Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 13;8(1):e22575.
doi: 10.2196/22575.

Participant Engagement in a Transmedia Storytelling Web-Based App Intervention for Mental Health of Latina Women: Qualitative Analysis

Patricia D Soderlund  1 , Adrienne S Martinez Hollingsworth  2 , MarySue V Heilemann  3
Affiliations

Participant Engagement in a Transmedia Storytelling Web-Based App Intervention for Mental Health of Latina Women: Qualitative Analysis

Patricia D Soderlund et al. JMIR Ment Health. .

Abstract

Background: Stigma, fear, and lack of knowledge regarding treatment options or where to get help create delays for Latina women in accessing needed mental health help. Story-based media interventions hold appeal for Latina women. Thus, we drew upon the Social Cognitive Theory by Bandura to create an evidence-based, transmedia storytelling web-based app for mental health called Catalina: Confronting My Emotions to connect Latina women to a curated set of mental health resources. Understanding how Latina women perceive various aspects of the web-based app will help design future expansions.

Objective: A previously published analysis led to the development of a category on how participants related to the lead character (Catalina) in the story line of the web-based app as a real person. However, the purpose of this analysis was to gain an understanding of participants' experiences with the extension of the dramatic story line of the web-based app beyond Catalina to a Latina nurse-therapist character named Veronica, who was featured prominently in the app's interactive content and bonus videos.

Methods: Qualitative analyses were conducted with interview data from a community-based sample of 28 English-speaking Latina women aged between 21 and 50 years who scored above the threshold for anxiety (Generalized Anxiety Disorder-7) and/or depression (Patient Health Questionnaire-9) but were not suicidal at screening. Data were collected 72 hours after participants engaged with our transmedia storytelling web-based app for mental health. Grounded theory methodology guided the 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 (gerund form of verbs in codes focused on action), informed by symbolic interactionism, and the development of categories with properties through constant comparison, memo writing, and the use of charts and diagrams.

Results: Our participants experienced a multiphase process that was most heavily related to Veronica, the Latina nurse-therapist character in our web-based app, who led them through a process to a place of action. We conceptualized this process as moving from passive viewer to active participant of a transmedia storytelling web-based app intervention. Overall, 3 new conceptual categories provided insight into women's experiences, including encountering a trustworthy nurse-therapist character, taking in messages that dispel old beliefs, and preparing when and how to take action. Each category has nuanced properties that reflect participants' experiences.

Conclusions: Active engagement with our web-based app led our sample to successfully transition 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-based apps using transmedia story extension and bonus videos needs to be based on input from the target group from the start of development through evaluation and testing.

Keywords: Latina; anxiety; depression; internet; mental health; mobile applications; mobile phone; storytelling; transmedia.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Depiction of the process of moving from a passive viewer to an active participant of the transmedia storytelling web-based app intervention.
Figure 2
Figure 2
Properties of the category of encountering a trustworthy nurse-therapist character.
Figure 3
Figure 3
Properties of the category of taking in relevant messages that dispel old beliefs.
Figure 4
Figure 4
Properties of the category of preparing when and how to take action.
See this image and copyright information in PMC

References

    1. Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC. Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):603–13. doi: 10.1001/archpsyc.62.6.603.62/6/603 - DOI - PubMed
    1. Ghio L, Gotelli S, Marcenaro M, Amore M, Natta W. Duration of untreated illness and outcomes in unipolar depression: a systematic review and meta-analysis. J Affect Disord. 2014 Jan;152-154:45–51. doi: 10.1016/j.jad.2013.10.002.S0165-0327(13)00731-3 - DOI - PubMed
    1. Jurkowski JM, Westin EL, Rossy-Millan J. Latina self-reported mental health and delay in health care in a new Latino destination. Women Health. 2010 May;50(3):213–28. doi: 10.1080/03630242.2010.482007. http://europepmc.org/abstract/MED/20512742 922580574 - DOI - PMC - PubMed
    1. Wassertheil-Smoller S, Arredondo EM, Cai J, Castaneda SF, Choca JP, Gallo LC, Jung M, LaVange LM, Lee-Rey ET, Mosley T Jr, Penedo FJ, Santistaban DA, Zee PC. Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol. 2014 Nov;24(11):822–30. doi: 10.1016/j.annepidem.2014.09.003. http://europepmc.org/abstract/MED/25439033 S1047-2797(14)00403-7 - DOI - PMC - PubMed
    1. Mental and Behavioral Health – Hispanics. US Department of Health and Human Services Office of Minority Health. 2019. [2020-07-10]. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=69 .

LinkOut - more resources