Other Titles
Piloting a Translational Adaptation of mHealth Intervention to Reduce Maternal & Neonatal Mortality in Cameroon [Poster Title]
Abstract
Background: The World Health Organization aims to reduce the global maternal mortality rate (MMR) to less than 70 per 100,000 live births by 2030. Mobile health interventions, particularly those adapted from high income settings, are increasingly recognized for their potential usefulness in addressing gaps to quality maternal and neonatal care in low-income countries. However, few studies protocolize the adaptation process, including stakeholder feedback and side-by-side adjustments required to ensure contextualize relevance.
Design: We used the 8 sequential phases of the ADAPT-ITT framework to iteratively transform the medical intervention service via Telephone (MIST) to mobile phone-based solution (mMIST) intervention, incorporating qualitative findings. In the first phase we conducted in-depth interviews and focus groups with key stakeholders including previously and currently pregnant women, primary healthcare providers, administrators, and representatives of the Ministry of Health, recruited by purposive sampling. Thematic coding and analysis via modified grounded theory approach were conducted using NVivo12 software. In the second phase we decided which aspects of MIST to adapt to mMIST. In the third phase, we made these changes which extensively documenting rationale and priorities to inform other similar studies in resources limited settings.
Results: A key element of the adaptation process involved determining how the mMIST intervention could address several healthcare system constraints, as well as infrastructure barriers, during active civil unrest in the country, while maintaining core components of the interventions. For example, (1) while patients and providers can call into MIST for support in the United States, in mMIST only providers were able to call into the system for support. (2) In the United states, the system is maintained on a VOIP line; however, this was impossible in Cameroon, necessitating use of a hardwired landline. (3) Non-clinician staff answer MIST in the United States, but due to limited infrastructure and staffing, mMIST calls were answered by nurses on duty at a centralized hospital location. Adaptations occurred across twenty-one domains with beta testing user feedback, which will be presented at Sigma is selected.
Conclusion: This provides an example of ADAPT-ITT informed scientific intervention transformation to enhance acceptability, feasibility, and contextual relevance in the setting of Cameroon.
Notes
References:
Budhwani, Henna, Comfort Enah, Christyenne L. Bond, Gregory Halle-Ekane, Eric Wallace, Janet M. Turan, Jeff M. Szychowski et al. "mHealth phone intervention to reduce maternal deaths and morbidity in Cameroon: protocol for translational adaptation." International Journal of Women's Health (2022): 677-686.
Wirsiy, Frankline Sevidzem, Denis Ebot Ako-Arrey, Patrick Achiangia Njukeng, Nicholas Tendongfor, Florence Titu Manjong, and L. K. Lukong. "Maternal mortality in Cameroon: a critical review of its determinants." J Gynecol Neonatal 2, no. 1 (2019): 106.
Wingood, Gina M., and Ralph J. DiClemente. "The ADAPT-ITT model: a novel method of adapting evidence-based HIV Interventions." JAIDS Journal of Acquired Immune Deficiency Syndromes 47 (2008): S40-S46.
Enah, Comfort, Victoria Jauk, Mary Glory Ngong, Christyenne Lily Bond, Lionel Neba Ambe, Rahel Mbah Kyeng, Roland Mbole et al. "Mobile Telephone Provider to Provider Helpline: A Pilot Study in Cameroon." AJOG Global Reports (2025): 100581.
Sigma Membership
Xi
Lead Author Affiliation
University of Pennsylvania, Philadelphia, Pennsylvania, USA
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Pilot/Exploratory Study
Keywords:
Global Leadership, Implementation Science, Maternal Health Services, Maternal Mortality, Infant Mortality, Nursing Interventions, Telehealth, Cameroon
Recommended Citation
Harbison, Hanne Sybil; Budhwani, Henna; Enah, Comfort; Tita, Alan; Wallace, Eric; Carlo, Waldemar; Ngong, Mary Glory; Tih, Pius M.; and Kyeng, Rahel Mbah, "Implementation Science Intervention Adaptation to Address Maternal and Neonatal Health in Cameroon" (2026). International Nursing Research Congress (INRC). 45.
https://www.sigmarepository.org/inrc/2026/posters_2026/45
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-29
Implementation Science Intervention Adaptation to Address Maternal and Neonatal Health in Cameroon
Toronto, Ontario, Canada
Background: The World Health Organization aims to reduce the global maternal mortality rate (MMR) to less than 70 per 100,000 live births by 2030. Mobile health interventions, particularly those adapted from high income settings, are increasingly recognized for their potential usefulness in addressing gaps to quality maternal and neonatal care in low-income countries. However, few studies protocolize the adaptation process, including stakeholder feedback and side-by-side adjustments required to ensure contextualize relevance.
Design: We used the 8 sequential phases of the ADAPT-ITT framework to iteratively transform the medical intervention service via Telephone (MIST) to mobile phone-based solution (mMIST) intervention, incorporating qualitative findings. In the first phase we conducted in-depth interviews and focus groups with key stakeholders including previously and currently pregnant women, primary healthcare providers, administrators, and representatives of the Ministry of Health, recruited by purposive sampling. Thematic coding and analysis via modified grounded theory approach were conducted using NVivo12 software. In the second phase we decided which aspects of MIST to adapt to mMIST. In the third phase, we made these changes which extensively documenting rationale and priorities to inform other similar studies in resources limited settings.
Results: A key element of the adaptation process involved determining how the mMIST intervention could address several healthcare system constraints, as well as infrastructure barriers, during active civil unrest in the country, while maintaining core components of the interventions. For example, (1) while patients and providers can call into MIST for support in the United States, in mMIST only providers were able to call into the system for support. (2) In the United states, the system is maintained on a VOIP line; however, this was impossible in Cameroon, necessitating use of a hardwired landline. (3) Non-clinician staff answer MIST in the United States, but due to limited infrastructure and staffing, mMIST calls were answered by nurses on duty at a centralized hospital location. Adaptations occurred across twenty-one domains with beta testing user feedback, which will be presented at Sigma is selected.
Conclusion: This provides an example of ADAPT-ITT informed scientific intervention transformation to enhance acceptability, feasibility, and contextual relevance in the setting of Cameroon.
Description
We applied the ADAPT-ITT framework to transform the US MIST provider support system into mMIST, a mobile health intervention for midwife-to-nurse intervention in Cameroon. Through stakeholder interviews and iterative adaptation, 21 contextual modifications were made to address infrastructure and conflict-related constraints. Findings offer a replicable guide for adapting digital maternal health interventions in resource-limited settings.