Of primary importance in healthcare innovation, intended to support the maternal healthcare of Indigenous Australian women, is cultural appropriateness; specifically, the cultural notion of ‘women’s business’. In traditional Indigenous Australian culture, it is senior women who teach young women about maternal healthcare and it is considered offensive for anyone other than a senior woman to instruct an Indigenous Australian women on such matters. This discussion will consider the challenges in developing a maternal healthcare app that aims to satisfy both the culturally sensitive requirements in addition to the medical requirements.
13. Jumping 45 years.
• http://www.mobilemamaalliance.org/
• Support Millennium Development Goals 4 and
5, which address maternal and child health.
14. Jumping 45 years.
• http://www.mobilemamaalliance.org/
• Support Millennium Development Goals 4 and
5, which address maternal and child health.
• Directly assists programs in Bangladesh, South
Africa, India and Nigeria
15. Mobile messages
• Mobile health messages are portable, accessible
and discreet and can be saved or shared. They can
provide information, dispel myths, highlight
warning signs and connect pregnant women and
new moms with local health services.
• MAMA’s adaptable messages are based on WHO
and UNICEF guidelines and have been developed
in close collaboration with a group of global health
experts who make up MAMA’s Health Content
Advisory Council.
16. MAMA Mobile messages
• Mobile health messages are portable, accessible
and discreet and can be saved or shared. They can
provide information, dispel myths, highlight
warning signs and connect pregnant women and
new moms with local health services.
• MAMA’s adaptable messages are based on WHO
and UNICEF guidelines and have been developed
in close collaboration with a group of global health
experts who make up MAMA’s Health Content
Advisory Council.
17. MAMA Core SMS
• The core messages are arranged by "age and
stage" in two sets. The pregnancy/baby
messages cover weeks 5 to 42 of pregnancy,
and the first year of the baby's life. The child
messages cover ages 1-3.
• This project only focusing on pregnancy
messages. Scope for further research.
• Examples
18. MAMA Core SMS
• The core messages are arranged by "age and
stage" in two sets. The pregnancy/baby
messages cover weeks 5 to 42 of pregnancy,
and the first year of the baby's life. The child
messages cover ages 1-3.
• This project only focusing on pregnancy
messages. Scope for further research.
• Examples
19. MAMA Core SMS
• The core messages are arranged by "age and
stage" in two sets. The pregnancy/baby
messages cover weeks 5 to 42 of pregnancy,
and the first year of the baby's life. The child
messages cover ages 1-3.
• This project only focusing on pregnancy
messages. Scope for further research.
• Examples
21. MAMA Bangladesh
Research
• Phone Surveys results in 2013 reveal: 75% of women and
gatekeeper respondents reported that they now have the ability
to take action to improve the health of the mother or baby as a
result of the MAMA messages.
• 69% of respondents reported attending at least four antenatal
care visits during their pregnancy vs. 32% nationally*
• 57% of respondents reported giving birth in a facility vs. 29%
nationally*
• 65% of respondents reported attending a postnatal care visit vs.
27% nationally*
• 82% of respondents reported exclusive breastfeeding vs. 64%,
BDHS nationally*
* Results based on 2013 phone surveys with MAMA Bangladesh subscribers as compared to the 2011
Bangladesh Demographic and Health Survey*
22. MAMA Bangladesh
Research
• Phone Surveys results in 2013 reveal: 75% of women and
gatekeeper respondents reported that they now have the ability
to take action to improve the health of the mother or baby as a
result of the MAMA messages.
• 69% of respondents reported attending at least four antenatal
care visits during their pregnancy vs. 32% nationally*
• 57% of respondents reported giving birth in a facility vs. 29%
nationally*
• 65% of respondents reported attending a postnatal care visit vs.
27% nationally*
• 82% of respondents reported exclusive breastfeeding vs. 64%,
BDHS nationally*
* Results based on 2013 phone surveys with MAMA Bangladesh subscribers as compared to the 2011
Bangladesh Demographic and Health Survey*
23. MAMA Bangladesh
Research
• Phone Surveys results in 2013 reveal: 75% of women and
gatekeeper respondents reported that they now have the ability
to take action to improve the health of the mother or baby as a
result of the MAMA messages.
