Invisible users in digital health : a scoping review of digital interventions to promote physical activity among CALD women

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.