Adaptation of a maternal and child mHealth programme: an example from Aotearoa New Zealand.

INTRODUCTION: Evidence for mHealth in the delivery of public health messages is growing. Cultural adaptations of existing mHealth programmes may be an efficient way to extend their reach to new target populations, but best practices for such adaptations are unclear. AIM: This paper describes the process of culturally adapting an existing parental and child health text messaging programme in a region of Aotearoa New Zealand in which there is a high proportion of Māori, a population that continues to experience systemic inequities in child health outcomes. METHODS: An adapted mHealth Development and Evaluation Framework informed the three-stage cultural adaptation process. Consultation with a local governance group and end-users established important factors in adapting and rebranding the programme. The adapted content was reviewed by local and external experts. The final messages underwent local translation into Te Reo Māori (Māori language), and all versions were pre-tested before rollout. RESULTS: The resultant intervention, txtpēpi, provides free information and support to families during pregnancy through the child's first two years. The programme is available in four versions: Te Reo Māori or English for parents or family members. The personalised messages are designed to support and enable end-users to engage with local services and essential health behaviours (e.g. immunisation). DISCUSSION: Cultural adaptations of existing mHealth programmes are a resource-intensive process but contribute vital information about how to develop culturally safe support for new populations.