Invisible Users in Digital Health: A Scoping Review of Digital Interventions to Promote Physical Activity Among Culturally and Linguistically Diverse Women

2026-02-03

AI Summary

Digital health interventions targeting culturally and linguistically diverse (CALD) women often struggle to sustain long-term engagement due to insufficient attention to deep-seated cultural factors. This study addresses this gap through a systematic scoping review of 18 relevant studies, integrating behavioral change theories with human-computer interaction design principles to propose a “Culturally Embedded Interaction Framework.” The framework comprises five dimensions: cultural grounding assessment, multimodal interaction, contextual-temporal adaptability, embedded social connectedness, and theory-informed cultural adaptation—thereby transcending conventional accessibility-centered design paradigms. The research further uncovers the paradox of technological solutionism’s ineffectiveness within low-activity social networks, offering CALD women a theoretically grounded and practically actionable strategy for culturally adaptive design.

Technology Category

• Humans and AI: Intelligent User Interfaces
• Application Domains: Humanities & Computational Social Science
• Cognitive Modeling & Cognitive Systems: Social Cognition And Interaction

Application Category

• User Modeling, Personalization and Recommendation: Practical large-scale studies of user experience
• Responsible Web: Human-perceived consequences of algorithmic deployment on the web
• Economics, Online Markets and Human Computation: Fairness, privacy, and diversity in economic environments

Abstract

Digital health has strong potential for promoting physical activity (PA), yet interventions often fail to sustain engagement among culturally and linguistically diverse (CALD) women. Prior reviews focus on short-term efficacy or surface-level localisation, while a design-oriented synthesis of deep cultural adaptation and long-term strategies remain limited. This scoping review systematically screened 1968 records, analysed 18 studies and identified a critical design paradox: techno-solutionist systems overlook social and cultural barriers, while social-support features often fail in low-activity social networks. To address this gap, we propose the Culturally Embedded Interaction Framework, integrating five dimensions: culturally-grounded measurement, multi-modal interaction, contextual and temporal adaptability, embedded social weaving, and theory-guided cultural adaptation. The framework advances beyond accessibility-focused approaches by mapping behavioural theory to design mechanisms that support sustained and culturally plural participation. We provide actionable design principles to help HCI researchers and practitioners move from one-size-fits-all models toward adaptive, theory-informed, and culturally sustaining design.

Problem

• culturally and linguistically diverse women
• digital health
• physical activity
• engagement
• cultural adaptation

Innovation

• Culturally Embedded Interaction Framework
• digital health interventions
• culturally and linguistically diverse women
• behavioral theory-driven design
• sustained engagement