A Transmedia Storytelling Intervention With Interactive Elements to Benefit Latinas’ Mental Health: Feasibility, Acceptability, and Efficacy

Abstract

BackgroundLatinos report higher rates of depression and anxiety than US whites but are less likely to receive care. Transmedia storytelling interventions accessible on the Internet via smartphones, tablets, and computers hold promise for reducing reluctance to explore or get help for symptoms because they are private, convenient, and can reach large numbers of people, including Latinas with mental health needs.ObjectiveThe purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a mental health transmedia intervention for Latinas with elevated symptoms of depression, anxiety, or both.MethodsA total of 28 symptomatic English-speaking Latina women aged 21 to 48 years participated in a 6-week study using a within-group design. All aspects of the study were completed via telephone or Internet. Participants used their personal devices to engage the Web-based transmedia intervention (in English) that included story-based videos, a data-informed psychotherapeutic video, an interactive video sequence, and a blog written from the point of view of one of the characters with links to mental health resources. Perceived confidence to get help and perceived importance for seeking immediate help were both measured using single-item questions. Participants completed surveys at baseline (via telephone) and 1 and 6 weeks after media engagement that measured various factors, including depression (Patient Health Questionnaire; PHQ-9 and PHQ-8) and anxiety (Generalized Anxiety Disorder scale; GAD-7). A telephone interview was conducted within 72 hours of media engagement. Action taken or intentions to get help (single-item question) and talking about the videos with others (single-item question) were measured 1 and 6 weeks after media engagement. Repeated measures analysis of variance was used to assess change in depression (PHQ-8) and anxiety (GAD-7) before transmedia engagement and 1 and 6 weeks after. Spearman correlations evaluated the association of confidence and importance of getting help with action taken, anxiety, and depression.ResultsAll 28 Latinas (English speakers) who engaged with the transmedia remained in the 6-week study. Within 1 week of transmedia engagement, 39% of women took action to get help, and 82% discussed the media with others. Symptoms of depression (F2,54=9.0, P<.001) and anxiety (F2,54=18.7, P<.001) significantly reduced across time. Higher levels of confidence were significantly associated with actions taken at 1 (P=.005) and 6 weeks (P=.04), and higher levels of importance were significantly associated with actions taken at 1 (P=.009) and 6 weeks (P=.003). Higher levels of confidence were associated with lower levels of depression (P=.04) and anxiety (P=.01) at 6 weeks.ConclusionsPreliminary findings indicate a culturally tailored mental health transmedia intervention is a feasible approach that holds promise for engaging large numbers of symptomatic English-speaking Latina women to begin the process of seeking help, as well as decreasing symptoms of anxiety and...

A Mental Health Storytelling Intervention Using Transmedia to Engage Latinas: Grounded Theory Analysis of Participants’ Perceptions of the Story’s Main Character

“…Our mixed methods design led to quantitative findings on the feasibility, acceptability, and limited efficacy of the transmedia intervention that have been reported elsewhere [ 2 ]. This qualitative analysis was guided by GT methodology to explore, analyze, describe, and interpret interview data on participants’ perceptions of the main character of the transmedia storyline.…”

“…Innovative ideas that harness the use of digital storytelling to engage users in mental health interventions involving smartphones, computers, tablets, or other devices merit exploration. Technological apps aimed at early detection, resource use, or Web-based mental health treatment that feature a human character [ 1 , 2 ], embodied conversational agent [ 3 ], virtual agent or coach [ 4 , 5 ], avatar, or fantasy character [ 6 ] can benefit from attention as to how characters affect user engagement. From Mexico [ 7 ] to the United States, photonovelas [ 8 , 9 ], webnovelas [ 10 ], and telenovelas to engage Latinos have been used in story-based research on a variety of physical health–related topics [ 11 - 16 ].…”

“…The researcher also collaborated with a computer programmer to create a user-friendly project webpage, as was described elsewhere [ 2 ]. The goal was to create an interface that had ease of navigation [ 31 ], the same aesthetic quality of the videos, plus an attractive, organized display of links on a black background with photos and clear, simple captions so features could be accessed in a sequence.…”

“…The 3 videos completed 1 arc in Catalina’s story (1 episode), so there was some resolution at the end. However, to continue with the transmedia intervention, the story-based videos were followed by another set of video logs and an interactive feature involving a character who portrayed Catalina’s nurse therapist, whom we named Veronica Sanchez, RN described elsewhere [ 2 ]. The final link on the website led to a blog written from Veronica’s point of view that provided links and contact information for local and online mental health resources including hotlines.…”

“…At that time, an additional access code was provided to participants so that they could share the videos, blog, and links with friends and family members of their choice. Results showed that women rated their ability to relate to Catalina at 6.95 on a 10-point scale; approximately 6 weeks after first engaging with Catalina in the media, 75% (21/28) of participants reported they were still thinking about the story-based media, and 79% (22/28) were still talking about it with others [ 2 ].…”