Development of a culturally and linguistically sensitive virtual reality educational platform to improve vaccine acceptance within a refugee population: the SHIFA community engagement-public health innovation programme.

To combat misinformation, engender trust and increase health literacy, we developed a culturally and linguistically appropriate virtual reality (VR) vaccination education platform using community-engaged approaches within a Somali refugee community. Community-based participatory research (CBPR) methods including focus group discussions, interviews, and surveys were conducted with Somali community members and expert advisors to design the educational content. Co-design approaches with community input were employed in a phased approach to develop the VR storyline. 60 adult Somali refugees and seven expert advisors who specialise in healthcare, autism research, technology development and community engagement. Somali refugees participated at the offices of a community-based organisation, Somali Family Service, in San Diego, California and online. Expert advisors responded to surveys virtually. We find that a CBPR approach can be effectively used for the co-design of a VR educational programme. Additionally, cultural and linguistic sensitivities can be incorporated within a VR educational programme and are essential factors for effective community engagement. Finally, effective VR utilisation requires flexibility so that it can be used among community members with varying levels of health and technology literacy. We describe using community co-design to create a culturally and linguistically sensitive VR experience promoting vaccination within a refugee community. Our approach to VR development incorporated community members at each step of the process. Our methodology is potentially applicable to other populations where cultural sensitivities and language are common health education barriers.

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: CF was a paid consultant on the project from inception until August of 2019. AMarchetti is a former employee of technology partner INVIVO and her engagement with the project began while she was with that organisation in 2018. SPB discloses Scripps Clinic Grants for clinical trials related to machine learning and technology designs in cardiovascular imaging, being a Pfizer Health Information Technology Advisory Board member on strategies related to health information technology, being a Bristol Meyers Squibb Digital Health Advisory Board member on strategies related to digital health technologies, being an Anthem AI Consultant on projects related to cardiovascular care, being a Proteus Health Chair DSMB on digital medication monitoring in hepatitis C, being an American College of Cardiology Innovations Advisory Group principal investigator and committee member on various innovation projects in cardiovascular care, having Analytics4Life Stock options as a scientific advisor on artificial intelligence in cardiovascular diagnostics, and having Blumio Stock options as a scientific advisor on new technology designs in hypertension. ME discloses US patents in IllumeSense, using data analytics and machine learning algorithms for clinical decision support for alternative health therapies. ME is also founder of IllumeSense as majority shareholder and principle. IS discloses that he is a paid employee of Distinct Insights. AS, NI and SS were all paid employees of Somali Family Service at the time of this research. AMohamed was also a paid research assistant for this project. All other authors declare that they have no relevant or material financial interests that relate to the research described in this paper.