Social Interaction Needs and Entertainment Approaches to Pregnancy Well-Being in mHealth Technology Design for Low-Income Transmigrant Women: Qualitative Codesign Study

Abstract

BackgroundLow-income Caribbean transmigrant women face unique health challenges during pregnancy that set forth multidimensional implications for the design of mobile health (mHealth). Acknowledgment of the unique health needs of low-income Caribbean immigrant women in the United States and what that entails regarding technology design remains rarely examined in the literature of mHealth technologies.ObjectiveThe goal of this study was to reveal the needs and gaps in mHealth interventions for pregnant immigrant women not yet realized in this field. These understandings reveal design opportunities for mHealth.MethodsThe use of the qualitative participatory action research approach of codesign workshops in this study resulted in design solutions by the participants after reflecting on their earlier focus group discussions. The highlights are not the resulting designs per se but rather the inferences derived from the researcher reflecting on these designs.ResultsThe designs exposed two themes relevant to this paper. First, the participants desired the inclusion and rebuilding of social and organizational relationships in mHealth. The resulting designs formulate an understanding of the women’s health-related social support needs and how technology can facilitate them. Second, the participants wanted entertainment with an element of social participation incorporated in mHealth pregnancy management interventions. This brings attention to the role entertainment can add to the impact mHealth can deliver for pregnancy well-being.ConclusionsThe study concluded with an examination of social and entertainment design implications that reveal pregnant immigrant women’s virtual health-related sharing habits, choice of sharing interaction scenarios during pregnancy (eg, local, long distance, one-way, two-way, and many-many), and choice of sharing media (eg, text, voice, and video). Additionally, the study revealed exclusions to social sharing capabilities in health technologies for these women.

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

“…The author takes a more in-depth view of this aspect in a recently published work [ 28 ]. The study expands the discussion on the social theme that emerged from the focus groups here and uses codesign workshops under a participatory action framework to propose social and organizational design needs and recommendations for effective mobile tools for the women.…”

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].…”

“… Akhavan 2012 [ 47 ] To describe and analyze midwives’ experiences of doula support for immigrant women in Sweden Sweden Community-based doula Qualitative descriptive 10 midwives N/A Interviews 3. 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.…”

“…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].…”