• 69% of respondents reported attending at least four antenatal
care visits during their pregnancy vs. 32% nationally*
• 57% of respondents reported giving birth in a facility vs. 29%
nationally*
• 65% of respondents reported attending a postnatal care visit vs.
27% nationally*
• 82% of respondents reported exclusive breastfeeding vs. 64%,
BDHS nationally*
* Results based on 2013 phone surveys with MAMA Bangladesh subscribers as compared to the 2011
Bangladesh Demographic and Health Survey*
24. MAMA Bangladesh
Research
• Phone Surveys results in 2013 reveal: 75% of women and
gatekeeper respondents reported that they now have the ability
to take action to improve the health of the mother or baby as a
result of the MAMA messages.
• 69% of respondents reported attending at least four antenatal
care visits during their pregnancy vs. 32% nationally*
• 57% of respondents reported giving birth in a facility vs. 29%
nationally*
• 65% of respondents reported attending a postnatal care visit vs.
27% nationally*
• 82% of respondents reported exclusive breastfeeding vs. 64%,
BDHS nationally*
* Results based on 2013 phone surveys with MAMA Bangladesh subscribers as compared to the 2011
Bangladesh Demographic and Health Survey*
25. MAMA Bangladesh
Research
• Phone Surveys results in 2013 reveal: 75% of women and
gatekeeper respondents reported that they now have the ability
to take action to improve the health of the mother or baby as a
result of the MAMA messages.
• 69% of respondents reported attending at least four antenatal
care visits during their pregnancy vs. 32% nationally*
• 57% of respondents reported giving birth in a facility vs. 29%
nationally*
• 65% of respondents reported attending a postnatal care visit vs.
27% nationally*
• 82% of respondents reported exclusive breastfeeding vs. 64%,
BDHS nationally*
* Results based on 2013 phone surveys with MAMA Bangladesh subscribers as compared to the 2011
Bangladesh Demographic and Health Survey*
26. MAMA South Africa Research
Most participants in a 2013 focus group discussion
felt the MAMA messages gave them new
information about how to care for their baby, and
specifically mentioned:
• When to introduce solid foods
• How to monitor developmental milestones
• When to vaccinate
• That they should never to leave the child
unattended on a bed or couch
27. Why Indigenous Australian women?
• The cost of healthcare for Indigenous Australians
compared to non-Indigenous Australians is not only
more expensive but also the maternal health outcomes
are significantly worse.
• In Australia, Indigenous health expenditure was
estimated to be $4.55 billion in 2010–11, 3.7% of the
total Australian health expenditure (Australian
Institute of Health and Welfare [AIHW], 2013).
• There is a higher prevalence of smoking during
pregnancy, hypertensive disorders, teenage pregnancy
and gestational diabetes (Prime Minister's Science,
Engineering and Innovation Council 2008).
28. Why Indigenous Australian women?
• The cost of healthcare for Indigenous Australians
compared to non-Indigenous Australians is not only
more expensive but also the maternal health outcomes
are significantly worse.
• In Australia, Indigenous health expenditure was
estimated to be $4.55 billion in 2010–11, 3.7% of the
total Australian health expenditure (Australian
Institute of Health and Welfare [AIHW], 2013).
• There is a higher prevalence of smoking during
pregnancy, hypertensive disorders, teenage pregnancy
and gestational diabetes (Prime Minister's Science,
Engineering and Innovation Council 2008).
29. Why Indigenous Australian women?
• The cost of healthcare for Indigenous Australians
compared to non-Indigenous Australians is not only
more expensive but also the maternal health outcomes
are significantly worse.
• In Australia, Indigenous health expenditure was
estimated to be $4.55 billion in 2010–11, 3.7% of the
total Australian health expenditure (Australian
Institute of Health and Welfare [AIHW], 2013).
• There is a higher prevalence of smoking during
pregnancy, hypertensive disorders, teenage pregnancy
and gestational diabetes (Prime Minister's Science,
Engineering and Innovation Council 2008).
30. State of Indigenous Maternal Health
• The maternal mortality ratio for Indigenous Australian
women between 2003-2005 was 21.5 deaths per
100,000, for non-Indigenous Australian women the
ratio was 7.9 per 100,000 Sullivan, Hall and King
(2008). This is known to be underestimated (Kildea,
2008 in Bar-Zeev et al., 2014).
