A Transmedia Storytelling Intervention With Interactive Elements to Benefit Latinas’ Mental Health: Feasibility, Acceptability, and Efficacy

Background Latinos report higher rates of depression and anxiety than US whites but are less likely to receive care. Transmedia storytelling interventions accessible on the Internet via smartphones, tablets, and computers hold promise for reducing reluctance to explore or get help for symptoms because they are private, convenient, and can reach large numbers of people, including Latinas with mental health needs. Objective The purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a mental health transmedia intervention for Latinas with elevated symptoms of depression, anxiety, or both. Methods A total of 28 symptomatic English-speaking Latina women aged 21 to 48 years participated in a 6-week study using a within-group design. All aspects of the study were completed via telephone or Internet. Participants used their personal devices to engage the Web-based transmedia intervention (in English) that included story-based videos, a data-informed psychotherapeutic video, an interactive video sequence, and a blog written from the point of view of one of the characters with links to mental health resources. Perceived confidence to get help and perceived importance for seeking immediate help were both measured using single-item questions. Participants completed surveys at baseline (via telephone) and 1 and 6 weeks after media engagement that measured various factors, including depression (Patient Health Questionnaire; PHQ-9 and PHQ-8) and anxiety (Generalized Anxiety Disorder scale; GAD-7). A telephone interview was conducted within 72 hours of media engagement. Action taken or intentions to get help (single-item question) and talking about the videos with others (single-item question) were measured 1 and 6 weeks after media engagement. Repeated measures analysis of variance was used to assess change in depression (PHQ-8) and anxiety (GAD-7) before transmedia engagement and 1 and 6 weeks after. Spearman correlations evaluated the association of confidence and importance of getting help with action taken, anxiety, and depression. Results All 28 Latinas (English speakers) who engaged with the transmedia remained in the 6-week study. Within 1 week of transmedia engagement, 39% of women took action to get help, and 82% discussed the media with others. Symptoms of depression (F2,54=9.0, P<.001) and anxiety (F2,54=18.7, P<.001) significantly reduced across time. Higher levels of confidence were significantly associated with actions taken at 1 (P=.005) and 6 weeks (P=.04), and higher levels of importance were significantly associated with actions taken at 1 (P=.009) and 6 weeks (P=.003). Higher levels of confidence were associated with lower levels of depression (P=.04) and anxiety (P=.01) at 6 weeks. Conclusions Preliminary findings indicate a culturally tailored mental health transmedia intervention is a feasible approach that holds promise for engaging large numbers of symptomatic English-speaking Latina women to begin the process of seeking help, as well as decreasing symptoms of anxiety and depression.

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A Mental Health Storytelling Intervention Using Transmedia to Engage Latinas: Grounded Theory Analysis of Participants� Perceptions of the Story�s Main Character (Preprint)

10.2196/preprints.10028 ◽

2018 ◽

Author(s):

MarySue V Heilemann ◽

Adrienne Martinez ◽

Patricia D Soderlund

Keyword(s):

