@Article{info:doi/10.2196/15914,
author="Ospina-Pinillos, Laura
and Davenport, Tracey A
and Navarro-Mancilla, Alvaro Andres
and Cheng, Vanessa Wan Sze
and Cardozo Alarc{\'o}n, Andr{\'e}s Camilo
and Rangel, Andres M
and Rueda-Jaimes, German Eduardo
and Gomez-Restrepo, Carlos
and Hickie, Ian B",
title="Involving End Users in Adapting a Spanish Version of a Web-Based Mental Health Clinic for Young People in Colombia: Exploratory Study Using Participatory Design Methodologies",
journal="JMIR Ment Health",
year="2020",
month="Feb",
day="6",
volume="7",
number="2",
pages="e15914",
keywords="Colombia; telemedicine; medical informatics; eHealth; mental health; cultural characteristics; cultural competency; ethnic groups; quality of health care; community-based participatory research; primary health care; patient participation; patient preference; patient satisfaction; consumer health information; methods; research design",
abstract="Background: Health information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties. Objective: Using participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C). Methods: This study involved the utilization of a research and development (R{\&}D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions. Results: A total of 2 co-design workshops were held with 18 users---young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions---young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context. Conclusions: The application of an R{\&}D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R{\&}D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C---a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time. ",
issn="2368-7959",
doi="10.2196/15914",
url="https://mental.jmir.org/2020/2/e15914",
url="https://doi.org/10.2196/15914"
}