Evaluation of inclusive patient education videos on mental health(care) by migrants in Europe: An Mhealth4all think-aloud study

Migrants face higher risks of developing mental health issues, such as posttraumatic stress disorder and psychosis, compared to individuals without a migrant or refugee background. However, they can encounter significant barriers to accessing mental healthcare, due to language difficulties, lack of interpreters, cultural stigma and system-related barriers. Furthermore, limited knowledge of the healthcare system further restrict access. Providing culturally tailored online multilingual health materials can enhance their access to mental healthcare, with co-created animated videos being a promising medium. Therefore, this study aimed to: 1) identify key factors influencing the evaluation of mental health educational videos by migrantsand their healthcare providers, focusing on critical mental health themes, and 2) actively involve these groups in in co-creating the videos based on feedback. Eight animated videos were developed through an iterative process involving the entire multidisciplinary MHealth4all consortium, including numerous feedback sessions. The videos were evaluated by using a hybrid approach that combined think-aloud observations and interviews with migrants (N = 38) and their healthcare providers (N =33). Thematic coding of the verbatim transcribed interviews revealed four essential aspects: comprehensibility, attractiveness, reliability, and relevance, with specific elements identified for both migrants and for their healthcare providers. These insights can guide the creation of effective health information materials for migrants facing mental health challenges.