Mobile-Based Ecological Momentary Interventions for Grief in China and Switzerland: Protocol for a Collaborative and Iterative Qualitative App Development Study.

Background: Bereavement is a common and inevitable part of life. However, it is also difficult and disruptive. Prolonged grief disorder has recently been added to the International Classification of Diseases, 11th Revision, and the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Grief is a deeply cultural experience; however, most research about grief and grief intervention is conducted in Western, educated, industrialized, rich, and democratic (WEIRD) countries. Support for grief is often limited and difficult to access. We propose that ecological momentary interventions (EMIs) present an opportunity to widen access to grief support and develop culturally relevant interventions, given EMIs' easy accessibility and opportunity to offer self-help support in people's natural environments. Objective: This study aims to describe the development protocol of 2 EMIs for grief, one in China and one in Switzerland. he EMIs are intended for individuals seeking additional grief support without a diagnosis of prolonged grief disorder. The EMIs will be developed to be culturally relevant and appropriate for each country; therefore, contextual factors may prescribe slightly different protocols to fit the needs of each cultural group. Methods: Both interventions will be developed using a collaborative research approach. This means that the content for the app will be developed after consultation with grief experts, bereaved participants (potential end users), and the research team. After the initial content development, another round of feedback will be gathered to ensure acceptability. Results: Funding for both studies has been secured through a grant in 2024. The scoping phase for both WEIRD and non-WEIRD contexts has been completed. At the time of submission, both studies have started recruitment, and the Chinese study has conducted interviews with 17 bereaved participants. The next steps are to continue recruitment and data gathering, analyze the collected data, and extract important themes for intervention components, and then begin the app content development. Results are expected by the end of 2026 and will subsequently be prepared for publication. Conclusions: The study presents 2 similar but nonidentical development protocols for EMIs for grief support in 2 countries, where one is a WEIRD country and the other is a non-WEIRD country. Similarities and differences in the developmental process across both countries are discussed, along with challenges associated with adapting grief interventions into an EMI format.