Background: Stigma, fear, and lack of knowledge regarding treatment options or where to get help create delays for Latina women in accessing needed mental health help. Story-based media interventions hold appeal for Latina women. Thus, we drew upon the Social Cognitive Theory by Bandura to create an evidence-based, transmedia storytelling web-based app for mental health called Catalina: Confronting My Emotions to connect Latina women to a curated set of mental health resources. Understanding how Latina women perceive various aspects of the web-based app will help design future expansions. Objective: A previously published analysis led to the development of a category on how participants related to the lead character (Catalina) in the story line of the web-based app as a real person. However, the purpose of this analysis was to gain an understanding of participants’ experiences with the extension of the dramatic story line of the web-based app beyond Catalina to a Latina nurse-therapist character named Veronica, who was featured prominently in the app’s interactive content and bonus videos. Methods: Qualitative analyses were conducted with interview data from a community-based sample of 28 English-speaking Latina women aged between 21 and 50 years who scored above the threshold for anxiety (Generalized Anxiety Disorder-7) and/or depression (Patient Health Questionnaire-9) but were not suicidal at screening. Data were collected 72 hours after participants engaged with our transmedia storytelling web-based app for mental health. Grounded theory methodology guided the analysis and interpretation of data that had been collected telephonically, recorded, and transcribed with identifiers removed. Analyses included initial and focused coding using process codes (gerund form of verbs in codes focused on action), informed by symbolic interactionism, and the development of categories with properties through constant comparison, memo writing, and the use of charts and diagrams. Results: Our participants experienced a multiphase process that was most heavily related to Veronica, the Latina nurse-therapist character in our web-based app, who led them through a process to a place of action. We conceptualized this process as moving from passive viewer to active participant of a transmedia storytelling web-based app intervention. Overall, 3 new conceptual categories provided insight into women’s experiences, including encountering a trustworthy nurse-therapist character, taking in messages that dispel old beliefs, and preparing when and how to take action. Each category has nuanced properties that reflect participants’ experiences. Conclusions: Active engagement with our web-based app led our sample to successfully transition from the viewpoint of the observer to the viewpoint of the experiencer, moving from a passive position of watching to active engagement that involved imagining, thinking, reflecting, and acting. Careful development of dramatic material for health-related web-based apps using transmedia story extension and bonus videos needs to be based on input from the target group from the start of development through evaluation and testing.

中文翻译：

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参与者参与跨媒体讲故事的基于 Web 的应用程序干预拉丁美洲妇女的心理健康：定性分析

背景：耻辱感、恐惧和缺乏关于治疗选择或从哪里获得帮助的知识导致拉丁裔妇女延迟获得所需的心理健康帮助。基于故事的媒体干预对拉丁裔女性具有吸引力。因此，我们利用 Bandura 的社会认知理论创建了一个基于证据的、跨媒体讲故事的基于网络的心理健康应用程序，名为Catalina: Confronting My Emotions，将拉丁裔女性与一组精心策划的心理健康资源联系起来。了解拉丁裔女性如何看待基于网络的应用程序的各个方面将有助于设计未来的扩展。客观的：之前发布的一项分析导致开发了一个类别，即参与者如何将基于网络的应用程序的故事情节中的主角（Catalina）作为真人进行关联。然而，此分析的目的是了解参与者的体验，将基于网络的应用程序的戏剧性故事情节从 Catalina 扩展到名为 Veronica 的拉丁裔护士-治疗师角色，该角色在应用程序的交互中占据显着位置内容和奖励视频。方法：对 28 名年龄在 21 至 50 岁之间、得分高于焦虑（广泛性焦虑症-7）和/或抑郁（患者健康问卷-9）阈值的拉丁裔女性社区样本的访谈数据进行了定性分析) 但在筛选时没有自杀倾向。在参与者使用我们的跨媒体讲故事基于网络的心理健康应用程序后 72 小时收集数据。扎根理论方法指导对通过电话收集、记录和转录并去除标识符的数据进行分析和解释。分析包括使用过程代码（专注于动作的代码中动词的动名词形式）的初始和集中编码，通过符号交互主义提供信息，以及通过不断比较、备忘录编写、结果：我们的参与者经历了一个与维罗妮卡最密切相关的多阶段过程，维罗妮卡是我们基于网络的应用程序中的拉丁护士-治疗师角色，她带领他们完成了一个过程，到达了一个行动地点。我们将这个过程概念化为从被动观众转变为基于网络应用程序干预的跨媒体讲故事的主动参与者。总体而言，3 个新的概念类别提供了对女性经历的洞察，包括遇到值得信赖的护士治疗师角色、接受消除旧观念的信息，以及准备何时以及如何采取行动。每个类别都有反映参与者体验的细微差别。结论：与我们基于 Web 的应用程序的积极互动使我们的样本成功地从观察者的视角转变为体验者的视角，从被动的观看转变为涉及想象、思考、反思和行动的主动参与。从开发开始到评估和测试，使用跨媒体故事扩展和奖励视频为与健康相关的基于网络的应用程序精心开发戏剧材料需要基于目标群体的输入。