Usability and Feasibility Study of a Remote Cognitive Behavioral Therapy System with Long-Term Unemployed Women

We present the results of the use of a cognitive behavioral therapeutic intervention tool to improve the mental, physical, and social health of a group of long-term unemployed women in Spain. Method: We sent automated text messages (SMS) to the mobile phones of long-term unemployed women selected at random from public social services. During a 28-day intervention period, women received four daily automated text messages on her mobile phone on a predetermined hourly schedule. We measured depression symptoms at the start and end of the intervention and we analyzed qualitative data to determine the acceptability of a remote SMS program. Results: Depression symptoms using the Personal Health Questionnaire-9 (PHQ-9), went from an average of 13.8 at baseline to 4.9 at the end of 28 days (p = 0.89). One hundred percent of the women reported that they liked receiving the text messages and most found them helpful

Assessing the Need and Receptivity for an Integrated Healthy Sexual and Dating Relationships Intervention for Community College Students

Background: In emerging adulthood, youth often become involved in more serious romantic relationships. However, many lack the skills to avoid an unplanned pregnancy or sexually transmitted infection (STI), and to ensure a healthy dating relationship. Community college students serve nearly half of all undergraduate students in the United States; yet, community colleges typically lack resources for sexual health promotion. Purpose: To assess the need and receptivity for a web-based integrated healthy sexual and dating relationships intervention among community college students. Methods: In summer 2016, we partnered with three community colleges in South Central Texas to conduct an online survey of students’ sexual behaviors and dating relationships, and usability testing of activities from an integrated, web-based healthy sexual and dating relationship intervention. Results: Online survey participants (n=271) were 70% female, 38% Hispanic, 24% White, 17% Black, and 16% Asian; 20% self-identified as sexual minority; mean age was 20.8 years (SD = 2.05). Participants reported high rates of sexual risk behavior including sex without a condom or an effective birth control method, low use of long-acting reversible contraception, frequent use of emergency contraception, and low use of dual protection to prevent pregnancy and sexually transmitted infections. Two-thirds reported experiencing any type of dating violence perpetration or victimization in the past year. Usability testing participants (n=14) were 86% female, 42% Hispanic, 50% Asian/Pacific Islander, 14% Black, and 7% White; 71% were sexually experienced; mean age was 20.7 years (SD = 1.64). The web-based activities were highly rated in terms of usability parameters, and positively impacted short-term psychosocial outcomes related to condom use, accessing contraceptive health services, and constructive interpersonal conflict resolution. Conclusion: Findings underscore the high need and receptivity for an integrated healthy sexual and dating relationship web-based intervention among community college students, an understudied subgroup of youth in emerging adulthood

Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review

Aim: Adolescents in low-and-middle-income countries (LMICs) are facing numerous developmental, sexual and reproductive health (SRH) challenges including exposure to multidimensional violence. Gender-based violence (GBV) specifically intimate partner violence (IPV) are both highly prevalent in LMICs and are strongly linked with poor SRH outcomes. However, GBV and IPV interventions have not yet been adequately integrated in SRH due to individual, social, cultural, service, and resource barriers. To promote long-term SRH, a more holistic approach that integrates GBV and IPV, and adolescent development needs is imperative. Digital health has the potential to address multiple service setup, provision, and addressing access barriers through designing and providing integrated SRH care. However, there are no guidelines for an integrated digital SRH and development promotion for adolescents in LMICs. Methods: An umbrella review was conducted to synthesize evidence in three inter-related areas of digital health intervention literature: (i) SRH, (ii) GBV specifically IPV as a subset, and (iii) adolescent development and health promotion. We first synthesize findings for each area of research, then further analyze the implications and opportunities to inform approaches to develop an integrated intervention that can holistically address multiple SRH needs of adolescents in LMICs. Articles published in English, between 2010 and 2020, and from PubMed were included. Results: Seventeen review articles met our review inclusion criterion. Our primary finding is that application of digital health strategies for adolescent SRH promotion is highly feasible and acceptable. Although effectiveness evidence is insufficient to make strong recommendations for interventions and best practices suggestions, some user-centered design guidelines have been proposed for web-based health information and health application design for adolescent use. Additionally, several digital health strategies have also been identified that can be used to further develop integrated GBV-IPV-SRH-informed services to improve adolescent health outcomes. We generated several recommendations and strategies to guide future digital based SRH promotion research from our review. Conclusions: Rigorous research that focuses on intervention effectiveness testing using a combination of digital health strategies and standardized albeit contextualized outcome measures would be important. Methodological improvement such as adoption of longitudinal experimental design will be crucial in generating evidence-based intervention and practice guidelines for adolescents in LMICs. Keywords: Gender-based violence, Intimate partner violence, Sexual and reproductive health, Low-and-middle - income countries, mHealth, Digital health, Adolescents Development, Revie

Feasibility and acceptability of a mobile phone intervention to improve post-rape service delivery in South Africa

Mobile health (mHealth) interventions – in which mobile phones are used to advance positive health outcomes – have only recently been applied to addressing broader questions of health governance. This report discusses research on a mobile phone app that was designed to create a coordinated platform through which rape victims could express their views on the quality of services and support offered by police and health-care workers in South Africa, in order to promote greater accountability between service providers and clients.The study, which assessed the feasibility and acceptability of the proposed app, comprised qualitative and quantitative research with rape victims and caregivers accessing follow-up services at four rape care centres in Tshwane district, Pretoria. Of 140 participants enrolled in the study (108 rape victims and 32 caregivers), 86.4% reported owning a mobile phone. However, the results also revealed that mobile phone theft during sexual assault was common, with 34 out of 63 participants (55%) who did not bring their mobile phones to their first visit to the facility reporting that their phone had been stolen during the assault. Nonetheless, the findings confirmed the feasibility of the app, which was subsequently developed and piloted. In addition, high levels of interest in using mobile phones to provide feedback on the quality of service delivery (95%) showed the potential value of such an intervention for improved communication between service users and providers.DFIDUSAIDOmidyar NetworkSID

Using Digital Technology for Sexual and Reproductive Health: Are Programs Adequately Considering Risk?

