JMIR Publications

ABSTRACT

Background:

With many socially disadvantaged populations experiencing a higher level of illness than the general population, health research has begun to recognize the impact of social determinants on health outcomes. Community-based research has increasingly become used to understand the complexities of local context. However, given the number of interdependent factors influencing individual well-being, no single methodology can explore this level of complexity alone. To put context into perspective, research processes need to shift from the sole use of Western methodologies and instead incorporate collaborative methods from non-traditional research. Specifically, Indigenous methodologies have been developed to better understand the complexity of context within multiple worldviews, but current studies have failed to apply these approaches within other cultural settings.

Objective:

This mixed-methods study will utilize Western and Indigenous methodologies to adapt a digital health program for remote communities in Uganda.

Methods:

Using the principles from community-based research and user-centered design, a four-phased mixed-methods study will be conducted. The Indigenous method of two-eyed seeing will be used to promote a reflexive engagement strategy throughout all study phases. Phase 1 will focus on partnership building to co-develop the project priorities and study design. Phase 2 will involve a needs assessment to elicit a context-focused understanding regarding the local clinic and community environment. Phase 3 will involve a series of system adaptations to co-design the program. Phase 4 will consist of a community-based field study to evaluate the usability and cultural-relevance of the adapted program.

Results:

The study was approved by the Makerere University School of Medicine Research Ethics Committee (Mak-SOMREC-2021-63) and the UHN Research Ethics Board (ID #: 20-6022). This protocol provides novel strategy leveraging a range of community-based methods to ensure the contextual significance of each community’s challenges are reflected within the design of the Medly Uganda program.

Conclusions:

By integrating the community’s local knowledge into the design of the Medly Uganda program, this will lead to the development of meaningful interventions that improve health outcomes.