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Enhancing Mental Health and Medication Adherence Among Men Who Have Sex With Men Recently Diagnosed With HIV With a Dialectical Behavior Therapy-Informed Intervention Incorporating mHealth, Online Skills Training, and Phone Coaching: Development Study Using Human-Centered Design Approach.

作者信息

Wang Liying, Yuwen Weichao, Hua Wenzhe, Chen Lingxiao, Forsythe Cox Vibh, Zheng Huang, Ning Zhen, Zhao Zhuojun, Liu Zhaoyu, Jiang Yunzhang, Li Xinran, Guo Yawen, Simoni Jane M

机构信息

Department of Psychology, University of Washington, Seattle, WA, United States.

School of Nursing & Healthcare Leadership, University of Washington, Tacoma, Tacoma, WA, United States.

出版信息

JMIR Form Res. 2023 Oct 13;7:e47903. doi: 10.2196/47903.


DOI:10.2196/47903
PMID:37831497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10611999/
Abstract

BACKGROUND: Mental health problems are common among men who have sex with men (MSM) living with HIV and may negatively affect medication adherence. Psychosocial interventions designed to address these urgent needs are scarce in China. Incorporating behavioral health theories into intervention development strengthens the effectiveness of these interventions. The absence of a robust theoretical basis for interventions may also present challenges to identify active intervention ingredients. OBJECTIVE: This study aims to systematically describe the development of a mobile health-based intervention for MSM recently diagnosed with HIV in China, including the theoretical basis for the content and the considerations for its technological delivery. METHODS: We used intervention mapping (IM) to guide overall intervention development, a behavioral intervention technology model for technological delivery design, and a human-centered design and cultural adaptation model for intervention tailoring throughout all steps of IM. RESULTS: The dialectical behavior therapy (DBT)-informed intervention, Turning to Sunshine, comprised 3 components: app-based individual skills learning, group-based skills training, and on-demand phone coaching. The theoretical basis for the intervention content is based on the DBT model of emotions, which fits our conceptualization of the intervention user's mental health needs. The intervention aims to help MSM recently diagnosed with HIV (1) survive moments of high emotional intensity and strong action urges, (2) change emotional expression to regulate emotions, and (3) reduce emotional vulnerability, as well as (4) augment community resources for mental health services. Technological delivery considerations included rationale of the medium, complexity, and esthetics of information delivery; data logs; data visualization; notifications; and passive data collection. CONCLUSIONS: This study laid out the steps for the development of a DBT-informed mobile health intervention that integrated app-based individual learning, group-based skills training, and phone coaching. This intervention, Turning to Sunshine, aims to improve mental health outcomes for MSM newly diagnosed with HIV in China. The IM framework informed by human-centered design principles and cultural adaptation considerations offered a systematic approach to develop the current intervention and tailor it to the target intervention users. The behavioral intervention technology model facilitated the translation of behavioral intervention strategies into technological delivery components. The systematic development and reporting of the current intervention can serve as a guide for similar intervention studies. The content of the current intervention could be adapted for a broader population with similar emotional struggles to improve their mental health outcomes.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/10611999/a19205b6fa7c/formative_v7i1e47903_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/10611999/961336533c92/formative_v7i1e47903_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/10611999/a19205b6fa7c/formative_v7i1e47903_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/10611999/961336533c92/formative_v7i1e47903_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6f4/10611999/a19205b6fa7c/formative_v7i1e47903_fig2.jpg

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The benefits of psychosocial interventions for mental health in men who have sex with men living with HIV: a systematic review and meta-analysis.

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[4]
Timely linkage to care among men who have sex with men newly diagnosed with HIV: A structural equation model adapted from the HIV-related stigma framework.

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[5]
Cultural adaptations of dialectical behavior therapy: A systematic review.

J Consult Clin Psychol. 2022-10

[6]
Trends in suicide mortality among people with HIV after diagnosis during 2012-18: a retrospective, national cohort study in China.

Lancet HIV. 2022-2

[7]
Centering Lived Experience in Developing Digital Interventions for Suicide and Self-injurious Behaviors: User-Centered Design Approach.

JMIR Ment Health. 2021-12-24

[8]
The growing field of digital psychiatry: current evidence and the future of apps, social media, chatbots, and virtual reality.

World Psychiatry. 2021-10

[9]
The effectiveness of adapted psychological interventions for people from ethnic minority groups: A systematic review and conceptual typology.

Clin Psychol Rev. 2021-8

[10]
Effectiveness of theory-based digital self-management interventions for improving depression, anxiety, fatigue and self-efficacy in people with neurological disorders: A systematic review and meta-analysis.

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