JMIR Publications

ABSTRACT

Background:

Globally, a significant proportion of young children fail to attain basic socioemotional and cognitive milestones due to poverty, poor nutrition, conflict and a range of other social factors. Supporting optimal childrearing practices may help to mitigate these. Given the ubiquity of personal digital technologies worldwide, direct delivery of evidence-based information about early childhood development holds great promise. To be effective, however, it is crucial that place-based cultural beliefs, traditions, circumstances and value systems of end users are incorporated into development of the content of these novel systems.

Objective:

This paper describes the iterative approach used to develop the Thrive by Five parenting app in collaboration with Afghan parents, caregivers, and subject matter experts (SMEs). We outline how: (1) a cultural framework and literature summary were used to understand the relevant cultural factors that impact childrearing in Afghanistan; (2) co-design informed the development and cultural contextualization of content to meet the specific needs of Afghan parents; and (3) the content was tested and refined in collaboration with key Afghan stakeholders.

Methods:

A cultural framework was developed to create knowledge about place-based factors impacting childrearing practices and early childhood development. Additionally, literature about sociocultural strengths that support healthy socioemotional and cognitive development in the early years was summarised. These learnings directly informed the preliminary content development for a beta version of the Thrive by Five app. Referred to as Collective Actions, the content comprised two components: ‘The Why’, reflecting evidence-based scientific information relating to early childhood development, and childrearing activities that parents and caregivers can engage in with the child to support their development. Eight co-design workshops were conducted in July-August 2021 and February 2022 to allow Afghan parents, caregivers, and SMEs the opportunity to test and provide feedback on the app.

Results:

The co-design outcomes informed the refinement of existing content and the development of new content to fill needs identified by parents, caregivers, and SMEs. Participants agreed that the app had the potential to deliver valuable information to Afghan parents; however, due to the volatility in the country, participants advised that content amendments were needed to include more activities that could be safely done indoors, as mothers and children are required to spend most of their time at home. Additionally, it was necessary to ensure the content aligns with restrictions on public engagement in music. Further, activities to help parents reduce children’s screentime, promote empathy, manage emotions, and regulate behaviour were requested.

Conclusions:

Developing an understanding of the current sociocultural context in Afghanistan through research and collaborative engagement with parents, caregivers, and SMEs, was critical to inform the development of culturally appropriate and contextually relevant content to empower Afghan parents and caregivers to support their children’s developmental potential.