Using High-Risk Adolescents' Voices to Develop a Comprehensible Cognitive Behavioral Therapy-Based Text-Message Program.
At-risk adolescents' comprehension of, and preferences for, the content of a text-message (SMS) delivered, cognitive behavioral therapy (CBT)-based depression prevention intervention was investigated using two qualitative studies. Adolescents with depressive symptoms and a history of peer violence were recruited from an urban emergency department. Forty-one participants completed semi-structured qualitative interviews. Thematic analysis using deductive and inductive codes were used to capture a priori and emerging themes. Five major themes were identified: CBT-based messages resonated with at-risk adolescents; high levels of peer violence, comorbid symptoms, and prior exposure to the mental health system were variables affecting preferred content; participants endorsed emotional regulation messages, but found mindfulness content difficult to understand via SMS; cognitive awareness and restructuring content was most acceptable when framed by self-efficacy content; adolescent participants generated applicable CBT content in their own voices. Overall, CBT-informed content was able to be distilled into 160-character text messages without losing its comprehensibility.
a Alpert Medical School of Brown University.
Margaret M
MM
Thorsen
b School of Public Health, Brown University.
John V
JV
Patena
c The Miriam Hospital and Alpert Medical School of Brown University.
Kate Morrow
KM
Guthrie
a Alpert Medical School of Brown University.|d Department of Emergency Medicine , Alpert Medical School, Brown University.
Anthony
A
Spirito
b School of Public Health, Brown University.|d Department of Emergency Medicine , Alpert Medical School, Brown University.
Megan L
ML
Ranney
D000293:Adolescent; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D032882:Comprehension; D003863:Depression / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D057240:Patient Preference / Q000523:psychology; D010379:Peer Group; D036301:Qualitative Research; D060145:Text Messaging; D014754:Violence
adolescent; depression prevention; mobile health; qualitative; text messaging/SMS