A Web-Based Intervention with Culturally Tailored Messages to Improve Mental Health Among Asian International Students with Mild-to-Moderate Depression: A Pilot Randomized Controlled Trial

摘要

The study aims to: 1) design, develop, and test culturally tailored messages to address the mental health needs of Asian international students (AIS); and 2) assess the potential and acceptability of a web-based intervention (myCompass program) with culturally tailored messages to reduce depressive symptoms and improve related mental health outcomes among AIS with mild-to-moderate depression.;The culturally tailored messages were designed, developed and tested through three focus groups (N=15), thirteen individual interviews (N=13), and an online survey (N=85) with AIS. Data was analyzed using the constant comparative method. The final cultural message themes used in the intervention arm included: 1) increasing the awareness of mental health and reducing stigma, 2) motivational quotes, 3) available and accessible resources for AIS to improve mental health, 4) seeking help from social network and interpersonal skills with American peers and faculty, 5) adjusting to American culture and college life, 6) coping strategies to reduce stress and improve mental health, and 7) safety issues for AIS. The PEN-3 cultural health communication model was used to frame the study.;A web-based intervention (myCompass program) with culturally tailored messages was conducted at Purdue University. Twenty-one AIS participants (N=21) with mild-to-moderate depression were recruited and randomly assigned to the intervention group (myCompass with culturally tailored messages; n=11) or the control group (myCompass with untailored messages; n=10). Data was collected at baseline, mid-intervention (3 weeks), and post-intervention (7 weeks), and analyzed on an intent-to-treat basis, using nonparametric tests.;The results showed large and significant improvement in the intervention group for depressive symptoms, help-seeking intention for emotional problems, and mental health self-efficacy from baseline to post-intervention. Further, the mental health self-efficacy level of the intervention group was significantly higher than the control group at post-intervention. Besides, the intervention participants who received culturally tailored messages were more likely to recommend the messages to other AIS than the control group, who received untailored messages. The results indicated that the use of the web-based program (i.e., myCompass) with culturally tailored messages could produce significant benefits to the mental health of AIS, and was acceptable to the users. The continued development of web-based intervention technology for mental health disorders with tailored components is crucial to reach many minorities who would not otherwise seek help. Further efforts need to focus on designing adapted elements for diverse populations, and examine both short- and long-term effectiveness.