• Perinatal death rate is twice as high for Indigenous
Australian infants (17.3 per 1000 births) compared to
non-Indigenous Australian infants (9.7 per 1000 births),
as is preterm birth (13.3% v. 8.0%) and low birth
weight (12.4% v. 5.9%) (Li, Zeki, Hilder, & Sullivan,
2012, in Bar-Zeev et al., 2014).
31. State of Indigenous Maternal Health
• The maternal mortality ratio for Indigenous Australian
women between 2003-2005 was 21.5 deaths per
100,000, for non-Indigenous Australian women the
ratio was 7.9 per 100,000 Sullivan, Hall and King
(2008). This is known to be underestimated (Kildea,
2008 in Bar-Zeev et al., 2014).
• Perinatal death rate is twice as high for Indigenous
Australian infants (17.3 per 1000 births) compared to
non-Indigenous Australian infants (9.7 per 1000 births),
as is preterm birth (13.3% v. 8.0%) and low birth
weight (12.4% v. 5.9%) (Li, Zeki, Hilder, & Sullivan,
2012, in Bar-Zeev et al., 2014).
32. Cultural Issues
• Thomas’s (2004) book, Reading Doctor’s Writing
was an attempt to understand, rather than ignore
the entanglement of healthcare research and the
brutality of colonialism in Australia. Thomas
reports… ‘The control of the sexuality of
Indigenous people, especially Indigenous women
(but rarely their sexual partners if they were white
men), was the central element of policy and
power’ (2004, p. 21). As a result of healthcare
research, this central policy theme was
responsible some of the cruelest excesses of
colonialism.
33. Cultural Issues
Linda Tuhiwia-Smith, an Indigenous researcher and member of the Maori
community, provides this sobering perspective:
• Stories about research and particularly researchers (the human carriers of
research) were intertwined with stories about all other forms of
colonisation and injustice. There were cautionary tales where the surface
story was not as important as the underlying examples of cultural protocol
broken, values negated, small tests failed and key people ignored. The
greater danger, however, was in the creeping policies that intruded into
every aspect of our lives, legitimated by research, informed more often by
ideology. The power of the research was not in the visits made by
researchers to our communities, nor by their fieldwork and the rude
questions they often asked . . . ‘We are the most researched people in the
world’ is a comment I have heard frequently from several Indigenous
communities. The truth of such a comment is unimportant, what does
need to be taken seriously is the sense of weight and unspoken cynicism
about research that the message conveys (1999, p. 3).
34. Cultural Issues
• Matthews (2011) report on more recent events,
describing the insidious nature of “culturally
insensitive research designs and methodologies
that fail to match the needs, customs, and
standards of Aboriginal communities” (p. 2). They
refer to the “ample examples of contemporary
research that has inappropriately required
Aboriginal people to discuss sensitive topics that
violate culturally determined gender roles or
community structures of authority” (2011, p. 2).
35. Women’s/Men’s Business
• A serious need for methodology design to proceed
with caution, with respect to cultural
requirements.
• ‘Men’s business’ involves hunting, conflicts, the
land, male anatomy and male ceremonial business
(Maher, 1999, p. 232). ‘Women’s business’ is
defined by Reid (1979) as... 'experience and
knowledge of menstruation, pregnancy, childbirth
and contraception' (cited in Barclay, Andre and
Glover 1989, p. 122).
36. Women’s/Men’s Business
• A serious need for methodology design to proceed
with caution, with respect to cultural
requirements.
• ‘Men’s business’ involves hunting, conflicts, the
land, male anatomy and male ceremonial business
(Maher, 1999, p. 232). ‘Women’s business’ is
defined by Reid (1979) as... 'experience and
knowledge of menstruation, pregnancy, childbirth
and contraception' (cited in Barclay, Andre and
Glover 1989, p. 122).
