Exploring Challenges in Conducting E-Mental Health Research Among Asian American Women

Abstract

In this discussion paper, we explore the challenges of conducting e-mental health intervention research among Asian American women and propose a model for addressing these barriers. Based on an extensive literature review, we identify two main types of barriers to conducting e-mental health intervention research among Asian American women: recruitment barriers and adherence barriers. Recruitment barriers are further subcategorized into those related to (1) stigmatized cultural beliefs about mental illness and mental health services; (2) lack of awareness about mental health services; and (3) language barrier. As to adherence barriers, the two identified subtypes concern (1) acuity and severity of mental health condition; and (2) lack of time. In order to enhance recruitment and adherence in e-mental health intervention research among the studied population, we formulate the following three main research strategies, namely: (1) considering the cultural and social contexts of Asian American women in the development of e-mental health interventions; (2) determining appropriate program length; and (3) conducting feasibility studies to test e-mental health interventions. We suggest that nurse researchers integrate our proposed model in conducting e-mental health interventions among Asian American women. Our proposed model also implies that nurses play an important role in encouraging Asian American women’s acceptance of and adherence to e-mental health interventions. In order to overcome the obstacles to conducting e-mental health research among Asian American women, we recommend that nurses familiarize themselves with credible, relevant, and evidence-based e-mental health resources and integrate online mental health services and information within their nursing practice.

Factors Associated with Mental Health Help-Seeking Among Asian Americans: a Systematic Review

“…In the current digital era and in light of the current pandemic Covid-19 that has resulted in severe disruptions in everyday lives, self-help efforts (computer-mediated and/or unguided website use) aimed at promoting mental health should be investigated more closely. The immense number of resources, information, and live support offered online should be investigated and with regards to its relevance and applicability of e-mental health services to ethnically and racially diverse populations [ 65 ]. E-mental health services like web-based psychological interventions with or without therapist support, smartphone applications, and online counseling increased reach and scope to mental health support [ 8 , 65 ].…”

“…The immense number of resources, information, and live support offered online should be investigated and with regards to its relevance and applicability of e-mental health services to ethnically and racially diverse populations [ 65 ]. E-mental health services like web-based psychological interventions with or without therapist support, smartphone applications, and online counseling increased reach and scope to mental health support [ 8 , 65 ]. This may be a more acceptable approach to addressing mental health concerns and/or expanding the types of mental health support utilized by AA ethnic subgroups.…”

“…Third, out of the 34 studies in this review, only seven studies (20.6%) explicitly used a theoretical framework to inform their research. Theoretical framework can guide understanding of phenomena by providing an organized approach for bringing together observations and facts from separate investigations, assisting in summarizing and linking findings into an accessible, coherent, useful structure, and providing a basis for prediction [ 65 ]. The Cultural Determinants of Help Seeking (CDHS) is a theoretical model that synthesized theoretical concepts and has been argued to have implications for cross-cultural health promotion, primary health care, and psychiatry [ 66 ].…”

Recruitment and Retention Strategies Among Racial and Ethnic Minorities in Web-Based Intervention Trials: Retrospective Qualitative Analysis

“…Active engagement individualized for participants (eg, assigning study staff to participants and ongoing study process quality assessment) [16,19,21] • Accommodating participants' family members (eg, separate hospitality room, entertainment, and snacks) [16] • Continuous showing of genuine care with respect (e-Community-Based Health Literacy-Focused Intervention for Cancer Control [e-CHECC-uP] study)…”

“…• Standardized and unified communication system (eg, dedicated study phone line or email address) [16,19] • Visit reminder protocol via automated text messaging (e-CHECC-uP study)…”