Mental Health ◽

Grounded Theory ◽

Mental Health Treatment ◽

Target Group ◽

Main Character ◽

Theory Analysis ◽

Emotional Life ◽

Symptoms Of Depression ◽

Transmedia Storytelling ◽

English Speaking

BACKGROUND Transmedia storytelling was used to attract English-speaking Latina women with elevated symptoms of depression and anxiety to engage in an intervention that included videos and a webpage with links to symptom management resources. However, a main character for the storyline who was considered dynamic, compelling, and relatable by the target group was needed. OBJECTIVE We conducted interviews with 28 English-speaking Latinas (target group) with elevated symptoms of depression or anxiety who participated in an Internet-accessible transmedia storytelling intervention. The objective of this study was to examine participants’ perceptions of the lead character of the story. Development of this character was informed by deidentified data from previous studies with members of the target group. Critique of the character from a panel of therapists informed editing, as did input from women of the target group. METHODS All interviews were conducted via telephone, audio-recorded, and transcribed. Data analysis was guided by grounded theory methodology. RESULTS Participants embraced the main character, Catalina, related to her as a person with an emotional life and a temporal reality, reported that they learned from her and wanted more episodes that featured her and her life. Grounded theory analysis led to the development of one category (She “just felt so real”: relating to Catalina as a real person with a past, present, and future) with 4 properties. Properties included (1) relating emotionally to Catalina’s vulnerability, (2) recognizing shared experiences, (3) needing to support others while simultaneously lacking self-support, and (4) using Catalina as a springboard for imagining alternative futures. Participants found Catalina’s efforts to pursue mental health treatment to be meaningful and led them to compare themselves to her and consider how they might pursue treatment themselves. CONCLUSIONS When creating a story-based mental health intervention to be delivered through an app, regardless of type, careful development of the main character is valuable. Theoretical guidance, previous deidentified data from the target group, critique from key stakeholders and members of the target group, and preliminary testing are likely to enhance the main character’s relatability and appropriateness, which can increase sustained engagement.

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Client Contact in Self-Help Therapy for Anxiety and Depression: Necessary But Can Take a Variety of Forms Beside Therapist Contact

Behaviour Change ◽

10.1017/bec.2012.4 ◽

2012 ◽

Vol 29 (2) ◽

pp. 63-76 ◽

Cited By ~ 8

Author(s):

France Talbot

Keyword(s):

Mental Health ◽

Health Service Delivery ◽

Anxiety And Depression ◽

Mental Health Service Delivery ◽

Large Numbers ◽

Cognitive Behavioural ◽

Multiple Trials ◽

Meta Analyses ◽

The Cost ◽

The Impact

Self-administered therapies (SATs) have been promoted as a way to increase access to evidence-based mental health services. Recent meta-analyses and literature reviews suggest that SATs with clinical guidance are more effective than SATs with no contact for the treatment of anxiety and depression. However, little attention has been paid to the role of nonguidance contact, contact that does not involve the provision of assistance in the application of specific therapy techniques such as emails to encourage treatment adherence. The present article examines the impact of nonguidance contact on the outcomes of SATs for anxiety and depression. Electronic databases were searched to identify studies conducted over the past two decades by independent research teams that have tested cognitive-behavioural SATs over multiple trials. Findings suggest that the involvement or guidance of a therapist is not essential for SATs to produce significant benefits as long as nonguidance contact is provided. It is suggested that even very minimal levels of nonguidance contact increase SAT's outcomes by motivating treatment engagement and improving adherence. The benefit of SATs that can be accessed directly by large numbers of individuals and that do not require therapist involvement to ensure efficacy can potentially significantly increase the cost effectiveness and quality of mental health service delivery.

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Promotion of Perinatal Mental Health

NUTA Journal ◽

10.3126/nutaj.v5i1-2.23454 ◽

2018 ◽

Vol 5 (1-2) ◽

pp. 33-39

Author(s):

Bhabani Adhikari

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Perinatal Period ◽

Perinatal Mental Health ◽

Anxiety And Depression ◽

Symptoms Of Depression ◽

Quality Health ◽

Healthy Housing ◽

Positive Support ◽

Quality Health Services

The aim of this paper is to discuss different aspects of perinatal mental health like; risk factor, impact, issues and to suggest the guidelines for promotion of perinatal mental health. Perinatal mental health is an emerging concept, generally refers to the period 22 completed weeks (i.e. 154 days) of gestation and ending seven completed days after birth. During the pregnancy women may suffer from different mental health problems such as anxiety and depression. Lack of nutritious food, proper healthy housing, and adequate time for rest, quality health services and positive support by the intimacy partner are major responsible factors for getting mental disorder during perinatal period. Problem with in-laws and domestic violence are also responsible for this. Individual, family, community and national agencies should aware the problem and difficulties of the perinatal period and ways to eliminating the associated problems by their action and efforts. Without waiting the sign and symptoms of depression all well pregnant women need to be screened as part of their perinatal health check.

