Application of Two-Eyed Seeing in Adolescent Mental Health to Bridge Design Thinking and Indigenous Collective Storytelling

Abstract

Background: eMental health apps are increasingly being considered for use in health care with growing recognition of the importance of considering end-user preferences in their design and implementation. The key to the success of using apps with Indigenous youth is tailoring the design and content to include Indigenous perspectives. In this study we used a Two-Eyed Seeing perspective to integrate Indigenous and human computer interaction methodologies to identify end-user preferences for a tablet-based mental health screening app used in a primary care clinic serving Indigenous youth. Objective: The research objectives used a Two-Eyed Seeing approach to (i) collectively create stories about Indigenous youth lived experiences accessing integrated primary care for their mental health concerns; and (ii) engage Indigenous youth in Design Circles to determine their usability preferences for digital mental health screening tools. Method: Eight adolescents (n = 4 young women; n = 3 young men; and n = 1 Two Spirit) between 20 to 24 years old who self-identified as Indigenous participated. Indigenous youth joined Design Circles to co-create a story about accessing mental health care and their needs and preferences for an eMental Health app. Results: Findings highlighted the importance of collective Indigenous storytelling about accessing integrated primary care for mental health needs. Participants created three persona stories about their challenges accessing mental health care and the role of social support. Participants sorted their usability design preferences for an eMental Health app to be inclusive of Indigenous knowledges. Conclusions: A Two-Eyed Seeing perspective was useful to incorporate a design thinking approach as collective storytelling among Indigenous youth. This research may inform and shape the design of eMental health apps used in health clinics to better engage Indigenous youth.

Two-Eyed Seeing Application in Research Analysis: An Integrative Review

“…Statement Acknowledging Indigenous Knowledge during Analysis. Three (n = 32; 7%) articles (Hall et al, 2015;Jaworsky, 2023;Sam et al, 2022;Wright et al, 2019c) of the 32 articles included a statement acknowledging Indigenous Knowledge during research analysis. In a study by Hall et al (2015), the research team identified that participant stories would be treated as Indigenous Knowledge including complex teachings, humorous additions, historical happenings, and/or sacred tellings depending on the intent of the shared story.…”

“…Nine articles (Bruner et al, 2019;Carter et al, 2017;Hall et al, 2015;Hatala et al, 2020;Jacklin et al, 2020;Martin et al, 2018;Stelkia et al, 2021;Vorobyova et al, 2022;Wright et al, 2019c) used two of the strategies and three articles (Latimer et al, 2020;Marsh et al, 2015;Rowan et al, 2015) used three strategies to involve Indigenous community members. Overall, all but five article (Jaworsky, 2023;Pilarinos et al, 2023;Sam et al, 2022;Shrivastava et al, 2020;Sylliboy, 2021) used a strategy to involve Indigenous community members during data analysis.…”