JMIR Publications

ABSTRACT

Background:

The advancements and abundance of mobile phones and portable health devices has created an opportunity to utilise mobile health (m-health) for population health systems. There is increasing evidence for the feasibility and acceptance of mHealth with Indigenous populations. Providing a synthesis of qualitative findings of mHealth with Indigenous populations will gain insights to the strengths and challenges to mHealth use in Indigenous healthcare settings.

Objective:

This review aimed to identify and synthesise qualitative data pertaining to the experiences and perceptions of mHealth from the perspectives, of end users (patients and health stakeholders’) living in colonial settler democracies; Canada, Australia, New Zealand, United States of America, the Pacific Islands, and the Sápmi region of northern Europe.

Methods:

Systematic searches of peer-reviewed, scientific papers were conducted across 5 databases in May 2021: PubMed, CINAHL, Embase, PsycINFO and Web of Science. Qualitative and/or mixed method studies were included where an mHealth intervention was the primary focus for responding to health challenges with Indigenous populations. Two authors independently screened papers for eligibility and assessed risk of bias using a modified version of the Critical Appraisal Skills Programme (CASP). A meta-aggregative approach was used to analyse the findings of included studies.

Results:

Seventeen papers met the eligibility criteria, eight studies with patients, seven studies with health stakeholders, and two studies that included both patients and health stakeholders. Studies were conducted in Australia (n=10), Canada (n=2), New Zealand (n=2), Papua New Guinea (n=1), United States of America (n=1), and Samoa (n=1). Our interpretation of these qualitative findings show commonalities between Indigenous patients and health stakeholders perceptions of mHealth. We summarise our findings in six themes: (1) mHealth literacy, (2) mHealth as a facilitator for connection and support, (3) mHealth content needed to be culturally relevant, (4) mHealth security and confidentiality, (5) mHealth supporting rather than replacing health stakeholders, and (6) workplace and organisational capacity.

Conclusions:

This research suggests that mHealth can meet the needs of both patients and health stakeholders when the mHealth intervention is culturally relevant, accounts for digital and health literacy, incorporate interactive components, is supported by workplaces, fits into health provider workflows, and meets security and confidentiality standards. Future mHealth research with Indigenous populations should partner with key representative stakeholders (e.g., patients, healthcare professionals, executive leaders) in the mHealth design appropriate to the purpose, people, setting, and delivery