Evidence map›Paper›PMID 39832159›Full record

ArticleJMIR formative research2025

Reflections of Foster Youth Engaging in the Co-Design of Digital Mental Health Technology: Duoethnography Study.

Ifunanya Ezimora, Tylia Lundberg, Dylan Miars, Jeruel Trujeque, Ashley Papias, Margareth V Del Cid, Johanna B Folk, Marina Tolou-Shams

Abstract read
In one paragraph

Article in JMIR formative research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ifunanya Ezimora *Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0001-7292-3742
Tylia Lundberg *Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0009-0003-0857-5888
Dylan MiarsDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0009-0008-0808-0937
Jeruel TrujequeDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0009-0009-5379-3220
Ashley PapiasDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0009-0007-1467-673X
Margareth V Del CidDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0003-2671-7010
Johanna B FolkDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0003-0503-7307
Marina Tolou-ShamsDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0003-2551-609X

Funding

Mentoring to reduce substance use for youth in the juvenile justice system.K24DA046569 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MARINA TOLOU-SHAMS · 2019 to 2026
$1.5M
Reducing Parenting Stress to Facilitate Justice-Involved Youth’s Treatment EngagementK23DA050798 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FOLK, JOHANNA BAILEY · 2021 to 2025
$1.1M
CASA and FostrSpace: Systems delivery of digital substance use prevention tools to foster youthR61DA059860 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TOLOU-SHAMS, MARINA · 2024 to 2024
$582k
NIDA NIH HHS K23 DA050798NIDA NIH HHS K24 DA046569NIDA NIH HHS R61 DA059860
6 · The paper itself

Abstract

backgroundCurrent 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.

objectiveThe 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.

methodsA 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.

resultsIn 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.

conclusionsThis 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.

Indexed as

Child, FosterFoster Home CareMental Health ServicesMobile ApplicationsAdolescentFemaleHumansMaleMental HealthQualitative ResearchSan Franciscoadolescentapp developmentco-designdigital health technologyduoethnographyfoster carefoster youthmental healthmHealthmobile healthyoung adult

Identifiers

PMID39832159
PMCPMC11791460

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.