Digital technologies provide opportunities for advancing sexual and reproductive health and services but also present potential risks. We propose 4 steps to reducing potential harms: (1) consider potential harms during intervention design, (2) mitigate or minimize potential harms during the design phase, (3) measure adverse outcomes during implementation, and (4) plan how to support those reporting adverse outcomes

Childhood victimization: The psychosocial functioning of traditional and cyer victims

Children are increasingly using computer technologies and many are experiencing online aggressive acts from their peers. News media reports have documented instances of cyber victimization, and social scientists have started to examine its characteristics and consequences. The present research evaluated a comprehensive conceptual model of cyber victimization as it relates to age, gender, traditional, face-to-face victimization, and classroom psychosocial functioning using structural equation modeling. 192 third through sixth grade students completed self-report and peer-report measures based on their experiences with cyber victimization, traditional victimization, and classroom psychosocial functioning at multiple levels of social complexity (including the individual, relationship, and group levels). The results indicated a fairly large prevalence of cyber victimization at these younger ages. In addition, the participants reported experiencing cyber victimization at comparable rates across grades, and between males and females. While some students may experience victimization in both contexts, there was not a significant relation between experiencing traditional victimization and cyber victimization in the current study. Consistent with previous literature, traditional victimization was significantly related to higher rates of loneliness, and lower rates of optimism about peer relations, number of mutual friendships, and social acceptability. Similarly, cyber victimization was positively related to children’s loneliness, and negatively related to children’s optimism about their peer relations and social acceptability. However, cyber victimization was not significantly related to number of mutual friendships. Results of the current study have important implications for our understanding of cyber victimization, directions for future research, as well as possible avenues for interventions

"It's all country boys:" rural young male perceptions of risk and protective factors for dating violence and technology-based interventions as an acceptable response

In 2019, one in eight US teens reported experiencing Teen Dating Violence (TDV) as physical, psychological, sexual, and online abuse. Studies show rural youth report up to twice the physical violence rates of urban youth but remain grossly undersampled and understudied, particularly rural young males. The Health-e BROs! Study (Better & Healthy Relationship Outcomes) was designed to begin to address this gap. An understudied aspect of dating violence prevention is young people's perception and communication of risks associated with TDV victimization and perpetration. Overall, 14 rural young males participated in three online focus groups, and another 13 completed phone interviews stratified by age - 15-17 (middle adolescents) and 18-24 (emerging adults). In this dissertation, two specific aims were addressed using distinct analytical approaches. First, using an interpretive and dialectical approach grounded in relational dialectics theory (RDT), this study explored TDV risk communication and risk perceptions among rural young males (ages 15-24). Our interpretive analysis identified two main themes of risk and protection dialectics: (1) Dialectics of Social Tensions and (2) Dialectics of Help-Seeking & Help-Giving. Within each main theme, constitutive sub-themes are described as dialectics accompanied by participant quotes. Dialectical tensions and contradictions were used as a heuristic framework. Our second aim investigated: (a) what rural male youth consider useful content, resources, and features in app-based dating violence prevention intervention and (b) unmet needs related to barriers and facilitators for using this type of intervention in rural contexts. The Unified Theory of Acceptance and Use of Technology (UTAUT) guided the second aim, and a qualitative descriptive approach was used to analyze this aim. Findings bear implications for advocates and practitioners working with rural youth in planning developmentally and culturally appropriate anti-TDV programs and will yield intervention, policy, and for researchers by providing a broader framework for the development of theory and effective violence prevention practice in low-income, rural contexts.Includes bibliographical reference

The American Academy of Health Behavior 2024 Annual Scientific Meeting: Health Communication, (Mis-)Information, and Behavior: Leveraging Technology for Behavioral Interventions and Health Behavior Research

The American Academy of Health Behavior (AAHB) hosted its 24th Annual Scientific Meeting at The DeSoto Hotel in Savannah, Georgia on April 14-17, 2024. The meeting\u27s theme was “Health Communication, (Mis-)Information, and Behavior: Leveraging Technology for Behavioral Interventions and Health Behavior Research . This publication describes the meeting theme and includes the refereed abstracts presented at the 2024 Annual Scientific Meeting

Effectiveness of a Psychosocial Therapy with SMS in Immigrant Women with Different Degrees of Depression

Immigrant women who are forced to adapt to a new cultural context often live in low income situations, have informal jobs, and experience social inclusion difficulties; these women frequently have mental health and social relationship problems. We conducted an experimental investigation with a group of vulnerable immigrant women who were receiving support from public social services. Our goal was to analyze the effectiveness of a bio-psychosocial therapy system with text messages to personal mobile phones. We grouped women by different degrees of depression. We studied psychosocial characteristics from personalized interviews and developed message banks to advise healthy habits and accompany moods. We programmed a remote delivery system, and for 26 days, each woman (n = 44) received four of our messages. We analyzed changes in mood and depression at the beginning and at the end of therapy and observed positive changes. The analysis of the initial and final (Personal Health Questionnaire) PHQ−9 quartile intervals shows that text messages significantly improve the mood and depression symptoms of immigrant women when the initial PHQ−9 value is greater than 5 (moderate depression)This research was funded by Autonomous Government of Galicia-Spain: General Directorate of Social Inclusion and the Postdoctoral Research ProgramS