JMIR Publications

ABSTRACT

Background:

Culturally diverse populations (including Aboriginal and Torres Strait Islander people, LGBTQIA+ people, and culturally and linguistically diverse people) in non-urban (i.e. regional, rural, or remote) areas face compounded barriers to accessing mental health care. Health Information Technologies (HITs) show promising potential to overcome these barriers.

Objective:

To identify how best to improve a mental health and wellbeing HIT for culturally diverse Australians in non-urban areas.

Methods:

We conducted ten co-design workshops (total N=105) in primary youth mental health services across predominantly non-urban areas of Australia and thematically analyzed workshop outputs. Due to local (including service) demographics, workshop participants naturalistically reflected culturally diverse groups.

Results:

We identified four main themes: control, usability, comfort, and health service delivery factors. The first three themes overlap with the three basic needs postulated by self-determination theory (autonomy, competence, and relatedness) and describe participant recommendations on how to design a HIT. The final theme includes barriers to adopting HITs for mental health care and how HITs can be used to support care coordination and delivery, and describe participant recommendations on how to use a HIT.

Conclusions:

While culturally diverse groups have specific concerns, their expressed needs fall broadly within relatively universal design principles. The findings of this study provide further support for applying self-determination theory to the design of HITs and reflect the tension in designing technologies for complex problems that overlap multiple medical, regulatory, and social domains, such as mental health care. Finally, we synthesize the identified themes into suggested guidelines for designing HITs for mental health.