Rebloom: translating research through multimodal interaction between social and felt worlds

Self-harm among young women is increasing globally, yet many do not disclose their distress, leaving families and communities unsure how to respond. Research shows that small, attuned gestures of presence and connection are often the most meaningful forms of support. ReBloom, an immersive interactive installation, was co-created to translate these insights into a publicly accessible, multimodal encounter. Created through collaboration among mental health researchers, creative technologists, artists, and 27 young women with lived experience of self-harm, the project translated research evidence into a publicly accessible encounter designed for embodied, sensory, and relational engagement. Using gesture-responsive interaction, motion capture, color transitions, sound, and narrative movement, ReBloom enabled participants to enact metaphors of attunement, emotional openness, and care. Installed in a large metropolitan shopping center, the work engaged diverse publics across ages and cultural backgrounds, generating forms of interaction ranging from playful exploration to reflective and emotionally resonant encounters. Ethnographic observation and thematic evaluation revealed that participants intuitively recognized the emotional arc of the work and frequently linked the experience to their own understandings of support, empathy, and mental health. The installation also surfaced important paradoxes in public engagement, including the tension between visibility and the desire for more private, cocoon-like spaces for reflection. This case study demonstrates how immersive, distributed storytelling can function as a powerful mode of arts-based knowledge translation, offering new pathways for communicating sensitive mental-health research in accessible, non-stigmatizing, and emotionally meaningful ways.

Rates of self-harm among young women are rising globally, representing an urgent public health concern and a profound challenge for families, clinicians, educators, and communities. In Australia, hospitalisations for self-harm among girls aged 15 to 19 years have nearly doubled in the past decade. Despite this escalation, self-harm often remains hidden; many young women do not disclose their experiences, while those around them report uncertainty about how to respond (Rheinberger et al., 2025). The support young women value most is not complex clinical intervention, but subtle, relational gestures:-presence, attunement, and non-judgement (Rheinberger et al., 2025). The challenge is how to communicate these insights to a broad public in ways that are accessible, safe, embodied, culturally attuned, and able to travel beyond clinical and academic settings.

This article responds to this challenge through ReBloom, a large-scale immersive interactive public art installation developed as part of a national suicide prevention initiative led by the Black Dog Institute (SPHERE – In The Know, n.d.). ReBloom was co-created in response to a suicide prevention study with 27 young women with lived experience of self-harm. The Arts-Based Knowledge Translation Lab at the Black Dog Institute, working through cross-institutional partnerships, led the knowledge translation component, seeking to move evidence off the page and into the world by transforming research insights into a multimodal, public, relational experience capable of engaging people who might not otherwise encounter research, policy, or mental health resources.

ReBloom was co-created by a transdisciplinary team including psychologists, sociologists, suicidology researchers, creative technologists, choreographers, designers, and lived experience contributors. The resulting work was an interactive, gesture-responsive installation in which visitors’ movement and proximity shaped the experience through co-presence in a shared space (Figure 1). From the outset, the work created rhythms of movement, pause, and re-engagement, first within the creative team and later for public audiences. These rhythms reflected how the young women described distress, coping, and support as fluid, relational, and non-linear. Distilled phrases from the young women were treated as generative prompts rather than fixed categories. To hold the emotional, symbolic, and ethical weight of their accounts, the team developed a shared metaphorical vocabulary using Renku, a Japanese linked-verse poetic form adapted as a structured metaphor-finding practice (Doran, 2025). Recurring motifs (opening and closing, contraction and expansion, light and dark, reaching and withdrawing), formed a shared symbolic language across clinical, creative, and technical domains, directly informing the installation's choreography, motion capture, particle systems, colour transitions, sound design, and gestural interaction logic.

Knowledge translation in health addresses a persistent problem: research findings often take 14 to 17 years to influence practice (Morris et al., 2011), remaining inaccessible due to academic language, paywalls, and format. Arts-based knowledge translation offers a different approach. Rather than relying on text alone, it uses images, movement, colour, sound, and metaphor to communicate research insights in ways that diverse audiences can feel and experience (Boydell, 2019; Garrido et al., 2024; Watfern et al., 2023). Impact emerges through emotional and cultural resonance, not just information transfer.

This approach aligns with transdisciplinary practice, where knowledge emerges through collaboration among people with different expertise and ways of knowing (Chandler et al., 2019). Distributed storytelling treats narrative as something created through the interaction of people, bodies, technologies, and spaces rather than as something told by a single author (Doran, 2025). Meaning is produced through gesture, image, sound, and spatial relations, not just words. This is particularly important for sensitive topics like self-harm, where communication needs to be non-stigmatising, emotionally spacious, and ethically grounded.

