be used to foster the involvement and support of family living far away in maternity care [49]. Without evidence, it is premature to make specific recommendations for care, however, based on the findings, healthcare providers should at minimum, be cognizant of and inquire about migrants' transnational contexts that may affect their health and well-being (see Table 5).…”

“…Other forms of transnational ties (i.e., 'ways of being') were mentioned in fewer papers. This included references to families worrying about relatives, including children who remained in the home country [54,55,59,60,67,86,105] and families staying connected via phone/ communication technologies and/or visits as a source of social and emotional support, to maintain cultural identity, and/or for assistance with childcare [21,22,31,48,49,67,69,85,90,95,96,102,105]. It also included families sending money back home [105], women seeking healthcare in their country to give birth [21], and families using transnational networks to obtain advice and health information-partly due to local care not being adapted [21,49,88,94,96,105].…”

“…Another paper mentioned that midwives thought that women may be having children in order to receive more governmental family allowance with the intention to use the money to financially support family members back home, although there was no indication on whether this was discussed or addressed with families [77]. In two other papers (by the same authors), the role of family back home as a source of emotional and social support during pregnancy was recognized and incorporated into a mhealth intervention; the application provided a forum for sharing information and could also be used to involve family members in prenatal care visits via conference calls [48,49].…”