Fleming John B, Hill Yvette N, Burns Michelle Nicole
Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
IMPACT LGBT Health and Development Program, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
JMIR Hum Factors. 2017 Aug 25;4(3):e22. doi: 10.2196/humanfactors.7392.
To date, we are aware of no interventions for anxiety and depression developed as mobile phone apps and tailored to young sexual minority men, a group especially at risk of anxiety and depression. We developed TODAY!, a culturally informed mobile phone intervention for young men who are attracted to men and who have clinically significant symptoms of anxiety or depression. The core of the intervention consists of daily psychoeducation informed by transdiagnostic cognitive behavioral therapy (CBT) and a set of tools to facilitate putting these concepts into action, with regular mood ratings that result in tailored feedback (eg, tips for current distress and visualizations of mood by context).
The aim of this study was to conduct usability testing to understand how young sexual minority men interact with the app, to inform later stages of intervention development.
Participants (n=9) were young sexual minority men aged 18-20 years (Mean=19.00, standard deviation [SD]=0.71; 44% black, 44% white, and 11.1% Latino), who endorsed at least mild depression and anxiety symptoms. Participants were recruited via flyers, emails to college lesbian, gay, bisexual, and transgender (LGBT) organizations, Web-based advertisements, another researcher's database of sexual minority youth interested in research participation, and word of mouth. During recorded interviews, participants were asked to think out loud while interacting with the TODAY! app on a mobile phone or with paper prototypes. Feedback identified from these recordings and from associated field notes were subjected to thematic analysis using a general inductive approach. To aid interpretation of results, methods and results are reported according to the consolidated criteria for reporting qualitative research (COREQ).
Thematic analysis of usability feedback revealed a theme of general positive feedback, as well as six recurring themes that informed continued development: (1) functionality (eg, highlight new material when available), (2) personalization (eg, more tailored feedback), (3) presentation (eg, keep content brief), (4) aesthetics (eg, use brighter colors), (5) LGBT or youth content (eg, add content about coming out), and (6) barriers to use (eg, perceiving psychoeducation as homework).
Feedback from usability testing was vital to understanding what young sexual minority men desire from a mobile phone intervention for symptoms of anxiety and depression and was used to inform the ongoing development of such an intervention.
迄今为止，我们所知的针对焦虑和抑郁的干预措施中，尚未有作为手机应用程序且专门针对年轻性少数男性群体开发的，而这一群体尤其容易出现焦虑和抑郁症状。我们开发了“今日！”（TODAY!）这款手机干预程序，它基于文化背景，面向被男性吸引且有临床显著焦虑或抑郁症状的年轻男性。该干预措施的核心包括每日基于跨诊断认知行为疗法（CBT）的心理教育以及一套便于将这些理念付诸行动的工具，同时还有定期的情绪评分，从而得出个性化的反馈（例如，针对当前困扰的小贴士以及按情境呈现的情绪可视化）。
本研究旨在进行可用性测试，以了解年轻性少数男性如何与该应用程序互动，为干预措施开发的后续阶段提供参考。
参与者（n = 9）为年龄在18 - 20岁的年轻性少数男性（平均年龄 = 19.00，标准差[SD] = 0.71；44%为黑人，44%为白人，11.1%为拉丁裔），他们认可至少存在轻度抑郁和焦虑症状。参与者通过传单、给大学同性恋、双性恋和跨性别（LGBT）组织发送电子邮件、网络广告、另一位研究人员的性少数青年研究参与数据库以及口碑相传等方式招募而来。在录制的访谈中，要求参与者在使用手机上的“今日！”应用程序或纸质原型时边操作边大声思考。从这些录音以及相关现场记录中识别出的反馈，采用一般归纳法进行主题分析。为辅助结果解读，根据定性研究报告的统一标准（COREQ）报告方法和结果。
可用性反馈的主题分析揭示了一个总体积极反馈的主题，以及六个反复出现的为持续开发提供参考的主题：（1）功能（例如，有新内容时突出显示），（2）个性化（例如，更具针对性的反馈），（3）呈现方式（例如，保持内容简洁），（4）美学（例如，使用更明亮的颜色），（5）LGBT或青年相关内容（例如，添加关于出柜的内容），以及（6）使用障碍（例如，将心理教育视为作业）。
可用性测试的反馈对于理解年轻性少数男性对于针对焦虑和抑郁症状的手机干预措施有何期望至关重要，并被用于为这种干预措施的持续开发提供参考。