Immersive and interactive technologies extend these approaches by creating experiences people can step into and shape through their presence and movement. Such systems operate within emerging phygital environments, where digital and physical worlds converge through spatial computing (Wang et al., 2025). Gesture-responsive systems enable communication through the body rather than words alone, supporting cross-cultural and intergenerational inclusivity. This is particularly suited to topics where insight is best conveyed through felt experience, such as emotional cycles of distress, withdrawal, and connection. ReBloom used these capacities through a responsive avatar and motion-tracking system, allowing participants, used here as a general term for audience and visitors, to enact patterns of withdrawal, reaching out, and connection through their own movement.

This article examines ReBloom as a case study in immersive, distributed, transdisciplinary knowledge translation. It shows how interactive art can translate sensitive mental health research into embodied public encounters, enabling non-stigmatising, emotionally resonant engagement and supporting meaning-making through gesture, metaphor, co-presence, and environment. Contributing to scholarship on arts-based knowledge translation (Boydell, 2019; Dadich et al., 2025), creative health (Birrell et al., 2025), transdisciplinary practice (Doran, 2025), and immersive public engagement (Watfern et al., 2023), the article (1) conceptualises knowledge translation as a distributed, embodied process; (2) documents the collaborative development and public installation of ReBloom; and (3) analyses ethnographic and think–feel–do findings to show how immersive encounters can support intuitive understanding, emotional attunement, and public reflection around self-harm.

Context

ReBloom was developed as an immersive, interactive public installation through a transdisciplinary collaboration bringing together insights from 27 young women with lived experience and a team spanning the arts, humanities, and clinical practice. Drawing on understandings of creative collaboration as a distributed social and embodied cognitive activity rather than a single authorial process (Pearlman and Sutton, 2022), the work followed a process of narrative translation informed by practices in film, dance, design, and interactive media. Distilled textual insights offered by the young women served as a script proxy, shaping how themes of care, presence, and stigma were interpreted and translated across movement, technology, and spatial design. Ethics approval encompassed both the foundational research and its translation into public engagement, with attention to trauma-informed practice and responsible communication about self-harm.

Knowledge translation framework

The project adopted an ecological, multimodal, and distributed model of knowledge translation, consistent with contemporary arts-based and transdisciplinary research (Boydell, 2019; Dadich et al., 2025). Knowledge translation was approached as a relational and experiential practice, in which meaning circulates through bodies, materials, settings, and metaphors rather than through linear dissemination alone. These insights directly informed the choice to work through immersive and embodied media, which could model such qualities experientially rather than propositionally, supporting ReBloom's interactive, non-verbal, and relational mode of engagement.

Collaborative-design and creative development process

Initial conceptual scoping

The team worked with stimulus materials including symbolic imagery, colour palettes, sound fragments, poetic associations, and references to existing immersive and interactive works. From the outset, cross-disciplinary dialogue centred on how the young women described distress, coping, and support as relational and situational rather than clinically bounded. Through this process, recurring motifs (images, ideas, and themes) emerged. These symbolic elements included flowers blooming and fading, night skies scattered with stars, natural landscapes shaped by seasonal change, gestures of reaching out and holding hands, and acts of listening. Rather than reproducing diagnostic framings, these recurring elements oriented the work toward shared human experiences of vulnerability, care, and re-engagement.

Renku-supported metaphor generation

To develop a shared symbolic language across disciplines, the team used Renku, a Japanese collaborative poetic form adapted for transdisciplinary metaphor-finding (Doran et al., 2021; Dorst et al., 2026). Working with phrases from the young women as prompts, the team generated metaphors including “a disappearing hole,” “reach in, reach out,” “take my hand,” and “the weather changes.” Figure 2 shows how recurring themes in the young women's phrases inspired the Renku process and translated into interactive experience. Selected phrases were used as prompts for turn-taking poetic responses, helping the team identify shared metaphors of reaching, weather, light, movement, and transformation. These metaphors articulated withdrawal, tentative re-engagement, and relational support, and were then developed across choreography, avatar behaviour, visual transitions, sound design, spatial atmosphere, and audience interaction. The figure shows how lived-experience language moved through collaborative metaphor generation into the multimodal design of ReBloom. The Renku guide used in this process is provided as Supplementary File S1.

From metaphor to movement, gesture, and visual language

Movement vocabulary was developed with a contemporary dancer selected to reflect the heterogeneity of young women's experiences. Gestures of curling inward, hesitation, reaching, softening, and reciprocal movement were translated through motion capture into behavioural states of a digital avatar, conceived as a feminine, plant-like presence that invited interaction through responsive, mirrored movement rather than representational realism.

