Co-Design of the RAISE Mobile Health Intervention for and with Caregivers of Detained Youth.

Abstract

Caregivers of detained adolescents often face significant stress and barriers to accessing resources needed to support their adolescents during community re-entry. This mixed-methods study used a participatory co-design approach to develop and pilot test a mobile health intervention aimed at reducing parenting stress among caregivers of detained adolescents with behavioral health needs. Eleven caregivers participated across two phases: co-design of the intervention (n = 6) and an open trial (n = 5). Co-design sessions engaged caregivers as equal partners to create an intervention (RAISE) tailored to their needs, incorporating mindfulness-based stress reduction, resources for navigating the juvenile legal system, and tools for improving family communication. Quantitative findings indicated high levels of caregiver engagement with the co-design process, with increased confidence in contributing to mobile app development and strong perceptions of the intervention's relevance. Qualitative thematic analysis highlighted caregiver priorities for intervention, including stress-management strategies, culturally relevant content, and mechanisms for community connection. Caregivers valued being recognized as integral collaborators and emphasized the importance of addressing structural barriers, such as stigma and systemic racism, within the app. The final RAISE app integrates evidence-based practices with user-driven features, offering a culturally relevant and accessible tool to support caregivers. Despite limitations, including a small sample size and technical challenges during the open trial, the study demonstrates the feasibility of participatory methods to address the unique needs of caregivers of detained adolescents. Future research will evaluate the efficacy of RAISE in reducing stress and improving outcomes for families of detained youth.Clinicaltrials.gov registration NCT05032742.