37. Women’s Business
• Traditionally, Aboriginal women gave birth in the place
where they were born, ‘on country’ with other women by
their side. Young women learn about borning and the
Grandmothers Law from the older women during their first
labour. Birthing is ‘women’s business’ and intricately
related to ‘Aboriginal Law’ and the ‘Dreamtime’. The
dreamtime explains creation and many of the rules and
symbols are expressed in the myths and stories that are
passed from generation to generation. The process of
borning is a process where the spirit of the land and the
people come together, and the place where a person is
born establishes their relationship to the land (Kildea,
Wardaguga & Dawumal, 2004, The Centre, para. 2).
38. Women’s/Men’s Business within a
Healthcare Context
• Breaches of these traditional divisions (e.g. female nurse
washing elderly initiated male Aboriginal, a female nurse
teaching an Aboriginal man self-catheterisation or a male
doctor undertaking a vaginal inspection) is likely to cause
great distress and ‘shame’. Shame is a complex concept
that is difficult to translate into non-Aboriginal English
(Maher, 1999, p. 232).
• Domestic violence, grog (alcohol) use and smoking are real
big problems... but we (non-Aboriginal midwives) can't be
the one trying to talk to them (pregnant women) about
this... it needs to be health workers, the old ladies (Elders)
doing all the talking… I feel like it always comes across like
your shaming (embarrassing, humiliating) them if you bring
it up... like pointing fingers... (Bar-Zeev et al., 2014, p. 293).
39. Women’s/Men’s Business within a
Healthcare Context
• Breaches of these traditional divisions (e.g. female nurse
washing elderly initiated male Aboriginal, a female nurse
teaching an Aboriginal man self-catheterisation or a male
doctor undertaking a vaginal inspection) is likely to cause
great distress and ‘shame’. Shame is a complex concept
that is difficult to translate into non-Aboriginal English
(Maher, 1999, p. 232).
• Domestic violence, grog (alcohol) use and smoking are real
big problems... but we (non-Aboriginal midwives) can't be
the one trying to talk to them (pregnant women) about
this... it needs to be health workers, the old ladies (Elders)
doing all the talking… I feel like it always comes across like
your shaming (embarrassing, humiliating) them if you bring
it up... like pointing fingers... (Bar-Zeev et al., 2014, p. 293).
40. Responsibility of Senior Indigenous
Australian Women
• Maternal healthcare is the traditional
responsibility of senior women. Senior female
family members such as grandmothers and
aunts assume important social roles to
pregnant women. Older women are greatly
respected and are often considered to have
the special knowledge and experience to
attend to women during pregnancy, childbirth
and the postpartum period (Callaghan, 2001).
41. A Methodology
• This methodology was only possible following recommendations
from MAMA, consultations with senior Indigenous Australian
women, consultations with healthcare professionals, and peer
reviews from The University ethics committee and the Aboriginal
Health and Medical Research Council (AH&MRC).
• The projects theoretical foundation originated within the
discipline of Human Computer Interaction (HCI), specifically,
within the discipline of Captology, which includes the study of
Persuasive Technology.
• From persuasive technology, MAMA, in the development of the
original messages, chose BJ Fogg’s model of behavior change.
• It was possible to extend and modify its usage for continued
application to the current study. The process is detailed in Fogg’s
paper, Creating Persuasive Technologies: An Eight-Step Design
Process (2009).
42. A Methodology
• This methodology was only possible following recommendations
from MAMA, consultations with senior Indigenous Australian
women, consultations with healthcare professionals, and peer
reviews from The University of Newcastle ethics committee and
the Aboriginal Health and Medical Research Council (AH&MRC).
• The projects theoretical foundation originated within the
discipline of Human Computer Interaction (HCI), specifically,
within the discipline of Captology, which includes the study of
Persuasive Technology.
• From persuasive technology, MAMA, in the development of the
original messages, chose BJ Fogg’s model of behavior change.
• It was possible to extend and modify its usage for continued
application to the current study. The process is detailed in Fogg’s
paper, Creating Persuasive Technologies: An Eight-Step Design
Process (2009).
43. A Methodology
• This methodology was only possible following recommendations
from MAMA, consultations with senior Indigenous Australian
women, consultations with healthcare professionals, and peer
reviews from The University of Newcastle ethics committee and
the Aboriginal Health and Medical Research Council (AH&MRC).
• The projects theoretical foundation originated within the
discipline of Human Computer Interaction (HCI), specifically,
within the discipline of Captology, which includes the study of
Persuasive Technology.