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Quality of Life Assessments in Individuals With Young-Onset Dementia and Their Caregivers

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720933348 ◽

2020 ◽

pp. 089198872093334

Author(s):

Divyansh Dixit ◽

John Spreadbury ◽

Rosanna Orlando ◽

Elaine Hayward ◽

Christopher Kipps

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Caregiver Burden ◽

Anxiety And Depression ◽

Single Item ◽

Proxy Reports ◽

Self Reports ◽

Health Related ◽

Young Onset Dementia

Background: Quality of life (QoL) has seldom been investigated or explicitly measured in young-onset dementia (YoD). The aims of this study were (1) to investigate and compare QoL self- and proxy reports in a sample of YoD patients and caregivers using different conceptual assessments of QoL and (2) to examine the relationship between caregiver QoL and both burden and mental health. Methods: There were 52 participants (26 YoD patient–caregiver dyads). The design was cross-sectional and part of a larger longitudinal prospective cohort study of YoD patients and caregivers. Primary measures included generic QoL (World Health Organization Quality of Life–short version [WHOQOL-BREF]), dementia-specific QoL (Quality of Life in Alzheimer’s Disease Scale [QoL-AD]), health-related QoL (EQ5D), and a single-item QoL measure. Secondary measures included caregiver burden (Zarit Burden Index), mental health (Hospital Anxiety and Depression Scale), and dementia severity (Clinical Dementia Rating). Results: Patient QoL self-reports were higher than caregiver proxy reports on the QoL-AD ( P = .001). Patient QoL self-reports for the WHOQOL-BREF ( P < .01) and single-item QoL ( P < .05) measure were significantly higher than caregiver self-reports. Dementia severity had no relationship with QoL self-reports. Caregiver burden, anxiety, and depression were negatively correlated with QoL when measured using a generic and single-item measure, but not with the health-related measure. Discussion: Patients and caregivers show a disparity in QoL reports, with patients tending to report higher QoL. Caregiver burden, anxiety, and depression should be areas targeted for interventions when supporting caregivers.

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Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465817000480 ◽

2017 ◽

Vol 46 (2) ◽

pp. 168-181 ◽

Cited By ~ 4

Author(s):

Chris Trimmer ◽

Richard Tyo ◽

Jennifer Pikard ◽

Claire McKenna ◽

Farooq Naeem

Keyword(s):

Mental Health ◽

Treatment Group ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Community Mental Health Services ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

Low Intensity

Background: Music has the potential to be an effective and engaging therapeutic intervention in the treatment of mental illness. This research area remains underdeveloped. Aims: This paper reports the feasibility of an innovative low-intensity CBT-based music (CBT-Music) group targeted to symptoms of depression and anxiety. Method: A total of 28 participants with symptoms of depression and anxiety who were attending community mental health services were recruited for the study and randomized into TAU (treatment as usual) plus low-intensity CBT-Music (treatment) or to TAU alone (control). The treatment group consisted of a 9-week music group that incorporated various components of CBT material into a musical context. Feasibility was the primary outcome. The secondary outcomes were a reduction in depression, anxiety (Hospital Anxiety and Depression Scale) and disability (WHO Disability Assessment Schedule 2.0) assessed at baseline and 10 weeks. Results: Recruitment proved feasible, retention rates were high, and the participants reported a high level of acceptability. A randomized control study design was successfully implemented as there were no significant differences between treatment and control groups at baseline. Participants in the treatment group showed improvement in disability (p = 0.027). Despite a reduction in depression and anxiety scores, these differences were not statistically significant. Conclusions: A low-intensity CBT-based music group can be successfully administered to clients of community mental health services. There are indications of effectiveness in reducing disability, although there appears to be negligible effect on symptoms of anxiety and depression. This is the first report of a trial of a low-intensity CBT-based music group intervention.

