Priorities on trauma-informed design of sexual and reproductive health-related digital technologies: A modified nominal group technique.

Objectives: This study brainstormed and identified key priorities for integrating trauma-informed care (TIC) principles into the design and utilization of sexual and reproductive health (SRH)-related digital technologies. Methods: We conducted a nominal group technique among interest holder groups in a large urban hospital in western Canada. The study occurred in four stages, (1) an introduction to the topic, (2) ideas generation, (3) in-person workshop, and (4) ideas ranking related to (i) SRH domains, (ii) population groups, and (iii) TIC approaches that should be prioritized in the design of health technologies. The data was analyzed using summative content analysis to produce a list of items, which were ranked and analyzed descriptively. Results: Twenty people took part in this study. The findings emphasized the need to center stigmatized and emotionally sensitive SRH domains such as abortion, contraception, and STI care and called for technological design to prioritize inclusivity for marginalized groups such as 2SLGBTQIA+ individuals, migrants, sex workers, and those with low socioeconomic status. The participants proposed approaches such as customizable user interfaces, opt-in/opt-out engagement, multilingual support, content warnings, privacy controls, and survivor codesign for consideration when designing SRH digital health interventions. Conclusion: This study highlights the urgent need to integrate TIC principles into digital technologies that are used to access highly stigmatized SRH services while centering the voices of marginalized populations in the codesign process. Despite the challenges in engaging trauma survivors in codesign, the trauma-informed design approaches identified can help create safe, empowering, and healing digital spaces for people with lived experiences of trauma.