• From persuasive technology, MAMA, in the development of the
original messages, chose BJ Fogg’s model of behavior change.
• It was possible to extend and modify its usage for continued
application to the current study. The process is detailed in Fogg’s
paper, Creating Persuasive Technologies: An Eight-Step Design
Process (2009).
44. A Methodology
• This methodology was only possible following recommendations
from MAMA, consultations with senior Indigenous Australian
women, consultations with healthcare professionals, and peer
reviews from The University of Newcastle ethics committee and
the Aboriginal Health and Medical Research Council (AH&MRC).
• The projects theoretical foundation originated within the
discipline of Human Computer Interaction (HCI), specifically,
within the discipline of Captology, which includes the study of
Persuasive Technology.
• From persuasive technology, MAMA, in the development of the
original messages, chose BJ Fogg’s model of behavior change.
• It was possible to extend and modify its usage for continued
application to the current study. The process is detailed in Fogg’s
paper, Creating Persuasive Technologies: An Eight-Step Design
Process (2009).
45. Persuasive Technology
Persuasive technology is defined in the Proceedings in First
International Conference on Persuasive Technology,(2006) as:
• Persuasive technology is the general class of technology that has
the explicit purpose of changing human attitudes and behaviors.
Persuasive technologies apply principles of social psychology in
influencing people; principles of credibility, trust, reciprocity,
authority and the like. … The scope of technologies that hold
persuasive potential is broader than ICT alone, and includes
persuasive product design and architectural design, yet the
interactive nature of computers uniquely enables user-sensitive
and user-adaptive responding, allowing persuasive messages to
be tailored to the specific user in question, presented at the right
place and at the right time, thereby heightening their likely
persuasive impact (Ijsselsteijn 2006, p. v).
46. Does Mobile Persuasive Technology Work?
Life-Style Change Positive Results Reported From SMS Behaviour Change Research
Increasing Physical Activity Fjeldsoe, Miller and Marshall, 2010; Sirriyeh, Lawton and Ward, 2010.
Weight Control Haapala, Barengo, Biggs, Surakka and Manninen, 2009; Joo and Kim, 2007.
Diet Control Soureti et al. 2012.
Management Of Anxiety
Symptoms
Riva, Preziosa, Grassi and Villani, 2006.
Smoking Cessation Rodgers et al. 2005; Brendryen and Kraft, 2008; Brendryen, Drozd and Kraft, 2008.
Alcohol Consumption Monitoring Kuntsche and Robert, 2009; Weitzel, Bernhardt, Usdan, Mays and Glanz, 2007; Ríos-Bedoya
and Hay, 2013.
Illicit Substance Abuse Monitoring Maher et al. 2010; Muench, Weiss, Kuerbis and Morgenstern, 2012; McClure, Acquavita,
Harding and Stitzer, 2013.
Therapeutic Communication For
Emotional Disorders
Gerber, Stolley, Thompson, Sharp and Fitzgibbon, 2009; Haapala et al. 2009; Hazelwood,
2008; Kharbanda, Stockwell, Fox and Rickert, 2009; Leong et al. 2006.
Reminders To Take Medications Mao, Zhang and Zhai, 2008; Strandbygaard, Thomsen and Backer, 2010; Miloh et al. 2009;
Franklin, Waller, Pagliari and Greene, 2006; Vilella et al. 2004.
Appointment Reminders Downer, Meara, Da Costa and Sethuraman, 2006; da Costa, Salomao, Martha, Pisa and
Sigulem, 2010; Koshy, Car and Majeed, 2008.
Sexual Health Education Perry et al. 2003; Lim et al. 2012; Levine, McCright, Dobkin, Woodruff and Klausner, 2008;
Gold et al. 2011; Mitchell, Bull, Kiwanuka and Ybarra, 2011.
Contraception Adherence Castano, Bynum, Andres, Lara and Westhoff, 2012; Hou, Hurwitz, Kavanagh, Fortin and
Goldberg, 2010.
Family Violence Management Howard, Friend, Parker and Streker, 2010.
47. Fogg’s (2009) Eight steps in early-stage
persuasive design Model.
