Integrating Cultural Relevance into a Behavioral mHealth Intervention for Native American Youth.

Native American communities are disproportionately affected by a number of behavioral health disparities, including higher rates of depression, substance abuse, and suicide. As mobile health (mHealth) interventions gain traction as methods for addressing these disparities, they continue to lack relevance to Native American youth. In an effort to explore the design of relevant behavioral mHealth intervention for Native American communities, we have developed ARORA (Amplifying Resilience Over Restricted Internet Access), a prototype behavioral mHealth intervention that has been co-designed with Native American youth, a community advisory board, and a clinical psychologist. In this paper, we qualitatively analyze our co-design and focus group sessions using a grounded theory approach and identify the key themes that Native American community members have identified as being critical components of relevant mHealth designs. Notably, we find that the Native American youth who participated in our focus groups desired a greater level of didactic interaction with cultural and behavioral health elements. We conclude with a discussion of the significant challenges we faced in our efforts to co-design software with Native American stakeholders and provide recommendations that might guide other HCI researchers and designers through challenges that arise during the process of cross-cultural design.

Designing a Mobile Game That Develops Emotional Resiliency in Indian Country.

Communities in Indian Country experience severe behavioral health inequities [11, 12]. Based on recent research investigating scalable behavioral health interventions and therapeutic best practices for Native American (NA) communities, we propose ARORA, a social and emotional learning intervention delivered over a networked mobile game that uses geosocial gaming mechanisms enhanced with augmented reality technology. Focusing on the Navajo community, we take a community-based participatory research approach to include NA psychologists, community health workers, and educators as co-designers of the intervention activities and gaming mechanisms. Critical questions involve operation of the application across low-infrastructure landscapes as well scalability of design practices to be inclusive of the many diverse NA cultural communities in Indian Country.