Theoretical Perspectives Towards Culture-Centered User Engagement Design for Mobile Health in the Global South

The main objective of this article is to propose a theoretical model for uncovering users’ socio-cultural contexts for user engagement designs, as well as to present a set of consolidating concepts to guide future research in mobile health (mHealth) designs to strengthen the theoretical framing of user engagement designs. First, we present a brief discussion of the importance of employing appropriate theoretical frameworks that promote user engagement. Second, we discuss different theoretical perspectives on user engagement. Two theoretical frameworks, activity theory and the communicative ecological framework, are used to frame an understanding of users’ socio-cultural contexts and inform the design of a framework called Design Process Engagement Enhancement System (DECENT) to support designers in mHealth engagement designs. This paper addressed the research question of how to uncover the socio-cultural contexts of a user group to inform the design of engaging digital artifacts (tools) by augmenting two phases of user-centered methodology with users’ socio-cultural filtration and socio-cultural checklists for user engagement designs. The DECENT framework is an adapted user-centered design framework that uses activity theory and the communicative ecological framework as theoretical framework for understanding the socio-cultural complexity of users in the context of mHealth. The findings of the paper suggest that to fully explain and design for user engagement in mHealth, an integrated approach incorporating a variety of technological and socio-cultural factors should be required.