Personal relevance of psychotherapy for Asian Americans: A mHealth problem-solving intervention to reduce stress (PRoP-AA)

摘要 拟议的干预措施，亚裔美国人心理治疗的个人相关性：移动健康问题- 解决措施以减少压力，旨在1)通过以下方式增加对心理健康服务的使用 使用他们的比例是白人的三分之一的人口，1和2)开发与个人相关的方法 减轻压力。实际和文化障碍阻碍了亚裔美国人使用心理健康服务2 包括特定人群中英语不流利，3健康素养不足，2和耻辱 周围的精神疾病，源于亚裔美国人在亚裔群体中共享的文化信仰。 在当前与Covid-19、7、8有关的健康危机中，对亚裔美国人的歧视上升 他们的身心健康可能会受到不利影响，9加强了改进选择的必要性，以 解决这些障碍。该提案旨在开发一个mHealth(移动健康)应用程序，该应用程序 系统地适应于在文化上与选定的亚裔美国人亚群相关。如果成功，那就是未来 开发将把这款应用程序扩展到更多的群体。 确定与个人相关的干预措施有可能减少持续存在的心理健康差距 在少数民族群体中，10增加对心理健康服务的参与。解决问题 治疗(PST)，这一项目将使用的干预措施，可能与亚洲人个人有关 美国人。PST是一种以技能为基础的心理社会干预，帮助个人管理负面情绪 应激事件的影响，这是减少精神病理的有效干预措施，例如 抑郁和其他各种心理困难。12解决问题的外部取向是 在文化上与亚洲价值观保持一致。13 拟议中的mHealth应用程序将首先为华裔美国人和韩裔美国人开发。这个 该项目将使用一种系统的方法来评估和调整PST，该方法整合了两个框架，顶层是 自下而上心理治疗适应和修改框架(PAMF)14和自下而上形成方法 用于适应心理治疗(FMAP)。15此外，应用程序布局、文本、视频和音频内容将是 本地化。用户将可以访问应用程序中的至少五个模块，一个简介和一个模块 构成PST的四项技能中的一项。该应用程序将包括亚裔美国人技能的视频建模和 互动功能，允许用户应用学到的技能，如写下想法和制定计划。 在第一阶段，项目组将：a)设计和开发最低限度可行的产品，使用迭代、用户- 以为中心的方法。在第二阶段，项目组将：a)完成内容和应用程序开发，b) 进行随机对照试验，评估干预效果。当研究结束时， Prop-AA将是第一款为亚裔美国人设计的基于证据的PST移动应用程序。

Abstract The proposed intervention, Personal relevance of psychotherapy for Asian Americans: A mHealth problem- solving intervention to reduce stress, is designed 1) to increase the use of mental health services by a population that uses them at one third the rate of Whites,1 and 2) to develop a personally-relevant approach to stress-reduction. Practical and cultural barriers inhibit the use of mental health services by Asian Americans2 including a lack of fluency in English amongst specific subpopulations,3 insufficient health literacy,2 and stigma surrounding mental illness which stems from Asian American cultural beliefs shared across subpopulations.4-6 With the rise in discrimination against Asian Americans during the current health crisis related to Covid-19,7,8 their physical and mental health may be adversely impacted,9 reinforcing the need for an improved option that addresses these barriers. This proposal aims to develop a mHealth (mobile health) application that is systematically adapted to be culturally relevant to select Asian American subpopulations. If successful, future development would extend the app to additional groups. Identifying personally-relevant interventions has the potential to reduce persistent mental health disparities among ethnic minority groups10 by increasing engagement with mental health services. Problem-Solving Therapy (PST), the intervention that will be used for this project, is likely to be personally relevant to Asian Americans. PST is a skills-based, psychosocial intervention to assist individuals in managing the negative effects of stressful events which is an effective intervention for reducing psychopathology, such as depression11 and a variety of other psychological difficulties.12 An external problem-solving orientation is culturally-syntonic to Asian values.13 The proposed mHealth app first will be developed for Chinese Americans and Korean Americans. The project will assess and adapt the PST using a systematic approach that integrates two frameworks, the top- down Psychotherapy Adaptation and Modification Framework (PAMF)14 and the bottom-up Formative Method for Adapting Psychotherapy (FMAP).15 In addition, the app layout, text, video, and audio content will be localized. Users will have access to at least five modules in the app, an introduction and one module for each of the four skills that comprise PST. The app will include video modeling of skills by Asian Americans and interactive features that will allow users to apply skills learned like writing down ideas and developing a plan. In Phase I, the project team will: a) design and develop a minimum viable product using an iterative, user- centered approach. In Phase II, the project team will: a) complete content and app development, and b) conduct a randomized controlled trial to evaluate the efficacy of the intervention. When the study concludes, PRoP-AA will be the first evidence-based PST mobile app designed for Asian Americans.