Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation
BackgroundThe COVID-19 pandemic increased disparities for communities burdened by structural barriers such as reduced affordable housing, with mental health consequences. Limited data are available on digital resources for public mental health prevention during the COVID-19 p...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2022-12-01
|
| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2022/12/e42031 |
| _version_ | 1797734495618596864 |
|---|---|
| author | Kenneth Wells April Denise Thames Alexander S Young Lily Zhang MarySue V Heilemann Daniela Flores Romero Adrian Oliva Felica Jones Lingqi Tang Melissa Brymer Thomas Elliott Armen Arevian |
| author_facet | Kenneth Wells April Denise Thames Alexander S Young Lily Zhang MarySue V Heilemann Daniela Flores Romero Adrian Oliva Felica Jones Lingqi Tang Melissa Brymer Thomas Elliott Armen Arevian |
| author_sort | Kenneth Wells |
| collection | DOAJ |
| description |
BackgroundThe COVID-19 pandemic increased disparities for communities burdened by structural barriers such as reduced affordable housing, with mental health consequences. Limited data are available on digital resources for public mental health prevention during the COVID-19 pandemic.
ObjectiveThe study aim was to evaluate engagement in and impact of free digital resources on the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website during COVID-19 in California.
MethodsA pilot evaluation of T4W/Juntos was performed, with partner agencies inviting providers, clients, and partners to visit the website and complete surveys at baseline (September 20, 2021, to April 4, 2022) and at 4-6–week follow-up (October 22, 2021, to May 17, 2022). Website use was assessed by three engagement items (ease of use, satisfaction, relevance), comfort in use, and use of six resource categories. Primary outcomes at follow-up were depression and anxiety (scores≥3 on Patient Health Questionnaire-2 item [PHQ2] and Generalized Anxiety Disorder-2 item [GAD2] scales). Secondary outcomes were post-pre differences in PHQ2 and GAD2 scores, and use of behavioral health hotlines and services the month before follow-up.
ResultsOf 366 eligible participants, 315 (86.1%) completed baseline and 193 (61.3%) completed follow-up surveys. Of baseline participants, 72.6% identified as female, and 21.3% identified as lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+). In terms of ethnicity, 44.0% identified as Hispanic, 17.8% as African American, 26.9% as non-Hispanic white, and 11.4% as other ethnicity. Overall, 32.7% had moderate anxiety or depression (GAD2/PHQ2≥3) at baseline. Predictors of baseline website engagement included being Hispanic versus other race/ethnicity (β=.27, 95% CI .10-.44; P=.002) and number of COVID-19–related behavior changes (β=.09, 95% CI .05-.13; P<.001). Predictors of comfort using the website were preferring English for website use (odds ratio [OR] 5.57, 95% CI 2.22-13.96; P<.001) and COVID-19–related behavior changes (OR 1.37, 95% CI 1.12-1.66; P=.002); receiving overnight behavioral health treatment in the prior 6 months (OR 0.15, 95% CI 0.03-0.69, P=.015) was associated with less comfort in website use. The main predictor of depression at follow-up (PHQ2≥3) was baseline depression (OR 6.24, 95% CI 2.77-14.09; P<.001). Engagement in T4W/Juntos was associated with lower likelihood of depression (OR 0.54, 95% CI 0.34-0.86; P=.01). Website use the month before follow-up was associated with a post-pre reduction in PHQ2 score (β=–.62, 95% CI –1.04 to –0.20; P=.004). The main predictor of GAD2≥3 at follow-up was baseline GAD2≥3 (OR 13.65, 95% CI 6.06-30.72; P<.001). Greater baseline website engagement predicted reduced hotline use (OR 0.36, 95% CI 0.18-0.71; P=.004).
