JMIR Publications

ABSTRACT

Background:

Foster youth have been excluded from conversations around tools designed to support their wellbeing, despite their lived expertise being crucial in dismantling barriers to care that can result in increased service access and improved mental health outcomes. Despite the proliferation of mental health digital applications, few focus specifically on foster youth or include them in the design process. Co-design centers the intended end-users during the design process, creating a direct relationship between potential users and developers. Co-design holds promise for creating foster youth centered tools, yet little is known about the co-design experience for foster youth and guidance on co-designing best practices with this group remain limited.

Objective:

The aim of this paper is to reflect on the experiences of four foster youth involved in the co-design of FostrSpace, a mobile web application designed through a collaboration between San Francisco Bay Area foster youth, clinicians and researchers from the Juvenile Justice Behavioral Health research team at the University of California, San Francisco, and Chorus Innovations, a rapid technology development platform specializing in participatory design practices.

Methods:

Duoethnography was conducted over a one-month period with the four transition-age former foster youth co-designers of FostrSpace via written reflections and a single in-person roundtable discussion. Reflections were coded and analyzed via thematic analysis.

Results:

Four main themes were derived from coding of the duoethnography reflections: power and control, resource navigation, building community and safe spaces, and identity. Themes related to power and control and resource navigation called attention to the challenges FostrSpace co-designers experienced trying to access basic needs, support from caregivers, and mental health resources as foster youth and former foster youth. Discussions of building community and safe spaces highlighted how foster youth communities had very positive effects on co-designers, and discussions related to identity revealed the complexities associated with understanding and embracing foster youth identity.

Conclusions:

This duoethnography study highlights the importance of centering the lived expertise of co-designers throughout the entire application development process. As the digital health field increasingly shifts toward using co-design methods to develop digital mental health technologies for underserved youth populations, we offer recommendations for researchers seeking to ethically and effectively utilize co-design methods. Active reflection throughout the co-design process, finding creative ways to engage in power-sharing practices to build community, and ensuring mutual benefit among co-designers are some of the recommended core components to address when co-designing youth behavioral health technologies.