"An App That Truly Works for Us": Co-Designing a Mobile Health Intervention to Support the Transition to Adulthood...

Autistic Latino young adults face significant disparities and a service cliff during their transition to adulthood. While mobile health (mHealth) applications offer a scalable solution, few evidence-based, culturally adapted programs have been successfully transitioned to mHealth platforms for this population. This study aimed to conduct a multi-stakeholder needs assessment to guide the development of a culturally adapted mHealth app designed to accompany the ¡Iniciando!/Launching! treatment program to support young adults transitioning to adulthood.

This study used a multi-phase, mixed-methods design. An initial needs assessment survey was administered to three key stakeholder groups: autistic young adults (N = 27), their Spanish-speaking parents (N = 26), and program clinicians (N = 9). An iterative refinement process followed, which included qualitative consultations with a Community Advisory Board (CAB) of autistic self-advocates and a User Experience/User Interface (UX/UI) team, a focus group with clinicians (N = 8), and two targeted follow-up surveys to define specific app features.

A strong consensus emerged on the need for features supporting executive functioning (e.g., reminders, task management) and practical transition-to-adulthood goals (e.g., employment and education hubs). The iterative design phase translated abstract concepts, like the highly-rated "social games," into concrete, user-informed specifications, including a scaffolded learning workflow and a gamification-based token economy. Young adults emphasized the importance of a modern user experience and expressed skepticism toward conversational AI, while parents and clinicians stressed that the app must supplement, not replace, human interaction.

This iterative, community-based approach provides a clear, stakeholder-driven blueprint for creating a highly desired mHealth intervention. By directly integrating the perspectives of end-users, this process ensures the final product is tailored to the specific needs of autistic Latinos, with the potential to reduce health disparities.