The Kids Hurt App: Development and testing of a web-based, pain self-report app for First Nations youth

First Nations children and youth may have unique ways to convey their health needs that have not been recognized by health providers. This may contribute to the disparity between high rates of mental health and physical pain and the low rates of treatment for the conditions they experience. Evidence suggests a colonial history has resulted in poor experiences with the healthcare system, lack of trust with health providers and miscommunication between clinicians and patients. Contemporary ways using both Indigenous and Western knowledge is needed to bridge the gap in communicating pain.

The aim of this qualitative study was to test the usability and clinical feasibility of the Kids Hurt App with First Nations youth and clinicians working with youth.

Using a Two-Eyed Seeing approach, the Kids Hurt App was developed using concepts from validated mood and pain assessment apps combined with community-based research that gathered First Nations youth and clinicians perspectives on quality, intensity and location of pain and hurt. The Kids Hurt App contains 16 screens accessible on any web-based device.

Three rounds of low-fidelity testing (n=19), two rounds of high-fidelity testing (n=20) and two rounds of clinical feasibility testing (n=10) were conducted with First Nations youth (10-19 years) to determine the relevance, validity and usability of the Kids Hurt App. High-fidelity testing was also conducted with 15 clinicians after completing the high-fidelity youth sessions. Youth had constructive suggestions that were used to improve the app in subsequent rounds of version testing. There was one main discrepancy between youth and clinicians related to a visual in their preference for way to convey pain. Youth's preference was maintained in the app.

All youth in all rounds of testing indicated they would use the Kids Hurt App if it was available to them in a health care setting with most clinicians noting the app would be useful in practice.