Recommendations for design of a mobile application to support management of anxiety and depression among Black American women

Abstract

Black American women experience adverse health outcomes due to anxiety and depression. They face systemic barriers to accessing culturally appropriate mental health care leading to the underutilization of mental health services and resources. Mobile technology can be leveraged to increase access to culturally relevant resources, however, the specific needs and preferences that Black women feel are useful in an app to support management of anxiety and depression are rarely reflected in existing digital health tools. This study aims to assess what types of content, features, and important considerations should be included in the design of a mobile app tailored to support management of anxiety and depression among Black women. Focus groups were conducted with 20 women (mean age 36.6 years, SD 17.8 years), with 5 participants per group. Focus groups were led by a moderator, with notetaker present, using an interview guide to discuss topics, such as participants' attitudes and perceptions towards mental health and use of mental health services, and content, features, and concerns for design of a mobile app to support management of anxiety and depression. Descriptive qualitative content analysis was conducted. Recommendations for content were either informational (e.g., information to find a Black woman therapist) or inspirational (e.g., encouraging stories about overcoming adversity). Suggested features allow users to monitor their progress, practice healthy coping techniques, and connect with others. The importance of feeling “a sense of community” was emphasized. Transparency about who created and owns the app, and how users' data will be used and protected was recommended to establish trust. The findings from this study were consistent with previous literature which highlighted the need for educational, psychotherapy, and personal development components for mental health apps. There has been exponential growth in the digital mental health space due to the COVID-19 pandemic; however, a one-size-fits-all approach may lead to more options but continued disparity in receiving mental health care. Designing a mental health app for and with Black women may help to advance digital health equity by providing a tool that addresses their specific needs and preferences, and increase engagement.

Telemedicine, e-Health, and Digital Health Equity: A Scoping Review

“…To date, there is no complete agreement on the definition of DHE, although the aforementioned documents of the World Health Organization represent a common thread between the different positions proposed by the authors [ 5 - 7 ]. However, the main shared elements among all the most recent definitions seem to be the promotion of one's health potential through digital tools [ 24 , 35 , 44 ], the reference to a list of risk factors [ 25 , 38 , 42 ] or to single risk factor [ 13 , 27 ] that can lead to some forms of marginalization, and the reference to the description of group/s of people at higher risk of inequalities [ 12 , 13 , 15 , 17 , 21 - 24 , 27 - 30 , 32 , 34 , 35 , 40 - 49 ].…”

“…Regarding the description of group/s of people at higher risk of inequalities, while the World Health Organization’ documents make a general reference to the concept of disadvantage, there is a common reference to a set of people or groups that could incur in forms of marginalization and could meet some barriers in the development of their health potential [ 5 - 7 ]. Those people are sometimes described in a general way as “groups of people with reduced resources” [ 23 , 30 , 36 , 42 ], or as “marginalized group/s or individuals” [ 15 , 21 , 22 , 28 , 38 , 46 ]. Some papers have described in a deeper way the group/s of people that could incur some forms of inequity (people with disability, people living in lower socio-economic areas, cultural ethnical, and economically diverse communities, elderly people, and people who live in rural areas) [ 27 , 40 ].…”

Attitudes Toward Seeking Mental Health Services and Mobile Technology to Support the Management of Depression Among Black American Women: Cross-Sectional Survey Study

“…Past interventions using modalities such as voice calls [21,22], video calls [23,24], SMS text messaging [25,26], and mobile apps [27][28][29][30] were effective in reducing depressive symptoms. Furthermore, the use of mobile technology may help mitigate barriers to receiving support by providing information on affordable options for mental health care, facilitating connections with preferred therapists (eg, shared identities, such as race and sexual orientation), eliminating travel time through the use of remote services, and may lessen stigma by providing a more discreet way to receive care [31][32][33].…”

Meeting People Where They Are: Hyper‐local Engagements Around COVID‐19 Misinformation in New Jersey

“…This study builds on Paris' previous work as a step towards normalizing these interventions in the field. While there are investigations of community sites of public health campaigns (Allen et al, 2020; Bossaller et al, 2022; Luo, 2018), and many studies around developing technical information systems to support public health (Clarke & Steele, 2015; Unertl et al, 2016; McCall et al, 2022) library and information science researchers can also more fully engage participatory action research or community‐engaged methods to enact or simulate a public‐forum experience to generate dialogue and recommendations about misinformation, public health issues, and community safety as an end in itself. This study aims to provide an example of such an endeavor that addresses Covid‐19 misinformation in New Jersey, one of the hardest‐hit states at the onset of the pandemic, that has seen its share of localized misinformation around Covid‐19 shaping daily life (Allred et al, 2021; Associated Press, 2021).…”