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Participant Engagement in a Transmedia Storytelling Web-Based App Intervention for Mental Health of Latina Women: Qualitative Analysis (Preprint)

10.2196/preprints.22575 ◽

2020 ◽

Author(s):

Patricia D Soderlund ◽

Adrienne S Martinez Hollingsworth ◽

MarySue V Heilemann

Keyword(s):

Mental Health ◽

Cognitive Theory ◽

Treatment Options ◽

Health Resources ◽

Active Engagement ◽

Latina Women ◽

Story Line ◽

Web Based ◽

Transmedia Storytelling ◽

The Web

BACKGROUND Stigma, fear, and lack of knowledge regarding treatment options or where to get help create delays for Latina women in accessing needed mental health help. Story-based media interventions hold appeal for Latina women. Thus, we drew upon the Social Cognitive Theory by Bandura to create an evidence-based, transmedia storytelling web-based app for mental health called <i>Catalina: Confronting My Emotions</i> to connect Latina women to a curated set of mental health resources. Understanding how Latina women perceive various aspects of the web-based app will help design future expansions. OBJECTIVE A previously published analysis led to the development of a category on how participants related to the lead character (Catalina) in the story line of the web-based app as a real person. However, the purpose of this analysis was to gain an understanding of participants’ experiences with the extension of the dramatic story line of the web-based app beyond Catalina to a Latina nurse-therapist character named Veronica, who was featured prominently in the app’s interactive content and bonus videos. METHODS Qualitative analyses were conducted with interview data from a community-based sample of 28 English-speaking Latina women aged between 21 and 50 years who scored above the threshold for anxiety (Generalized Anxiety Disorder-7) and/or depression (Patient Health Questionnaire-9) but were not suicidal at screening. Data were collected 72 hours after participants engaged with our transmedia storytelling web-based app for mental health. Grounded theory methodology guided the analysis and interpretation of data that had been collected telephonically, recorded, and transcribed with identifiers removed. Analyses included initial and focused coding using process codes (gerund form of verbs in codes focused on action), informed by symbolic interactionism, and the development of categories with properties through constant comparison, memo writing, and the use of charts and diagrams. RESULTS Our participants experienced a multiphase process that was most heavily related to Veronica, the Latina nurse-therapist character in our web-based app, who led them through a process to a place of action. We conceptualized this process as moving from passive viewer to active participant of a transmedia storytelling web-based app intervention. Overall, 3 new conceptual categories provided insight into women’s experiences, including encountering a trustworthy nurse-therapist character, taking in messages that dispel old beliefs, and preparing when and how to take action. Each category has nuanced properties that reflect participants’ experiences. CONCLUSIONS Active engagement with our web-based app led our sample to successfully transition from the viewpoint of the observer to the viewpoint of the experiencer, moving from a passive position of watching to active engagement that involved imagining, thinking, reflecting, and acting. Careful development of dramatic material for health-related web-based apps using transmedia story extension and bonus videos needs to be based on input from the target group from the start of development through evaluation and testing.

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Anxiety and depression symptoms, the recovery from symptoms, and loneliness before and after the COVID-19 outbreak among the general population: Findings from a Dutch population-based longitudinal study

PLoS ONE ◽

10.1371/journal.pone.0245057 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245057

Author(s):

Peter G. van der Velden ◽

Philip Hyland ◽

Carlo Contino ◽

Hans-Martin von Gaudecker ◽

Ruud Muffels ◽

...

Keyword(s):

Mental Health ◽

General Population ◽

Repeated Measures ◽

Population Based ◽

Reliable Change Index ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Dutch Population ◽

