Indigenous Women and Their Nutrition During Pregnancy (the Mums and Bubs Deadly Diets Project): Protocol for a Co-designed mHealth Resource Development Study

Background: Nutrition in pregnancy is pivotal to optimizing infant growth and maternal well-being. The factors affecting Indigenous people's food and nutrition intake are complex with a history of colonization impacting the disproportionate effect of social determinants to this day. Literature regarding the dietary intake or dietary priorities of Indigenous women in Australia is scarce, with supportive, culturally appropriate resources developed for and with this group rare. Research suggests mobile health (mHealth) tools are effective in supporting health knowledge of Indigenous people and positive health behavior changes when designed and developed with the expertise of Indigenous communities. Objective: This study seeks to build the body of knowledge related to nutrition needs and priorities for Indigenous women in Australia during pregnancy. Further, this project team and its participants will co-design an mHealth digital tool to support these nutrition needs. Methods: The Mums and Bubs Deadly Diets study recruits Indigenous women and health care professionals who support Indigenous women during pregnancy into 2 phases. Phase 1 (predesign) uses a mixed methods convergent design using a biographical questionnaire and social or focus groups to inform phase 2 (generative). Phase 2 will use a participatory action research process during co-design workshops to iteratively develop the digital tool; the exact actions within a workshop will evolve according to the participant group decisions. Results: To date, this project has undertaken phase 1 focus groups at all Queensland sites, with New South Wales and Western Australia to begin in early to mid-2023. We have recruited 12 participants from Galangoor Duwalami, 18 participants from Carbal in Toowoomba, and 18 participants from Carbal in Warwick. We are expecting similar numbers of recruits in Western Australia and New South Wales. Participants have been both community members and health care professionals. Conclusions: This study is an iterative and adaptive research program that endeavors to develop real-world, impactful resources to support the nutrition needs and priorities of pregnant Indigenous women in Australia. This comprehensive project requires a combination of methods and methodologies to ensure Indigenous voices are heard at each stage and in all aspects of research output. The development of an mHealth resource for this cohort will provide a necessary bridge where there is often a gap in access to nutrition resources for women in pregnancy in Indigenous communities. International Registered Report Identifier (IRRID): DERR1-10.2196/45983