1. Choose a simple behavior to target
2. Choose a receptive audience
3. Find what is preventing the target behavior
4. Choose an appropriate channel
5. Find relevant examples of persuasion technology
6. Imitate successful examples
7. Test and iterate quickly
8. Expand on success
Fogg (2009) intended flexibility in the process, with each step
representing a milestone, rather than a rigid step-by-step process.
Adapting the sequence to the circumstances, according to Fogg, ‘… is
a valid part of the design process’ (Fogg 2009, p. 2).
48. Fogg’s (2009) Eight steps in early-stage
persuasive design Model.
1. Choose a simple behavior to target
2. Choose a receptive audience
3. Find what is preventing the target behavior
4. Choose an appropriate channel
5. Find relevant examples of persuasion technology
6. Imitate successful examples
7. Test and iterate quickly
8. Expand on success
Fogg (2009) intended flexibility in the process, with each step
representing a milestone, rather than a rigid step-by-step process.
Adapting the sequence to the circumstances, according to Fogg, ‘… is
a valid part of the design process’ (Fogg 2009, p. 2).
49. Adapting Messages To the Australian
Healthcare System
The first team will be made up of healthcare
professionals with experience working in Indigenous
healthcare, two from midwifery and two from obstetrics.
The healthcare team:
• Check that the content is correct for Indigenous
Australian women.
• Adapt messages to reflect the conditions of pregnant
Indigenous Australian women.
• Add new messages that address local health concerns
for Indigenous Australian women. (MAMA 2014d)
50. Adapting Messages To the Australian
Healthcare System
The first team will be made up of healthcare
professionals with experience working in Indigenous
healthcare, two from midwifery and two from obstetrics.
The healthcare team:
• Check that the content is correct for Indigenous
Australian women.
• Adapt messages to reflect the conditions of pregnant
Indigenous Australian women.
• Add new messages that address local health concerns
for Indigenous Australian women. (MAMA 2014d)
51. Adapting Messages To the Australian
Healthcare System
The first team will be made up of healthcare
professionals with experience working in Indigenous
healthcare, two from midwifery and two from obstetrics.
The healthcare team:
• Check that the content is correct for Indigenous
Australian women.
• Adapt messages to reflect the conditions of pregnant
Indigenous Australian women.
• Add new messages that address local health concerns
for Indigenous Australian women. (MAMA 2014d)
52. Adapting Messages To Pregnant
Indigenous Australian Women
The second team will be made up of senior Indigenous Australian women. Members of
this team are required to be Grandmothers, Auntie’s or Mothers, the traditional owners
of ‘women’s business’.
The culture team:
• Review of healthcare language: to reword the messages into the traditional style
they would use if speaking personally to a younger pregnant woman.
• Review healthcare terms: for example, in some cultures, the term ‘health worker’ or
‘health clinic’ is used, but in other cultures this may not convey the correct meaning.
• Check foods and produce: references to food items must be familiar to younger
Indigenous Australian women.
• Review local customs and practices: in many cultures, for example, it is common for
women to eat certain foods or non-foods during pregnancy; senior women will need
to reveal local practices and beliefs and adapt the messages accordingly (MAMA
2013b).
53. Adapting Messages To Pregnant
Indigenous Australian Women
The second team will be made up of senior Indigenous Australian women. Members of
this team are required to be Grandmothers, Auntie’s or Mothers, the traditional owners
of ‘women’s business’.
The culture team:
• Review of healthcare language: to reword the messages into the traditional style
they would use if speaking personally to a younger pregnant woman.
• Review healthcare terms: for example, in some cultures, the term ‘health worker’ or
‘health clinic’ is used, but in other cultures this may not convey the correct meaning.
• Check foods and produce: references to food items must be familiar to younger
Indigenous Australian women.
• Review local customs and practices: in many cultures, for example, it is common for
women to eat certain foods or non-foods during pregnancy; senior women will need
to reveal local practices and beliefs and adapt the messages accordingly (MAMA
2013b).
54. Adapting Messages To Pregnant
Indigenous Australian Women
The second team will be made up of senior Indigenous Australian women. Members of
this team are required to be Grandmothers, Auntie’s or Mothers, the traditional owners
of ‘women’s business’.
