Exploring the cultural appropriateness and usefulness of an mHealth program for optimal infant feeding in an urban Aboriginal and Torres Strait Islander Health Service : growing healthy at Inala

Publication Type:
Thesis
Issue Date:
2018
Full metadata record
Background: Inappropriate infant feeding practices are associated with poor health and may contribute to excess weight gain. Aboriginal and Torres Strait Islander infants have lower rates of breastfeeding, higher rates of early introduction of solids and higher rates of childhood obesity compared to other Australians. There is a lack of evidence about effective and culturally relevant programs addressing infant feeding for Aboriginal and Torres Strait Islander families. The delivery of health promotion programs using mobile phones (mHealth) offers a promising new avenue for engaging Aboriginal and Torres Strait Islander families. The Growing healthy program is an app and website targeting healthy infant feeding practices for parents experiencing socioeconomic disadvantage. Growing healthy at Inala is an exploratory study of this program amongst Aboriginal and Torres Strait Islander families in an urban area. Objective: The aims of this study were to explore whether the Growing healthy app is a suitable approach to provide infant feeding support to parents of Aboriginal and Torres Strait Islander infants. Also, to explore the key factors that need to be considered in adapting such a program to ensure that it is culturally appropriate and engaging. Methods: This study was conducted at an urban Aboriginal and Torres Strait Islander primary health care service. Two participant groups were involved: parents of Aboriginal and Torres Strait Islander infants aged less than nine months; and clinical staff of the health service. A multiple method approach, with predominantly qualitative methods, was used and comprised of three components. Firstly, an informal discussion with parents was held to explore the appropriateness and acceptability of key messages provided in the program’s app. Secondly, parents used the program for at least six weeks, after which they participated in semi structured interviews. There were two rounds of interviews conducted with most parents, and interviews explored parent’s experiences of using the program, and suggestions for improvement. The app analytic data provided insight into how the parents used the program and which messages they accessed. Finally, two group discussions with staff of the health care service were conducted to explore their perceptions of the program. Results: Two parents attended the informal discussion and ten parents used the program for at least six weeks and participated in semi-structured interviews. A total of nineteen staff members participated in group discussions with staff. The data suggested that the Growing healthy app has the potential to provide infant feeding support for parents of Aboriginal infants in an urban setting, as it was perceived to be a helpful, consistent, reassuring and an easily accessible source of information and support. Parents raised less concerns with the cultural appropriateness of the app than the staff. Most staff thought modifications were required for the app to be considered culturally appropriate and acceptable. The look and feel of the app were important factors for cultural considerations. Presenting information as stories or real-life experiences in the app were suggestions parents and staff made. Conclusions: The findings suggest that the Growing healthy app may be a suitable mode for providing infant feeding support to Aboriginal and Torres Strait Islander families if key cultural insights are considered to maximise engagement and potential impact. While there were differing opinions of the staff and parents about key cultural insights, the parents implied that they accepted the app as it was promoted by a trusted health care practitioner through a trusted health care service.
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