JMIR Publications

ABSTRACT

Background:

Delays in seeking needed mental health treatment are alarmingly high, especially for Latinxs. Stigma, fear, lack of knowledge of treatment options, or where to get help compound the problem. Since the prevalence of depression among Latina women is higher than for Latino men, innovative ways to help Latinas connect with care are needed. Story-based, character-driven media interventions hold appeal for Latinas. Thus, we drew upon Bandura’s Social Cognitive Theory to create an evidence-based transmedia storytelling mental health web-app called Catalina: Confronting My Emotions to connect Latinas to a curated set of mental health resources including therapy options. It is crucial to understand how Latinas perceived various aspects of the web-app and its content to help design future expansions of interventions like this.

Objective:

Qualitative analyses were done with interview data from a community-based sample of 28 English-speaking Latinas aged 21-50 who scored above threshold for anxiety (GAD7) and/or depression (PHQ-9) but were not suicidal at screening. Data was collected 72 hours after participants engaged with a transmedia storytelling mental health web-app. A previously published analysis led to the development of one category focused on participants’ perceptions of the lead character (Catalina) in the web-app’s storyline (Relating to the lead character as a real person). However, the purpose of the current study was to analyze participants’ experiences with transmedia features of the web-app that extended the storyline beyond Catalina through interactive and bonus videos that did not feature the Catalina character directly, but extended the story through another character: her Latina nurse-therapist, Veronica.

Methods:

Grounded theory methodology guided 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 (action codes) informed by Symbolic Interactionism, development of categories and properties through constant comparison, memo writing, the use of charts and diagrams.

Results:

Analysis led to development of a Grounded Theory called: Moving from passive viewer to active participant in a transmedia mental health web-app. The theory starts with the previously published category about relating to the main character (Catalina) and is extended by three new categories including: (1) Encountering a trustworthy nurse-therapist character, (2) Taking in messages that dispel old beliefs, and (3) Preparing when and how to take action.

Conclusions:

The active engagement with our web-app by our sample of Latinas showed that they successfully transitioned 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-apps using transmedia story extensions needs to be based on input from the target group from the start of development through evaluation and testing.