(P24-19-26) “It Starts with Positivity”: Designing a CBT-Informed mHealth Tool for Mothers Experiencing Food Insecurity

Objectives: Mothers experiencing food insecurity face chronic stress and have limited cognitive bandwidth, which can hinder healthy behavior adoption. Cognitive Behavioral Therapy (CBT) can improve coping to free bandwidth when delivered via mHealth applications (apps). Despite mHealth’s potential, apps developed without input from mothers experiencing food insecurity may fail to fully address their high stress burden, thereby limiting effects. This study explored mothers’ perceptions of mHealth apps to inform development of a CBT-informed coping app.

Methods: A community advisory board (CAB) of mothers experiencing food insecurity (n=10) was recruited from community organizations across Oklahoma. Participants completed a series of 3 iterative Zoom semi-structured interviews (30–60 minutes each) exploring: (1) features and design, (2) proposed CBT-based messaging, and (3) engagement strategies. Interviews were conducted in English or Spanish approximately two weeks apart to allow intervention plan refinement (January 2026- March 2026). Transcripts were analyzed via rapid thematic analysis.

Results: Food insecurity was both a material challenge and a continuous psychological burden requiring coping. Seven participants had used mHealth apps, though many discontinued due to excessive notifications or limited relevance. Key themes included: (1) apps were most valued when they provided actionable, real-time support for daily decisions, like stress management; (2) sustained use depended on ease of integration into existing routines; and (3) personalization and supportive communication reduced fear of judgment. These insights informed modifications to the intervention plan, including fewer daily messages, increased personalization, and embedded resource navigation. Notably, many participants voluntarily expressed interest in using the app.

Conclusions: Mothers experiencing food insecurity saw a CBT-informed mHealth app as a promising stress-management tool. Engaging mothers in early design may increase relevance, offering a model for digital interventions in high-stress, resource-limited populations.

Funding Sources: Oklahoma Tobacco Settlement Endowment Trust (TSET) and the University of Oklahoma TSET Health Promotion Research Center