Background: The resources of West African mental health care systems are severely constrained, which contributes to significant unmet mental health needs. Consequently, people with psychiatric conditions often receive care from traditional and faith healers. Healers may use practices that constitute human rights violations, such as flogging, caging, forced fasting, and chaining. Objective: The aim of this study is to partner with healers in Ghana to develop a smartphone toolkit designed to support the dissemination of evidence-based psychosocial interventions and the strengthening of human rights awareness in the healer community. Methods: We conducted on-site observations and qualitative interviews with healers, a group co-design session, content development and prototype system build-out, and usability testing. Results: A total of 18 healers completed individual interviews. Participants reported on their understanding of the causes and treatments of mental illnesses. They identified situations in which they elect to use mechanical restraints and other coercive practices. Participants described an openness to using a smartphone-based app to help introduce them to alternative practices. A total of 12 healers participated in the co-design session. Of the 12 participants, 8 (67%) reported having a smartphone. Participants reported that they preferred spiritual guidance but that it was acceptable that M-Healer would provide mostly nonspiritual content. They provided suggestions for who should be depicted as the toolkit protagonist and ranked their preferred content delivery modality in the following order: live-action video, animated video, comic strip, and still images with text. Participants viewed mood board prototypes and rated their preferred visual design in the following order: religious theme, nature motif, community or medical, and Ghanaian culture. The content was organized into modules, including an introduction to the system, brief mental health interventions, verbal de-escalation strategies, guided relaxation techniques, and human rights training. Each module contained several scripted digital animation videos, with audio narration in English or Twi. The module menu was represented by touchscreen icons and a single word or phrase to maximize accessibility to users with limited literacy. In total, 12 participants completed the M-Healer usability testing. Participants commented that they liked the look and functionality of the app and understood the content. The participants reported that the information and displays were clear. They successfully navigated the app but identified several areas where usability could be enhanced. Posttesting usability measures indicated that participants found M-Healer to be feasible, acceptable, and usable. Conclusions: This study is the first to develop a digital mental health toolkit for healers in West Africa. Engaging healers in user-centered development produced an accessible and acceptable resource. Future field testing will determine whether M-Healer can improve healer practices and reduce human rights abuses. Trial Registration:

中文翻译：

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一个数字工具包 (M-Healer)，用于改善西非精神疾病患者的护理和减少人权侵犯：以用户为中心的设计、开发和可用性研究

背景：西非精神卫生保健系统的资源严重受限，导致严重的精神卫生需求未得到满足。因此，患有精神疾病的人通常会得到传统和信仰治疗师的护理。治疗师可能会使用构成侵犯人权的做法，例如鞭打、囚禁、强制禁食和锁链。目标：本研究的目的是与加纳的治疗师合作开发智能手机工具包，旨在支持传播循证心理社会干预措施并加强治疗师社区的人权意识。方法：我们对治疗师进行了现场观察和定性访谈、小组协同设计会议、内容开发和原型系统构建以及可用性测试。结果：共有 18 名治疗师完成了个人访谈。参与者报告了他们对精神疾病的原因和治疗方法的理解。他们确定了他们选择使用机械约束和其他强制性做法的情况。参与者描述了使用基于智能手机的应用程序来帮助向他们介绍替代实践的开放态度。共有12名治疗师参加了协同设计会议。在 12 名参与者中，8 名 (67%) 报告称拥有智能手机。参与者报告说他们更喜欢精神指导，但 M-Healer 提供大部分非精神内容是可以接受的。他们为谁应该被描绘为工具包的主角提供了建议，并按以下顺序排列了他们首选的内容交付方式：真人视频、动画视频、漫画、和带有文字的静止图像。参与者查看情绪板原型并按照以下顺序对他们喜欢的视觉设计进行评分：宗教主题、自然主题、社区或医疗以及加纳文化。内容被组织成模块，包括系统介绍、简短的心理健康干预、口头降级策略、引导式放松技巧和人权培训。每个模块都包含几个脚本化的数字动画视频，带有英语或 Twi 的音频旁白。模块菜单由触摸屏图标和单个单词或短语表示，以最大限度地提高识字率有限的用户的可访问性。总共有 12 名参与者完成了 M-Healer 可用性测试。参与者评论说，他们喜欢该应用程序的外观和功能，并且了解其内容。参与者报告说信息和显示很清楚。他们成功地浏览了应用程序，但确定了几个可以增强可用性的领域。后测可用性措施表明，参与者发现 M-Healer 是可行的、可接受的和可用的。结论：这项研究是第一个为西非治疗师开发数字心理健康工具包的研究。让治疗师参与以用户为中心的开发，产生了一种可访问和可接受的资源。未来的现场测试将确定 M-Healer 是否可以改善治疗师的做法并减少侵犯人权的行为。试用注册：