Emotional Loneliness ◽

Before And After

Objectives Examine the effects of the COVID-19 pandemic on the mental health and loneliness in the general population. More specifically, the study focused on prevalence of anxiety and depression symptoms, the extent to which individuals with existing symptoms recovered or not, the prevalence of subtypes of loneliness, and the extent to which loneliness before and during this pandemic was associated with anxiety and depression symptoms. Methods Data was extracted from the longitudinal LISS panel, based on a probability sample of the Dutch population, with assessments on loneliness in October 2019 (T1) and June 2020 (T4), and anxiety and depression symptoms in November 2019 (T2), March 2020 (T3) and June 2020 (T4; Ntotal = 4,084). Loneliness was examined with the De Jong Gierveld Loneliness Scale and anxiety and depression symptoms with the Mental Health Inventory (MHI-5). Results Repeated measures multivariate logistic regression analyses (RMMLRA) showed a statistical significant lower prevalence of anxiety and depression symptoms after the outbreak (T4 = 15.3%) than before (T2 = 16.8%) and during the COVID-19 outbreak (T3 = 17.2%). According to the Reliable Change Index, the distribution of recovery categories (remission, improvement, unchanged and worsening symptoms) after the outbreak did not differ significantly from the distribution of these categories before the outbreak. RMMLRA revealed that the prevalence of emotional loneliness increased significantly after the outbreak (T1 = 18.4%, T4 = 24.8%). Among individuals who were not lonely before and after the outbreak the prevalence of symptoms decreased significantly (T2 = 7.0%, T4 = 4.4%) and, likewise, among those who were not lonely anymore after the outbreak (T2 = 21.5%, T4 = 14.5%). However, the prevalence of symptoms increased significantly among those who became lonely during the pandemic (T2 = 17.9%, T4 = 26.3%). Conclusions Findings suggest that this pandemic did not negatively affect the prevalence of anxiety and depression symptoms nor the normal recovery of symptoms among the general population during the first four months, but that emotional loneliness increased.

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Evaluating the Factors (Stress, Anxiety and Depression) Affecting the Mental Health Condition of Nurses During the COVID-19 Pandemic

Evaluation & the Health Professions ◽

10.1177/01632787211062660 ◽

2021 ◽

pp. 016327872110626

Author(s):

Oğuz Işık ◽

Dilaver Tengilimoğlu ◽

Nurperihan Tosun ◽

Aysu Zekioğlu ◽

Onur Tengilimoğlu

Keyword(s):

Mental Health ◽

Health Condition ◽

Social Needs ◽

Fear Of Death ◽

Anxiety And Depression ◽

Mental Health Condition ◽

Online Questionnaire ◽

Related Factors ◽

Symptoms Of Depression ◽

Household Members

This study aimed to determine the depression, anxiety and stress levels that have negatively impacted nurses’ mental health during the COVID-19 pandemic. A sample group of 826 nurses working in Turkey were asked to fill in an online questionnaire in order to evaluate their psychological responses and the related factors that have adversely affected their mental health during the COVID-19 pandemic. In total, 696 nurses (84.3%) showed symptoms of depression, 644 (78%) reported anxiety and 543 (65.74%) reported stress. This study also highlighted that the most concerning factor for the nurses was the risk of transmitting the COVID-19 infection to their household members (89.2%). The most important problems faced by the nurses during COVID-19 included equipment shortages (50.7%), administrative problems (38.5%) and issues such as accommodation and nutrition (27.4%). These were found to have a statistically significant correlation with the nurses’ levels of depression, anxiety and stress. The fear of losing a household member, the inability to their household’s social needs and the fear of death were among the factors that concerned nurses during the COVID-19 pandemic, significantly affecting their levels of depression, anxiety and stress. Taking the necessary measures to deal with the aforementioned problems and fears is important to protect the health, productivity and efficiency of nurses during the pandemic period.

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Symptoms of depression at discharge after PCI are associated with an increased risk of 1-year mortality: findings from the national DenHeart study

European Heart Journal ◽

10.1093/ehjci/ehaa946.3417 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

B Borregaard ◽

S.N Nielsen ◽

J.F Lassen ◽

L.O Jensen ◽

L Thrysoe ◽

...

