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Development and Testing of the Kids Hurt App, a Web-Based, Pain Self-Report App for First Nations Youths: Mixed
Karlee Francis1,2, Julie Francis3, Margot Latimer4,5
1Eskasoni Health Centre, Eskasoni, Nova Scotia, Canada.
JMIR Human Factors
|March 3, 2025
Summary
First Nations youths found the Kids Hurt App usable for communicating pain and health needs. Clinicians also found the app useful, suggesting it can bridge communication gaps in healthcare settings.
Area of Science:
- Indigenous Health
- Digital Health Tools
- Qualitative Research
Background:
- First Nations children and youth face disparities in mental and physical health treatment due to communication barriers with healthcare providers.
- Historical trauma and mistrust stemming from colonial practices impact healthcare experiences for Indigenous populations.
- Bridging communication gaps requires integrating Indigenous and Western knowledge in healthcare delivery.
Purpose of the Study:
- To evaluate the usability and clinical feasibility of the Kids Hurt App among First Nations youths and clinicians.
- To assess the app's effectiveness in capturing the unique ways First Nations youths express their health needs, particularly pain.
- To inform the development of culturally relevant digital health tools for Indigenous youth.
Main Methods:
- The Kids Hurt App was co-developed using a Two-Eyed Seeing approach, integrating validated pain assessment features with community-based research.
- Iterative testing involved multiple rounds of low-fidelity, high-fidelity, and clinical feasibility assessments with First Nations youths (10-19 years) and clinicians.
- User feedback, including preferences for visual pain representation, was incorporated to refine the app's design and functionality.
Main Results:
- First Nations youths provided valuable suggestions that improved the app's relevance, validity, and usability across testing phases.
- A key finding was the successful integration of youth preferences for pain visualization, even when differing from clinician input.
- Both youths and clinicians demonstrated high acceptance, with all participating youths indicating willingness to use the app and most clinicians finding it beneficial.
Conclusions:
- The Kids Hurt App is a usable and clinically feasible tool for First Nations youths to communicate their health needs and pain.
- The app has the potential to improve healthcare communication and address treatment disparities experienced by Indigenous youth.
- This study highlights the importance of co-design and incorporating Indigenous perspectives in developing digital health solutions.
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