An Exploration of the Goodness of Fit of Web-Based Tools forMāori: Qualitative Study Using Interviews and Focus Groups

Background: Indigenous communities often have poorer health outcomes and services under traditional models of care. InNew Zealand, this holds true for M & amacr;ori people who are t & amacr;ngata whenua (the indigenous people). Several barriers exist that decreasethe likelihood of indigenous communities often have poorer health outcomes and poor service fit under traditional models ofcare, including access issues, systemic and provider racism, and a lack of culturally safe and responsive services. Web-basedinterventions (WBIs) have been shown to be effective in supporting mental health and well-being and can overcome some ofthese barriers. Despite the large number of WBIs developed, more investigation is needed to know how well WBIs fit with anindigenous worldview and how they meet the needs of indigenous communities so that a digitally based future does not drivesocial and health inequities. Objective: This study aims to explore the goodness-of-fit of WBIs of M & amacr;ori individuals, the indigenous people of Aotearoa/NewZealand.Methods: We used interviews (n=3) and focus groups (n=5) with 30 M & amacr;ori participants to explore their views about WBIs.Interviews were analyzed using reflexive thematic analysis by members of the research team. Results: Overall, there was a perception that the design of WBIs did not align with the M & amacr;ori worldview, which centers aroundpeople, relationships, spirituality, and holistic views of well-being. A total of 4 key themes and several subthemes emerged,indicating that WBIs were generally considered a poor fit for M & amacr;ori. Specifically, the themes were as follows: (1) WBIs aredisconnected from the core values of te ao M & amacr;ori (the M & amacr;ori worldview), (2) WBIs could be helpful in the right context, (3) thereare significant barriers that may make it harder for M & amacr;ori to use WBIs than other groups, and (4) ways to improve WBIs to helpengagement with M & amacr;ori. Conclusions: While WBIs are often considered a way to reduce barriers to care, they may not meet the needs of M & amacr;ori whenused as a stand-alone intervention. If WBIs are continued to be offered, developers and researchers need to consider how todevelop WBIs that are responsive and engaging to the needs of indigenous communities rather than driving inequities. Ideally,WBIs should be developed by the people they are intended for to fit with those populations' world views.