Developing Tailored Messages to Improve Mental Health and Adjustment of Asian International Students

The purpose of the study was to develop tailored messages improving mental health and adjustment of Asian international students (AIS) in the US. The PEN-3 cultural model was used to contextualize the role of culture in mental health needs of AIS. Messages were developed through a multi-step participatory process with consisting of three focus groups (n=15), thirteen individual interviews, one expert consultation, and finally an online survey (n=85). The study led to the development of seven broad themes with seven tailored messages under each theme (total 49). Seven broad themes were: increasing the awareness of mental health and reducing stigma; motivational quotes; available and accessible resources for AIS to improve mental health; seeking help from social network and developing interpersonal skills; adjusting to American culture and college life; coping strategies to reduce stress and improve mental health and adjustment; and safety issues. The implications for culturally responsive programs are discussed.

African American men who become mental health advocates

Using a narrative approach, this study explored how African American men became mental health advocates. This ancillary study is part of a formative within an ongoing community based intervention program that was designed to promote mental health of African Americans (AMEN) project within an ongoing community based intervention program that was designed to promote mental health of African Americans (AMEN) project. Narrative research techniques were used to analyze and synthesize the data. Analysis generated one major theme (interdependence) with four supporting sub-themes (credibility, social depression, stigma, and calling). These findings and insights through this qualitative study guided the AMEN project team to formulate effective communication strategies in establishing working relationships with community partners and wider stakeholders as well as crafting culturally tailored messages for African American participants.

From toilet to table: value-tailored messages influence emotional responses to wastewater products

Background Products made from recycled organic materials are an important part of a circular economy, but the question is whether they will be adopted by the public. Such products can elicit strong emotional responses and public resistance. As a case in point, we studied products made from sewage waste, such as recycled toilet paper, which can serve as material alternative to wood and plastic when making household items (e.g., tables). In an experimental study, we investigated the role of values in emotional responses to such wastewater products, and whether emotional responses were influenced by value-tailored messages. We expected that people would experience positive emotions towards products that supported their values, especially when the messages emphasised the benefits of these products for their values (e.g., when the products were presented as good for the environment). We presented participants with one of two messages describing wastewater products as having positive implications for either biospheric values (i.e. positive consequences for the environment) or hedonic values (i.e. positive consequences for personal enjoyment). We predicted that the relationship between values and positive emotions would be stronger when the messages emphasised the positive implications of wastewater products for one’s core values. Additionally, we predicted that emotions would be associated with acceptability and intentions to purchase the products. Results The more strongly people endorsed biospheric values, the more positive emotions they reported towards wastewater products. As expected, this relationship was stronger when the environmental benefits of products were emphasised. Hedonic values were significantly but weakly associated with more negative and more positive emotions, and this did not depend on the message framing. However, we found that emphasising pleasurable benefits of wastewater products reduced positive emotions in people with weaker hedonic values. Positive and negative emotions were significantly associated with higher and lower acceptability of the products and intentions to purchase the products, respectively. Conclusions Our findings have implications for the effective marketing of wastewater products. For people with strong biospheric values, emphasising the positive environmental consequences may promote wastewater products. Such biospheric messages do not seem to make the products less (or more) appealing for people with strong hedonic values, who do not generally have strong emotional responses to these products. We discuss the theoretical implications of our findings and avenues for future research.

Challenges of and Solutions for Developing Tailored Video Interventions That Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: Tutorial

