To address the pediatric obesity pandemic disproportionately affecting Latino children, particularly in the Caribbean, this study developed and validated a culturally tailored Spanish version of the Family Nutrition Physical Activity (FNPA) instrument for the Dominican context. Through a multi-step iterative process involving bilingual medical professionals, ten healthcare providers, and 50 guardians of children aged 6–12, the tool underwent rigorous translation and cognitive validation. Participants found the Spanish FNPA easy to understand and culturally relevant. Essential modifications included adding local examples—such as specific sugar-sweetened beverages—and guidance on healthy sleep practices to ensure accurate responses. Ultimately, the study confirmed that the translated FNPA is culturally appropriate for Dominican families and providers. These findings support the use of the instrument in the Dominican Republic and suggest that future research should explore its applicability in other Spanish-speaking regions to compare behavioral trends across diverse settings.
Introduction: Digital mental health interventions are especially relevant in low- and middle-income countries, where access to face-to-face care is limited. However, many platforms insufficiently incorporate user experience, reducing engagement and effectiveness, particularly among vulnerable populations. Methods: This study adopted an exploratory mixed-methods approach conducted across four sequential phases to improve a Brazilian digital mental health platform focused on anxiety and stress management. Data were collected from four sources: focus groups with 36 community leaders from a low-income urban area; surveys with 36 highly educated users; think-aloud usability interviews with 10 participants; and an online survey with 102 young adults. Qualitative and quantitative data were integrated to identify design and content gaps. Results: Participants consistently reported the need for culturally resonant language, shorter and more dynamic videos, greater diversity among presenters, and improved visual design and accessibility. These findings guided platform adaptations, including revised audiovisual formats, updated language and imagery, and enhanced accessibility features. The results reinforce the importance of user-centered and culturally sensitive design in digital mental health tools, particularly in socially diverse contexts. Conclusion: Findings suggest that user-centered adaptation processes can help improve the usability and cultural relevance of digital mental health interventions.
IntroductionAccess to reliable internet is recognized as a social determinant of health, yet many migrant and seasonal farmworkers in North Carolina (NC) face barriers to connectivity due to rural housing locations and limited infrastructure. In response to these challenges, the NC Farmworker Health Program implemented a pilot program that installed ruggedized internet routers in employer-provided farmworker housing where other internet options were not available to improve digital inclusion and telehealth access.MethodsThis qualitative study evaluated the program four years after implementation through interviews with Hispanic farmworkers (n=9) and farm owners (n=5), internet performance tests, and site observations at participating NC farms in 2024.ResultsFindings showed that internet access fostered communication with family among Hispanic farmworkers. However, there were significant programmatic challenges, including weak or limited signal range, poor internet speed, lack of privacy, minimal cybersecurity, and low awareness of telehealth services. Farm owners supported the program but expressed concerns about sustaining it without continued funding due to performance limitations and costs.ConclusionThese findings highlight the importance of sustainable, high-quality internet in rural farmworker housing and suggest a need for expanded support, improved performance, and greater education around tools such as telehealth to address inequities that agricultural communities face.
