Designing an mHealth Intervention for People With Visible Differences Based on Acceptance and Commitment Therapy: Participatory Study Gaining Stakeholders’ Input (Preprint)

Abstract

BACKGROUND Given their growing popularity, mobile health apps (mHealth) may offer a viable method of delivering psychological intervention for people who have an atypical appearance (visible difference) and struggle with appearance-related distress. Acceptance and Commitment Therapy (ACT), a third-wave cognitive-behavioural approach, has been used effectively in mHealth and is being increasingly applied clinically to common psychosocial difficulties associated with visible difference. We planned to design an ACT-based mHealth intervention for this group. OBJECTIVE The authors sought to gain key stakeholder input from user representatives and psychological clinicians to optimise the intervention’s design for future development and uptake. METHODS Within a participatory design framework, we used a mix of qualitative methods including usability sessions and a focus group in a face-to-face workshop, and interviews and textual feedback collected remotely, all of which the authors analysed using template analysis. RESULTS The combined findings suggest strengths and challenges of mHealth as an intervention platform for the population, including considerations regarding safeguarding and users’ ongoing engagement. Participants expressed design preferences towards relatable human content, interactive and actionable features, flexibility of use and accessible, engaging content. CONCLUSIONS Findings offer valuable design directions for ACT It Out and other related interventions, emphasising the need to carefully guide users through the intervention while acknowledging the limited time and space afforded by mHealth as a platform.