Qualitative Feedback From a Text Messaging Intervention for Depression: Benefits, Drawbacks, and Cultural Differences

BACKGROUND: Mobile health interventions are often standardized and assumed to work the same for all users; however, we may be missing cultural differences in the experiences of interventions that may impact how and if an intervention is effective. OBJECTIVE: The objective of the study was to assess qualitative feedback from participants to determine if there were differences between Spanish speakers and English speakers. Daily text messages were sent to patients as an adjunct to group Cognitive Behavioral Therapy (CBT) for depression. METHODS: Messages inquired about mood and about specific themes (thoughts, activities, social interactions) of a manualized group CBT intervention. There were thirty-nine patients who participated in the text messaging pilot study. The average age of the participants was 53 years (SD 10.4; range of 23-72). RESULTS: Qualitative feedback from Spanish speakers highlighted feelings of social support, whereas English speakers noted increased introspection and self-awareness of their mood state. CONCLUSIONS: These cultural differences should be explored further, as they may impact the effect of supportive mobile health interventions. TRIAL REGISTRATION: Trial Registration: Clinicaltrials.gov NCT01083628; http://clinicaltrials.gov/ct2/show/study/NCT01083628 (Archived by WebCite at http://www.webcitation.org/6StpbdHuq).