These states were extended into an interactive environment by the creative technology team. Colour transitions, light modulation, and sound design shifted responsively across phases of contraction, attunement, and openness. Visual textures referenced living ecological patterns, including forest-like atmospheres, organic growth and decay, and seasonal cycles. Earthy browns and ochres associated with withdrawal gave way to lighter tones, including greens, pinks, and purples suggestive of renewal. Cycles of light and shadow evoked weather, time, and regeneration rather than narrative progression. Participants engaged through movement, shaping the figure's responses and sensing how presence and attuned interaction altered the environment.

Interactive system and technical design

The installation employed camera-based gesture recognition to initiate a fixed behavioural loop in the avatar, which unfolded through a sequence of shifting states. Once triggered, the avatar progressed through phases marked by changes in movement, colour, and sound. In the first phase, reflection and inner light, slow, exploratory movement was accompanied by ambient tonal shifts. The second phase, isolation and distress, featured constricted movement, denser particle fields, and dissonant sound. In the final phase, fluid movement gave rise to vibrant colours, rhythmic patterns, and a more expansive expressive environment. Visitor gestures visibly shifted the avatar's state, allowing them to experience how presence and attuned movement altered the system in real time.

Site selection and installation context

Three potential contexts were considered for the installation, namely, an art gallery, an entertainment precinct, and a public shopping centre. While galleries provided a reflective ambience conducive to contemplation, they limited reach and constrained opportunities for broad public engagement. Entertainment precincts, by contrast, foregrounded novelty and escapism, which conflicted with the work's contemplative objectives. Accordingly, a major shopping centre (Westfield Chatswood, Sydney) was selected as the preferred site. The venue enabled incidental engagement within an everyday public environment and supported accessible, low-threshold encounters with the work (Pettersen et al., 2026). To optimise visibility and accessibility, the installation was located in a high-traffic corridor and supplemented with interpretive signage and trained facilitators to support safe and informed interaction.

Iterative research and development cycles

Seven iterative development cycles supported the co-creation and refinement process. The initial cycle involved thematic abstraction from the qualitative study, followed by metaphor generation using the collaborative Renku method. Subsequent cycles focused on embodied exploration and choreographic scoring, informing motion-capture and avatar development, while interaction prototyping integrated gesture recognition, particle logic, and layered sound design. Later cycles addressed adaptation to public-site conditions, including lighting, accessibility, and safety, followed by a soft launch to enable testing and refinement based on audience feedback. Together, these cycles reflect an iterative and relational approach to arts-based knowledge translation rather than a fixed pipeline (Dadich et al., 2025; Watfern et al., 2023).

Evaluation

The impact of the ReBloom immersive arts-based installation was evaluated using qualitative ethnographic methods informed by arts-based knowledge translation. Data were collected from voluntary participants through three complementary methods: (1) brief semi-structured interviews conducted in situ; (2) an online qualitative questionnaire accessed via QR code following engagement; and (3) systematic observational field notes documenting interactions with the installation. Interview and questionnaire prompts explored how participants experienced and made meaning from the installation, including emotional responses, cognitive reflections, and observable behaviours. Demographic items were included to assess community reach. Qualitative data were analysed using reflexive thematic analysis to identify patterns of meaning across data sources, while centring participants’ voices and context (Braun and Clarke, 2022, Lafrenière and Cox, 2012). The evaluation drew on ethnographic observation methods and emergent thematic analysis rather than structured framework analysis. While prompts were informed by affective, cognitive, and behavioural dimensions of engagement, the analysis prioritised themes that surfaced organically from participant interaction, which better suited the distributed, embodied nature of the installation.

This case study demonstrates that knowledge translation can function as a distributed, multimodal, and embodied ecology of meaning. ReBloom translated research findings about self-harm into a sensory field where audience members were able to feel the emotional logics of connection, presence, and attuned support described by young women in the foundational study, see Table 1 (Rheinberger et al., 2025).

ReBloom also functioned as a distributed storytelling system (Doran, 2025), in which meaning emerged through embodied interaction rather than a pre-scripted narrative. When audience members moved closer, the avatar's heartbeat became audible; when she raised her hand and participants mirrored her gesture, the avatar rose and began to dance. One child remarked, “Her heartbeat matches mine,” while another observed, “She's sad… we make her feel better,” articulating the narrative embedded through action rather than explanation. Audience members’ movements and pauses often prompted others to engage, allowing meaning to circulate across bodies, technologies, and the surrounding environment. In this context, knowledge translation operated as a shared, reflective space where understanding was enacted through experiences of relational presence and interaction.

