Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 14, 2020
Date Accepted: Nov 12, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Guidelines for Designing Health Information Technologies for Mental Health Drawn from Co-Design with Culturally Diverse Populations: Thematic Analysis
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.
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