Design and development of Ms Radiance: a culturally sensitive, tailor made bilingual educational initiative utilizing Instagram® for transgender women in Malaysia

Abstract Background: Transgender women in Malaysia are marginalized and face barriers in accessing health care. Low oral health care utilization along with gaps in knowledge and perceived low risk of transmission of STIs through oral sexual practices have been identified through formative research. Tailored educational interventions focusing on the needs of transgender women in Malaysia are crucial for addressing these gaps. Methods: Employment of the ADDIE (analyse, design, develop, implement and evaluate) instructional framework and participant involvement and engagement (PPIE) of the transgender community in the design and development of a social media based educational intervention, Ms Radiance is described. Pilot implementation of the intervention on Instagram® for a 3-week period was evaluated with an online pre-test/post-test study of a single group of transgender women (n=30) participants along with assessment of feasibility and accessibility. Results: Areas of concern identified through formative research were used to derive research objectives of the intervention and mapped to the educational content. PPIE was vital in ensuring that the educational content was delivered as artistic posts, stories and reels that were bilingual, peer-reviewed and culturally competent. Ms Radiance was feasible (100% retention, 93% post-intervention completion rate) and acceptable (positive post-intervention feedback and 79% indicated recommending the intervention to others). Conclusion. A first of its kind intervention for transgender women in Malaysia was designed and developed with PPIE and pilot tested. The feedback from the pilot will help in improving the intervention for a scaled-up version of the study.