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

Terika McCall; Megan Threats; Malvika Pillai; Adnan Lakdawala; Clinton S Bolton 3rd

doi:10.3389/fdgth.2022.1028408

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

Front Digit Health. 2022 Dec 23:4:1028408. doi: 10.3389/fdgth.2022.1028408. eCollection 2022.

Authors

Terika McCall^{1

2

3}, Megan Threats^{3

4}, Malvika Pillai^{5

6}, Adnan Lakdawala⁷, Clinton S Bolton 3rd⁸

Affiliations

¹ Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States.
² Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States.
³ Center for Interdisciplinary Research on AIDS (CIRA), Yale School of Public Health, New Haven, CT, United States.
⁴ School of Information, University of Michigan, Ann Arbor, MI, United States.
⁵ Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
⁶ Department of Medicine, Stanford University, Stanford, CA, United States.
⁷ Elimu Informatics, El Cerrito, CA, United States.
⁸ Rex Bariatric Specialists, Rex/UNC Hospitals, Raleigh, NC, United States.

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.

Keywords: African Americans; anxiety; depression; digital health; mHealth; mental health; telemedicine; women.

Grants and funding

TM and MP were supported by funding from the National Library of Medicine (NLM) under award number T15LM012500 during the time the study was conducted. TM is currently supported by funding from the NLM under award number R01LM013477. MT is supported by the National Institute of Mental Health of the National Institutes of Health under award number R25MH087217. The Edward G. Holley research grant, from the School of Information and Library Science at UNC, provided funding for focus group materials and participant remuneration.