Understanding the challenges of deploying a milestone-tracking application in a cross-cultural context

Abstract

Actively tracking children's developmental milestones can alert caregivers to possible developmental delays. However, this can be difficult since there are only a few resources that provide reliable and culturally sensitive references for tracking and logging developmental progress. To address this issue, we adapted the milestone-tracking mobile application of the Centers for Disease Control and Prevention for Mexican-Spanish-speaking individuals and called it ActEarlyMEX. We conducted both a usability study (including two culturally different cohorts) and a two-month deployment study to understand milestone-tracking behavior in the real world. The usability study helped us create a culturally relevant app that we evaluated in the deployment study, in which we recruited 24 participants (18 parents and 6 family members) from a local day care center. The results showed that ActEarlyMEX provided participants with insights into age-appropriate developmental milestones. The participants also indicated that multiple caregivers should be allowed to simultaneously use ActEarlyMEX and that there should be a feature that automatically updates relevant milestones based on a child's behavior. The results also provide insights for researchers that investigate culturally situated health informatics and define a set of design guidelines for studying milestone tracking.