Background Video is a versatile and popular medium for digital health interventions. As mobile device and app technology advances, it is likely that video-based interventions will become increasingly common. Although clinic waiting rooms are complex and busy environments, they offer the opportunity to facilitate engagement with video-based digital interventions as patients wait to see their providers. However, to increase efficiency in public health, leverage the scalability and low cost of implementing digital interventions, and keep up with rapidly advancing technology and user needs, more design and development guidance is needed for video-based tailored interventions. Objective We provide a tutorial for digital intervention researchers and developers to efficiently design and develop video-based tailored digital health interventions. We describe the challenges and solutions encountered with Positive Health Check (PHC), a hybrid app used to deliver a brief, interactive, individually tailored video-based HIV behavioral counseling intervention. PHC uses video clips and multimedia digital assets to deliver intervention content, including interactive tailored messages and graphics, a repurposed animated video, and patient and provider handouts generated in real time by PHC. Methods We chronicle multiple challenges and solutions for the following: (1) using video as a medium to enhance user engagement, (2) navigating the complexity of linking a database of video clips with other digital assets, and (3) identifying the main steps involved in building an app that will seamlessly deliver to users individually tailored messages, graphics, and handouts. Results We leveraged video to enhance user engagement by featuring “video doctors,” full-screen video, storyboards, and streamlined scripts. We developed an approach to link the database of video clips with other digital assets through script coding and flow diagrams of algorithms to deliver a tailored user experience. We identified the steps to app development by using keyframes to design the integration of video and digital assets, using agile development methods to gather iterative feedback from multidisciplinary teams, and creating an intelligent data-driven back-end solution to tailor message delivery to individual users. Conclusions Video-based digital health interventions will continue to play an important role in the future of HIV prevention and treatment, as well as other clinical health practices. However, facilitating the adoption of an HIV video intervention in HIV clinical settings is a work in progress. Our experience in designing and developing PHC presented unique challenges due to the extensive use of a large database of videos tailored individually to each user. Although PHC focuses on promoting the health and well-being of persons with HIV, the challenges and solutions presented in this tutorial are transferable to the design and development of video-based digital health interventions focused on other areas of health.

Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey

The study analyzed the association of the fear of contagion for oneself and for family members (FMs) during the first wave of the COVID-19 pandemic, with demographic and socioeconomic status (SES) and health factors. The study was performed within the EPICOVID19 web-based Italian survey, involving adults from April–June 2020. Out of 207,341 respondents, 95.9% completed the questionnaire (60% women with an average age of 47.3 vs. 48.9 years among men). The association between fear and demographic and SES characteristics, contacts with COVID-19 cases, nasopharyngeal swab, self-perceived health, flu vaccination, chronic diseases and specific symptoms was analyzed by logistic regression model; odds ratios adjusted for sex, age, education and occupation were calculated (aORs). Fear for FMs prevailed over fear for oneself and was higher among women than men. Fear for oneself decreased with higher levels of education and in those who perceived good health. Among those vaccinated for the flu, 40.8% responded they had feelings of fear for themselves vs. 34.2% of the not vaccinated. Fear increased when diseases were declared and it was higher when associated with symptoms such as chest pain, olfactory/taste disorders, heart palpitations (aORs > 1.5), lung or kidney diseases, hypertension, depression and/or anxiety. Trends in fear by region showed the highest percentage of positive responses in the southern regions. The knowledge gained from these results should be used to produce tailored messages and shared public health decisions.

Online Behavioral Screener with Tailored Obesity Prevention Messages: Application to a Pediatric Clinical Setting

Obesity prevention involves promoting healthy eating and physical activity across all children. Can we leverage technology to feasibly survey children’s health behaviors and deliver theory-based and user-tailored messages for brief clinical encounters? We assessed the acceptability and utility of an online pediatric-adapted liking survey (PALS) and tailored messages among children receiving non-urgent care in a pediatric emergency department (PED). Two hundred and forty-five children (average age = 10 years, racially/ethnically diverse, 34% overweight/obese from measured indices, 25% of families reporting food insecurity) and their parents/caregivers participated. Each reported the child’s activity and behaviors using the online PALS and received two to three messages tailored to the responses (aligned with elaboration likelihood and transtheoretical models) to motivate behavioral improvements or reinforce healthy behaviors. Most children and parents (>90%) agreed the PALS was easy to complete, encouraging thought about their own/child’s behaviors. The child’s PALS responses appeared reasonable (fair-to-good child–parent intraclass correlations). Most children and parents (≥75%) reported the tailored messages to be helpful and favorable for improving or maintaining the targeted behavior. Neither message type (motivating/reinforcing) nor favorability responses varied significantly by the child’s weight or family’s food security status. In summary, children and parents found the PALS with tailored messages acceptable and useful. The message types and responses could help focus brief clinical encounters.