JMIR Publications

ABSTRACT

Background:

Depression and other mental health disorders are prevalent in people living with chronic health conditions. While digital cognitive behavioral therapy (digital CBT) is considered an effective treatment, African Americans are less likely to engage in and adhere to digital therapies for mental health disorders compared to whites.

Objective:

This study sought to understand digital CBT perceptions and preferences of African Americans living with sickle cell disease (SCD).

Methods:

African Americans living with SCD from various U.S. locations were invited to participate in a focus group. Participants were introduced to a health coach-supported mental health app and then asked a series of questions about the usability and appeal of the program, as well as, more generally what would make a digital mental health program effective for them. The authors reviewed the focus group transcripts and conducted a qualitative analysis of the results.

Results:

Twenty-five people participated in the focus groups. Five primary themes emerged regarding how app content and related coaching could be modified to enhance digital CBT engagement: 1. Connection with others living with SCD; 2. Personalization of app content and coaching; 3. Characteristics of coaches; 4. Journaling and pain tracking; and 5. Considerations for optimal engagement.

Conclusions:

Enhancing user experience by making digital CBT tools relevant to patient populations is critical for optimizing program engagement and uptake. Our findings highlight potential strategies to modify and/or design digital CBT tools for users with SCD and may also be applicable to patients with other chronic conditions. Clinical Trial: Registration: ClinicalTrials.gov NCT04587661