Mobile Health interventions for modifying indigenous maternal and child-health related behaviours: a systematic review (Preprint)

Abstract

The transition to motherhood is a pivotal time for promoting healthy behaviours, particularly among indigenous women, who encounter significant barriers to accessing health information. Mobile health interventions (mHealth) promoting healthy lifestyle changes, offer an adaptable and inexpensive method for improving access health information but require cultural appropriateness and suitability for acceptance and effectiveness in indigenous populations. No systematic review on effective mHealth interventions for indigenous women during pregnancy and the early childhood years has been conducted.

This study evaluated the effectiveness of mHealth interventions, promoting healthy lifestyle changes, for indigenous mothers and children from conception to five years post-partum. It explored the effectiveness differences based on participant engagement, intervention nature, and provision of context.

A systematic search of five databases; SCOPUS, MEDLINE, CINAHL, PsycINFO, and ProQuest (Dissertation or Thesis); was conducted to identify studies focusing on maternal and child health, indigenous populations, and mHealth following a pre-registered PROSPERO protocol (CRD42023395710). HealthInfoNet was searched for grey literature and the reference lists of included studies were hand searched. Randomised controlled trials and other interventional study designs including pre-post comparison and cohort studies were eligible for inclusion. Quality of studies was evaluated by two independent reviewers using the Mixed Methods Quality Appraisal Tool and the Centre of Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. Details from the studies was extracted using a predeveloped extraction form and a descriptive synthesis of the data was performed.

Of the 688 articles screened, only three met the eligibility criteria. Each paper evaluated a different mHealth intervention. The three mHealth interventions identified were: Remote Prenatal Education, the Short Messaging System (SmS) Parent Action Intervention, and the Screening, Brief Intervention and Referral to Treatment eCHECKUP To Go. All included studies had a small sample size, and none provided a rationale for the power calculation of the sample size for the outcomes reported. Therefore, it was not possible to establish whether the differences in the effectiveness were due to the interventions.

The current literature does not have any evidence of the effectiveness of mHealth interventions for maternal and child health behaviour change. A thorough evaluation with consideration of cultural contexts and user preferences during intervention design and development is crucial for maximizing their potential. Despite scant evidence, mHealth interventions, hold promise for enhancing indigenous mothers' health.