User Testing an mHealth Behavioral Health App for Hopi/Tewa Youth During the COVID-19 Pandemic: Usability Study

Area of Science:

• Digital Health
• Mental Health Interventions
• Cultural Competency in Healthcare

Background:

• American Indian/Alaska Native (AI/AN) populations face significant behavioral health disparities.
• Barriers to mental health resources and broadband access are prevalent on tribal lands.
• Mobile health (mHealth) offers a potential solution for delivering culturally relevant interventions.

Purpose of the Study:

• To assess the potential and acceptability of the ARORA mHealth app among Hopi/Tewa youth.
• To gather feedback for the iterative design of an app promoting mindfulness and cultural values.
• To support ongoing participatory action research in AI/AN communities.

Main Methods:

• Co-design of the ARORA app prototype with Hopi/Tewa and Navajo youth and adults.
• Online usability testing and interviews with 9 Hopi/Tewa youth (aged 16-24).
• Quantitative assessment using a modified Mobile Application Rating Scale and qualitative thematic analysis of focus group data.

Main Results:

• The ARORA app received a generally positive reception, with a mean usability score of 3.71.
• Qualitative feedback indicated a desire for greater cultural specificity, particularly in visual elements.
• Thematic saturation was reached with 9 participants, highlighting key areas for app improvement.

Conclusions:

• The ARORA prototype demonstrated participant interest and engagement in mindfulness activities.
• Hopi/Tewa youth provided valuable feedback for enhancing app usability and cultural grounding.
• Remote user testing protocols are essential for mHealth research in rural or hard-to-reach communities, especially when in-person meetings are not feasible.