Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 4, 2023
Date Accepted: Aug 8, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Improve Mental Health and Medication Adherence among Men Who Have Sex with Men Recently Diagnosed with HIV in China: Systematic Development of a Dialectical Behavior Therapy-Based mHealth Intervention
ABSTRACT
Background:
Incorporating behavioral health theories into intervention development strengthens the effectiveness of these interventions. For mHealth intervention development, it is crucial to include additional theories that specifically guide the technological delivery aspect. However, a limited number of mHealth intervention studies have clearly outlined the theoretical foundations for both intervention content development and technological delivery. This absence of a robust theoretical basis may negatively influence intervention efficacy and present challenges when evaluating the effectiveness of individual components and any necessary intervention adaptations.
Objective:
The objective of this study was to systematically describe the development of an mHealth intervention for men who have sex with men (MSM) recently diagnosed with HIV in China, including the theoretical basis for the content and the considerations for its technological delivery.
Methods:
We used intervention mapping to guide overall intervention development, behavioral intervention technology model for technological delivery design, and human-centered design and cultural adaptation model for intervention tailoring throughout all steps of intervention mapping.
Results:
The mHealth intervention, Turning to Sunshine, consisted of three components: individual skills learning through a mobile application, skills learning group, and on-demand phone coaching. The theoretical basis of the intervention content is based on the Dialectical Behavior Therapy (DBT) model of emotions, which fits our conceptualization of intervention user’s mental health needs. The intervention aims to help MSM recently diagnosed with HIV to 1) Survive moments of high emotional intensity and strong action urges; 2) Change emotional expression to regulate emotions; and 3) reduce emotional vulnerability and to help the community capacity around providing mental health support. Technological delivery considerations included rationale of the medium, complexity, and aesthetics of the information delivery, data logs, data visualization, notifications, and passive data collection..
Conclusions:
This study laid out the steps of the development of an mHealth intervention, Turning to Sunshine, that aims to improve mental health outcomes for MSM newly diagnosed with HIV in China. The intervention mapping framework informed by human-centered design principles and cultural adaptation considerations offered a systematic approach to develop the current intervention and tailor it to the target intervention users. The behavioral intervention technology model facilitated the translation of behavioral intervention strategies into technological delivery components. The systematic development and reporting of the current intervention can serve as a guide for similar intervention studies. The content of the current intervention could be adapted to a broader population with similar emotional struggles to improve their mental health outcomes. Clinical Trial: NA
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