Ezimora Ifunanya, Lundberg Tylia, Miars Dylan, Trujeque Jeruel, Papias Ashley, Del Cid Margareth V, Folk Johanna B, Tolou-Shams Marina
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
JMIR Form Res. 2025 Jan 20;9:e53231. doi: 10.2196/53231.
Current research on digital applications to support the mental health and well-being of foster youth is limited to theoretical applications for transition-aged foster youth and support platforms developed without intentional input from foster youth themselves. Centering the lived expertise of foster youth in digital solutions is crucial to dismantling barriers to care, leading to an increase in service access and improving mental health outcomes. Co-design centers the intended end users during the design process, creating a direct relationship between potential users and developers. This methodology holds promise for creating tools centered on foster youth, yet little is known about the co-design experience for foster youth. Understanding foster youth's experience with co-design is crucial to identifying best practices, knowledge of which is currently limited.
The aim of this paper is to reflect on the experiences of 4 foster youth involved in the co-design of FostrSpace, a mobile app designed through a collaboration among foster youth in the San Francisco Bay Area; clinicians and academics 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. Key recommendations for co-designing with foster youth were generated with reference to these reflections.
A duoethnography study was conducted over a 1-month period with the 4 transition-aged former foster youth co-designers of FostrSpace via written reflections and a single in-person roundtable discussion. Reflections were coded and analyzed via reflexive thematic analysis.
In total, 4 main themes were identified from coding of the duoethnography reflections: power and control, resource navigation, building community and safe spaces, and identity. Themes of power and control and resource navigation highlighted 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 pertaining to building community and safe spaces highlighted the positive effect of foster youth communities on co-designers, and discussions related to identity revealed the complexities associated with understanding and embracing foster youth identity.
This duoethnography study highlights the importance of centering the lived expertise of co-designers throughout the app 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 engage youth co-designers. Actively reflecting 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 behavioral health technologies for youth.
目前关于支持寄养青年心理健康和福祉的数字应用研究，仅限于针对过渡年龄寄养青年的理论应用，以及在没有寄养青年自身有意参与的情况下开发的支持平台。将寄养青年的实际经验置于数字解决方案的中心，对于消除护理障碍、增加服务可及性和改善心理健康结果至关重要。协同设计在设计过程中以目标终端用户为中心，在潜在用户和开发者之间建立直接关系。这种方法有望创建以寄养青年为中心的工具，但对于寄养青年的协同设计体验却知之甚少。了解寄养青年的协同设计体验对于确定最佳实践至关重要，而目前这方面的知识有限。
本文旨在反思4名参与FostrSpace协同设计的寄养青年的经历。FostrSpace是一款移动应用程序，由旧金山湾区的寄养青年、加利福尼亚大学旧金山分校少年司法行为健康研究团队的临床医生和学者，以及专注于参与式设计实践的快速技术开发平台Chorus Innovations合作设计。参考这些反思，得出了与寄养青年进行协同设计的关键建议。
通过书面反思和一次面对面圆桌讨论，对4名FostrSpace过渡年龄的前寄养青年协同设计师进行了为期1个月的双民族志研究。通过反思性主题分析对反思内容进行编码和分析。
对双民族志反思进行编码后，共确定了4个主要主题：权力与控制、资源导航、建立社区和安全空间以及身份认同。权力与控制和资源导航主题突出了FostrSpace协同设计师作为寄养青年和前寄养青年在试图获取基本需求、照顾者的支持和心理健康资源时所经历的挑战。关于建立社区和安全空间的讨论突出了寄养青年社区对协同设计师的积极影响，与身份认同相关的讨论揭示了理解和接受寄养青年身份认同的复杂性。
这项双民族志研究强调了在整个应用程序开发过程中以协同设计师的实际经验为中心的重要性。随着数字健康领域越来越倾向于使用协同设计方法为服务不足的青年群体开发数字心理健康技术，我们为寻求以道德和有效的方式让青年协同设计师参与的研究人员提供建议。在整个协同设计过程中积极反思、找到创造性的方式参与权力分享实践以建立社区，以及确保协同设计师之间的互利，是为青年设计行为健康技术时建议解决的一些核心组成部分。