The creative process involved exploring many ideas while maintaining a strong, shared sense of ethical responsibility. Given the sensitivity of the topic of self-harm, the team continually checked that the work communicated care and presence without feeling confrontational or, at the other extreme, avoiding the issue. For example, we decided against immersive, entertainment-style spaces, as expectations of spectacle would not support the reflective engagement we wanted. Early visuals that felt narrowly feminine were also broadened to allow for more intersectional and intergenerational resonance, and similar iterative refinements shaped the soundscape and physical gestures. The Renku sessions became a turning point, helping the team find a shared embodied understanding across disciplines and confirming our ethical alignment.

ReBloom illustrates how immersive technologies can advance inclusive knowledge translation through low-barrier, tacit, and cross-linguistic communication. Gesture-based interaction reduced literacy demands and cognitive load; very young children, older adults, and multilingual audience members intuitively grasped the emotional narrative. Audience members responded to sensory cues - colour shifts, heartbeat illumination, and movement patterns - demonstrating that immersive environments can communicate psychological concepts through somatic and aesthetic channels (Doran, 2025; Watfern et al., 2023). One audience member proposed linking the avatar's heartbeat to his own heart rate, suggesting future opportunities to integrate ethical biofeedback into knowledge translation processes. These observations reinforce the argument that immersive technologies can shift from storytelling to story-doing (Wang et al., 2025), positioning audiences as co-authors within dynamic meaning-making systems. Locating the installation in a shopping centre was central to its impact, as these open, everyday environments function as distributed sites of social interaction and informal culture-making, drawing diverse publics across life stages, cultural backgrounds, and emotional states (Pettersen et al., 2026).

Audience members described the experience as calming, moving, or quietly profound. A mother reflected, “We ask how you are, but don't really ask”, while a Māori father linked the work to cultural responsibilities: “It's important to support our kids… my brother raised three girls”. Such interactions show how immersive knowledge translation can activate family-based and cultural narratives of care. The public context also produced a productive paradox. Several young women - particularly women with lived experience - reported feeling somewhat exposed, engaging with the work in an open public space. They expressed a desire for cocoon-like, semi-private installations for deeper emotional processing. These same individuals also acknowledged that public visibility is crucial to reduce stigma, confront silence, and normalise conversations about self-harm. This tension reflects a broader knowledge translation challenge (Boydell et al., 2017): effective communication around sensitive topics requires a plurality of settings, balancing reflective privacy with collective public acknowledgment.

Despite the demonstrated value of ReBloom as a knowledge translation strategy, three limitations warrant mention. First, its effectiveness was assessed within a single geographic and cultural context, which may constrain the generalisability of findings to other settings. Second, while ReBloom successfully engaged audience members through embodied and aesthetic modalities, the evaluation relied primarily on qualitative feedback and did not formally involve the original 27 young women; however, the significance of the work was nonetheless registered when one of the young women travelled interstate to experience the installation and described it as meaningful. Third, the installation required substantial resources, including technical infrastructure, skilled facilitation, and public-site permissions, which may pose challenges for scalability and sustainability in resource-limited environments.

ReBloom suggests that knowledge translation for sensitive mental health topics can operate through gesture, colour, sound, and embodied interaction rather than relying primarily on text or clinical language. The installation enabled audiences to experience some of what the research found: that small, attuned gestures of presence can matter in supporting young women experiencing distress.

This work offers several contributions to arts-based knowledge translation. First, immersive technologies may communicate psychological insights through embodied experience, potentially making research more accessible across literacy levels, languages, ages, and cultural backgrounds. Second, public spaces like shopping centres can serve as sites for mental health knowledge translation, enabling incidental encounters that would be difficult to achieve in clinical or academic settings. Third, the work revealed a tension between public visibility (which may challenge stigma) and the need for private, reflective spaces (which some participants desired) - suggesting that effective knowledge translation may require multiple formats and contexts.

The transdisciplinary process also yielded methodological insights. Using collaborative metaphor-finding through Renku enabled clinical researchers, technologists, choreographers, and lived experience contributors to develop a shared symbolic language. This approach valued different ways of knowing and produced work that honoured the emotional complexity of participants’ accounts whilst remaining ethically grounded.

As self-harm rates among young women continue to rise globally, research needs to reach beyond academic journals and clinical settings. This case study indicates that arts-based, immersive approaches may translate sensitive findings into emotionally resonant public encounters. Future research might explore how such installations could be adapted across cultural contexts, scaled through distributed networks, or integrated with communities.