Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 15, 2018
Open Peer Review Period: Jun 20, 2018 - Aug 15, 2018
Date Accepted: Apr 15, 2019
Date Submitted to PubMed: Jun 12, 2019
(closed for review but you can still tweet)
The evaluation of the effectiveness of a musical cognitive restructuring app for Black inner-city girls
ABSTRACT
Background:
Research on mhealth apps in adolescence is growing, however little attention has been paid to Black adolescents, particularly Black girls. This is reflective of the fact that within psychological intervention research Black girls are under-researched and underserved. Cognitive restructuring is an important tool in anxiety and fear management. Operationally defined, cognitive restructuring involves two parts: (a) recognizing and deconstructing erroneous thoughts and (b) replacing the negative anxiety and stress provoking thoughts with positive thoughts. In our work with Black adolescent females, we found at times that cognitive restructuring is a difficult skill to practice on one’s own. Thus, drawing upon the importance of music in the Black community, we developed the “Build Your Own Theme Song” app (BYOTS© app) to deliver a musical form of the technique to middle school Black girls.
Objective:
In this mixed method study, we evaluated the effectiveness of the BYOTS© app. Specifically, we examined the hypothesis that participants will expect the app to be effective in reducing negative thoughts and that the app will meet their positive expectations. In addition, data generated from the app will demonstrate a reduction in negative thinking. A reduction in anxiety is also hypothesized.
Methods:
Seventy-two (72) Black/biracial seventh and eighth grade adolescent females were enrolled in Sisters United Now (S.U.N.), an eight(8)-session culturally-infused and app augmented stress and anxiety sister circle intervention. Prior to using the BYOTS© app, girls completed the MASC-2 and app expectations survey. Usage data was collected from the app including an assessment of negative thinking before and after listening to their song. After completion of the intervention, focus groups were held to gather qualitative data on participants’ app experience.
Results:
Results using paired sample t-tests indicate negative thinking was significant lower at day 7 than day 1 (t=1.69, P=.05). Anxiety from pre-use of the app to post-use of the app was also reduced (t=2.82, P= .004). Four effectiveness themes emerged from the focus groups, difference in behavior and temperament, promotes calmness, helpfulness in stressful home situations, and focused thinking via the S.U.N. theme song.
Conclusions:
The BYOTS© app is a useful tool for delivering musical cognitive restructuring to reduce negative thinking and anxiety in an underserved urban population. Changes were supported both quantitatively and qualitatively. Participants, their peers and their family noted the difference. Findings support expanding the research to Black girls of various socioeconomic statuses and geographic diversity. Currently, the app augments S.U.N., a culturally-relevant intervention. Future research will explore BYOTS© as a standalone application. Clinical Trial: not an RCT
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.