mHealth for Mental Health: Culturally-tailored Interventions for Managing Anxiety and Depression in African American Women

The rates of mental illness among African American women are comparable to the general population, however, they significantly underutilize mental health services compared to their white counterparts. Previous studies revealed that mHealth interventions increase access to mental health services and resources, and are effective in reducing anxiety and depression. Approximately 80% of African American women own smartphones. This presents a great opportunity to use mobile technology to help reduce the disparity in mental health service utilization and improve health outcomes. The purpose of this dissertation study is to examine the attitudes and perceptions of African American women towards using mental health services, and the feasibility of using mobile technology to deliver mental health services and resources. Eligible participants were African American women (≥ 18 years of age). Participants were recruited through convenience sampling methods (e.g., social media) to complete a web-based survey (n=395), participate in a focus group (4 groups of 5 participants), or test and evaluate a mental health app developed to help African American women manage anxiety and depression (n=15). Results from the study revealed that African American women have favorable views toward seeking mental health services. However, respondents identified many barriers to seeking treatment. Most of the barriers were related to cost, not knowing where to get services, lack of time, and concern of stigma. Findings from the study showed that respondents were more comfortable with using voice call or video call when compared with text messaging or use of a mobile app to communicate with mental health professionals for help in managing anxiety and depression. User-centered recommendations focused on the type of content (e.g., information to find a Black female therapist) and features (e.g., group chat rooms) that should be included in an app culturally-tailored for African American women. Suggestions to increase app usage (e.g., ability to learn coping techniques) and establish trust (e.g., transparency on how user data is protected) were also discussed. The findings of this study demonstrated the need for additional research into the use of mobile technology to provide African American women with more accessible and convenient options for mental health care.Doctor of Philosoph