The culture team:
• Review of healthcare language: to reword the messages into the traditional style
they would use if speaking personally to a younger pregnant woman.
• Review healthcare terms: for example, in some cultures, the term ‘health worker’ or
‘health clinic’ is used, but in other cultures this may not convey the correct meaning.
• Check foods and produce: references to food items must be familiar to younger
Indigenous Australian women.
• Review local customs and practices: in many cultures, for example, it is common for
women to eat certain foods or non-foods during pregnancy; senior women will need
to reveal local practices and beliefs and adapt the messages accordingly (MAMA
2013b).
55. Adapting Messages To Pregnant
Indigenous Australian Women
The second team will be made up of senior Indigenous Australian women. Members of
this team are required to be Grandmothers, Auntie’s or Mothers, the traditional owners
of ‘women’s business’.
The culture team:
• Review of healthcare language: to reword the messages into the traditional style
they would use if speaking personally to a younger pregnant woman.
• Review healthcare terms: for example, in some cultures, the term ‘health worker’ or
‘health clinic’ is used, but in other cultures this may not convey the correct meaning.
• Check foods and produce: references to food items must be familiar to younger
Indigenous Australian women.
• Review local customs and practices: in many cultures, for example, it is common for
women to eat certain foods or non-foods during pregnancy; senior women will need
to reveal local practices and beliefs and adapt the messages accordingly (MAMA
2013b).
56. Testing Messages
• Messages will be tested on pregnant
Indigenous Australian women aged 16-30, as
to whether they like the wording and ‘tone’ of
the messages. They will be asked to pick from
a set of three, the message they like the best.
• It allows the observation of how the women
reacts to the messages.
• Again, women are not required to speak
about women’s business.
57. Testing Messages
• Messages will be tested on pregnant
Indigenous Australian women aged 16-30, as
to whether they like the wording and ‘tone’ of
the messages. They will be asked to pick from
a set of three, the message they like the best.
• It allows the observation of how the women
reacts to the messages.
• Again, women are not required to speak
about women’s business.
58. Testing Messages
• Messages will be tested on pregnant
Indigenous Australian women aged 16-30, as
to whether they like the wording and ‘tone’ of
the messages. They will be asked to pick from
a set of three, the message they like the best.
• It allows the observation of how the women
reacts to the messages.
• Again, women are not required to speak
about women’s business.
59. Further Research
• It is at the completion of this project that the SMS are
ready for use in clinical trials. Yet, even at this stage,
positive behavior change is not guaranteed, the messages
have merely been developed to a point where they have
the maximum possibility of success.
• Field studies, such as those used in HCI are recommended
for testing technology systems designed for health
behavior change, even short studies that contain a
significant qualitative component uncover bugs in the
system that can go undetected, even in lab-based usability
testing (Rogers et al. 2007).
• Only after the system has matured, Random Controlled
Trials (RCTs) become necessary to demonstrate that the
new technology is effective.
60. Further Research
• It is at the completion of this project that the SMS are
ready for use in clinical trials. Yet, even at this stage,
positive behavior change is not guaranteed, the messages
have merely been developed to a point where they have
the maximum possibility of success.
• Field studies, such as those used in HCI are recommended
for testing technology systems designed for health
behavior change, even short studies that contain a
significant qualitative component uncover bugs in the
system that can go undetected, even in lab-based usability
testing (Rogers et al. 2007).
• Only after the system has matured, Random Controlled
Trials (RCTs) become necessary to demonstrate that the
new technology is effective.
61. Further Research
• It is at the completion of this project that the SMS are
ready for use in clinical trials. Yet, even at this stage,
positive behavior change is not guaranteed, the messages
have merely been developed to a point where they have
the maximum possibility of success.
• Field studies, such as those used in HCI are recommended
for testing technology systems designed for health
behavior change, even short studies that contain a
significant qualitative component uncover bugs in the
system that can go undetected, even in lab-based usability
testing (Rogers et al. 2007).
• Only after the system has matured, Random Controlled
Trials (RCTs) become necessary to demonstrate that the
new technology is effective.
63. Question Time
• If I don’t have time to answer your question,
please feel free to email me at:
reece.george@uon.edu.au
• This presentation is available for download at:
http://reecegeorge.com