National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand.
Tranzo Scientific Centre for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Transl Behav Med. 2019 Jul 16;9(4):720-736. doi: 10.1093/tbm/iby093.
The obesity rate in New Zealand is one of the highest worldwide (31%), with highest rates among Māori (47%) and Pasifika (67%). Codesign was used to develop a culturally tailored, behavior change mHealth intervention for Māori and Pasifika in New Zealand. The purpose of this article is to provide an overview of the codesign methods and processes and describe how these were used to inform and build a theory-driven approach to the selection of behavioral determinants and change techniques. The codesign approach in this study was based on a partnership between Māori and Pasifika partners and an academic research team. This involved working with communities on opportunity identification, elucidation of needs and desires, knowledge generation, envisaging the mHealth tool, and prototype testing. Models of Māori and Pasifika holistic well-being and health promotion were the basis for identifying key content modules and were applied to relevant determinants of behavior change and theoretically based behavior change techniques from the Theoretical Domains Framework and Behavior Change Taxonomy, respectively. Three key content modules were identified: physical activity, family/whānau [extended family], and healthy eating. Other important themes included mental well-being/stress, connecting, motivation/support, and health literacy. Relevant behavioral determinants were selected, and 17 change techniques were mapped to these determinants. Community partners established that a smartphone app was the optimal vehicle for the intervention. Both Māori and Pasifika versions of the app were developed to ensure features and functionalities were culturally tailored and appealing to users. Codesign enabled and empowered users to tailor the intervention to their cultural needs. By using codesign and applying both ethnic-specific and Western theoretical frameworks of health and behavior change, the mHealth intervention is both evidence based and culturally tailored.
新西兰的肥胖率位居世界前列（31%），毛利人（47%）和太平洋岛民（67%）的肥胖率最高。本研究采用共同设计方法为新西兰的毛利人和太平洋岛民开发了一种文化适宜的行为改变移动健康干预措施。本文旨在概述共同设计方法和流程，并描述如何利用这些方法和流程为选择行为决定因素和改变技术提供信息并构建一种理论驱动的方法。本研究中的共同设计方法基于毛利人和太平洋岛民合作伙伴与学术研究团队之间的合作。这涉及与社区合作确定机会、阐明需求和愿望、知识生成、设想移动健康工具以及原型测试。毛利人和太平洋岛民整体健康和促进健康的模式是确定关键内容模块的基础，并分别应用于行为改变的相关决定因素和基于理论的行为改变技术，这些技术来自理论领域框架和行为改变分类学。确定了三个关键内容模块：身体活动、家庭/whānau[大家庭]和健康饮食。其他重要主题包括心理健康/压力、联系、动机/支持和健康素养。选择了相关的行为决定因素，并将 17 种改变技术映射到这些决定因素上。社区合作伙伴确定智能手机应用程序是该干预措施的最佳载体。开发了毛利人和太平洋岛民版本的应用程序，以确保功能和功能既具有文化特色又能吸引用户。共同设计使用户能够根据自己的文化需求调整干预措施。通过使用共同设计并应用特定于种族和西方的健康和行为改变理论框架，该移动健康干预措施既具有循证依据又具有文化适宜性。
