JMIR Publications

ABSTRACT

Background:

Digital technologies are increasingly recognised for their equalising effect, improving access to affordable health care regardless of gender, ethnicity, socioeconomic status, or geographic region. The Thrive by Five app is designed to promote positive interactions between children and their parents, extended family, and trusted members of the community to support their socioemotional and cognitive development in the first five years of life and to strengthen connections to culture and community.

Objective:

The aim of this paper is to describe the iterative co-design process that underpins the development and refinement of the Thrive by Five app features, functions, and content. Minderoo Foundation commissioned this work as a Quality Improvement activity to support a quality and engaging user experience and to inform the development of culturally appropriate and relevant content for parents and caregivers in each country in which the app is implemented. Importantly, the local experts and parents and caregivers referenced in this protocol participate in but are not the subjects of this quality improvement research.

Methods:

The app content is comprised of ‘The Why’ which present scientific principles that underpin socioemotional and cognitive development in early childhood. The scientific information is coupled with ‘Collective Actions’ or activities for parents, extended family, and members of the community to engage in with the children to support their healthy development and to promote positive connections between parents, families and communities and these young children. Importantly, the initial content is designed and iteratively refined in collaboration with a subject matter expert group from each country (i.e., alpha testing). This content is then configured into the app (either a beta version or localised version) for testing (i.e., beta testing) by local parents and caregivers as well as experts who then are invited to provide their feedback and suggestions for improvements in app content, features, and functions via a brief web-based survey and a series of co-design workshops. Descriptive statistics will be used to analyse survey data and analysis of qualitative data from the workshops will follow established thematic techniques.

Results:

At the time of this publication, the co-design protocol had been completed with Indonesian and Afghan subject matter experts, parents, and caregivers, with results expected to be published by mid-2022. Having completed the work for the first two proof of concept countries, the protocol will be implemented in the remaining 28 countries serially, with an additional country beginning the co-design process every 4 to 6 weeks.

Conclusions:

Mobile technologies are the primary means of internet connection in many countries around the globe, which underscores the potential for mobile health (mHealth) programs to improve access to valuable, evidence-based, and previously unavailable parenting information. However, for maximum impact, it is critically important to ensure that mHealth programs are designed in collaboration with the target audience to support the alignment of content with parents’ cultural values and traditions and its relevance to their needs and circumstances.