Initial design of culturally informed behavioral intervention technologies: developing an mHealth intervention for young sexual minority men with generalized anxiety disorder and major depression

Abstract

Background: To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies.

Objective: This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men.

Methods: We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored.

Results: General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users' ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied.

Conclusions: This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities.

Keywords: anxiety; cultural competency; depression; eHealth; male adolescents; male homosexuality; minority health; mobile health; young adult.

Figure 1

Process for the initial design of a behavioral intervention technology targeting generalized anxiety disorder and major depression among male sexual minority youth (rectangle=internal processes; trapezoid=process resulting in the input of information).

Figure 2

The population-specific theory of affective change used to guide the design of a behavioral intervention technology targeting generalized anxiety disorder and major depression among male sexual minority youth.