Keyword(s):

Mental Health ◽

Depression Scale ◽

Adverse Outcomes ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Symptoms Of Depression ◽

Increased Risk ◽

All Cause Mortality

Abstract Background Although survival rates among patients with coronary artery disease have increased since the introduction of treatment with percutaneous coronary intervention, PCI, the effect of psychological factors such as symptoms of anxiety and depression on adverse outcomes are sparsely described. Purpose The objective of the current study was to investigate the association between symptoms of anxiety and depression and 1-year mortality after PCI. Methods A national cross-sectional survey at hospital discharge (responders, n=3,366) with register-based follow-up among patients having undergone elective or emergency PCI. Mental health was measured using the Hospital Anxiety and Depression Scale, HADS, and divided into symptoms of anxiety (HADS-A) and symptoms of depression (HADS-D). The association between mental health (HADS-A and HADS-D) and 1-year all-cause mortality were investigated with Cox Proportional Hazard models with time to death as the underlying time scale. The results are presented as hazard ratios (HR) with 95% confidence intervals (CI) and adjusted for sex, age and Tu-comorbidity score. Results At discharge, 32% of the population reported symptoms of anxiety (HADS-A ≥8) and 19% reported symptoms of depression (HADS-D ≥8). After one year, the mortality rate among patients being alive at discharge was 2.1%. All-cause mortality did not differ among patients reporting symptoms of anxiety compared to patients without symptoms of anxiety (2.3% vs 1.9%, p=0.454), whereas all-cause mortality was higher among patients reporting symptoms of depression compared to those, who did not (4.3% vs 1.6%, p≤0.001). In the regression analyses, symptoms of anxiety (HADS-A ≥8) was not associated with 1-year mortality (HR 1.16 95% CI 0.70–1.92); however, symptoms of depression was (HADS-D ≥8, HR 2.27 95% CI 1.38–3.73, adjusted analyses). Based on the continuous scores of HADS-D, a one-point increase in scores was associated with a 12% higher risk of 1-year mortality (HR 1.12 95% CI 1.05–1.18) (Figure 1). Conclusion After PCI, nearly one-third of patient report symptoms of anxiety and one-fifth symptoms of depression. Symptoms of anxiety was not associated with 1-year mortality, whereas symptoms of depression increased the risk of 1-year mortality. Figure 1 Funding Acknowledgement Type of funding source: None

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Emotion regulation difficulties and interpersonal problems during the COVID-19 Pandemic: Predicting anxiety and depression

10.31234/osf.io/g5d8r ◽

2021 ◽

Author(s):

Ole Andre Solbakken ◽

Omid V. Ebrahimi ◽

Asle Hoffart ◽

Jon T. Monsen ◽

Sverre Urnes Johnson

Keyword(s):

Mental Health ◽

Emotion Regulation ◽

Mental Health Problems ◽

Interpersonal Problems ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Social Distancing ◽

Symptoms Of Depression ◽

Interpersonal Difficulties ◽

The Impact

Background: Central components of psychological functioning, such as difficulties in emotion regulation and interpersonal problems are likely to have been substantially impacted by COVID-19 and the amelioration measures of societal lock-down and social distancing. In turn, these factors are likely to predict mental health outcomes, such as symptoms of depression and anxiety throughout the pandemic and beyond. Methods: To investigate this issue, we conducted an internet-based survey with 10,061 responders at the height of lock-down (T1). After social distancing measures had been eased (T2), 4,936 responders (49.1%) completed the survey again. Results: Emotion regulation difficulties, interpersonal problems, and symptoms of depression and anxiety decreased from T1 to T2, but changes were minor. After controlling for age and gender, emotion regulation- and interpersonal difficulties were associated with anxiety and depression throughout the study period, and changes in all domains occurred in concert. More extensive problems with emotion regulation at T1 predicted greater reductions in both symptom domains as amelioration measures were eased, while the converse was true for interpersonal problems. Furthermore, the impact of initial emotion regulation difficulties on subsequent changes in both anxiety- and depressive symptoms was dependent on the level of interpersonal difficulties, so that high interpersonal problem load at T1 reversed the effect of emotion regulation difficulties on symptom development. Conclusions: The results suggest that emotion regulation- and interpersonal difficulties are highly central to mental health during the pandemic, and may be important targets for remediation to reduce mental health problems throughout the course of the pandemic and beyond.

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