ConclusionsEthnicity/language and COVID-19–related behavior changes were associated with website engagement; engagement and use predicted reduced follow-up depression and behavioral hotline use. Findings are based on participants recommended by community agencies with moderate follow-up rates; however, significance was similar when weighting for nonresponse. This study may inform research and policy on digital mental health prevention resources. |
| first_indexed | 2024-03-12T12:45:13Z |
| format | Article |
| id | doaj.art-2c115fa855974b439726a4e6f8e1efb7 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-03-12T12:45:13Z |
| publishDate | 2022-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj.art-2c115fa855974b439726a4e6f8e1efb72023-08-28T23:24:18ZengJMIR PublicationsJMIR Formative Research2561-326X2022-12-01612e4203110.2196/42031Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered EvaluationKenneth Wellshttps://orcid.org/0000-0002-7454-6589April Denise Thameshttps://orcid.org/0000-0001-8414-7189Alexander S Younghttps://orcid.org/0000-0002-9367-9213Lily Zhanghttps://orcid.org/0000-0002-6251-6913MarySue V Heilemannhttps://orcid.org/0000-0001-5490-6076Daniela Flores Romerohttps://orcid.org/0000-0003-1731-3380Adrian Olivahttps://orcid.org/0000-0002-3565-8369Felica Joneshttps://orcid.org/0000-0002-7165-0401Lingqi Tanghttps://orcid.org/0000-0002-3636-9948Melissa Brymerhttps://orcid.org/0000-0002-2313-5616Thomas Elliotthttps://orcid.org/0000-0003-3172-9884Armen Arevianhttps://orcid.org/0000-0001-5508-4131 BackgroundThe COVID-19 pandemic increased disparities for communities burdened by structural barriers such as reduced affordable housing, with mental health consequences. Limited data are available on digital resources for public mental health prevention during the COVID-19 pandemic. ObjectiveThe study aim was to evaluate engagement in and impact of free digital resources on the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website during COVID-19 in California. MethodsA pilot evaluation of T4W/Juntos was performed, with partner agencies inviting providers, clients, and partners to visit the website and complete surveys at baseline (September 20, 2021, to April 4, 2022) and at 4-6–week follow-up (October 22, 2021, to May 17, 2022). Website use was assessed by three engagement items (ease of use, satisfaction, relevance), comfort in use, and use of six resource categories. Primary outcomes at follow-up were depression and anxiety (scores≥3 on Patient Health Questionnaire-2 item [PHQ2] and Generalized Anxiety Disorder-2 item [GAD2] scales). Secondary outcomes were post-pre differences in PHQ2 and GAD2 scores, and use of behavioral health hotlines and services the month before follow-up. ResultsOf 366 eligible participants, 315 (86.1%) completed baseline and 193 (61.3%) completed follow-up surveys. Of baseline participants, 72.6% identified as female, and 21.3% identified as lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+). In terms of ethnicity, 44.0% identified as Hispanic, 17.8% as African American, 26.9% as non-Hispanic white, and 11.4% as other ethnicity. Overall, 32.7% had moderate anxiety or depression (GAD2/PHQ2≥3) at baseline. Predictors of baseline website engagement included being Hispanic versus other race/ethnicity (β=.27, 95% CI .10-.44; P=.002) and number of COVID-19–related behavior changes (β=.09, 95% CI .05-.13; P<.001). Predictors of comfort using the website were preferring English for website use (odds ratio [OR] 5.57, 95% CI 2.22-13.96; P<.001) and COVID-19–related behavior changes (OR 1.37, 95% CI 1.12-1.66; P=.002); receiving overnight behavioral health treatment in the prior 6 months (OR 0.15, 95% CI 0.03-0.69, P=.015) was associated with less comfort in website use. The main predictor of depression at follow-up (PHQ2≥3) was baseline depression (OR 6.24, 95% CI 2.77-14.09; P<.001). Engagement in T4W/Juntos was associated with lower likelihood of depression (OR 0.54, 95% CI 0.34-0.86; P=.01). Website use the month before follow-up was associated with a post-pre reduction in PHQ2 score (β=–.62, 95% CI –1.04 to –0.20; P=.004). The main predictor of GAD2≥3 at follow-up was baseline GAD2≥3 (OR 13.65, 95% CI 6.06-30.72; P<.001). Greater baseline website engagement predicted reduced hotline use (OR 0.36, 95% CI 0.18-0.71; P=.004). ConclusionsEthnicity/language and COVID-19–related behavior changes were associated with website engagement; engagement and use predicted reduced follow-up depression and behavioral hotline use. Findings are based on participants recommended by community agencies with moderate follow-up rates; however, significance was similar when weighting for nonresponse. This study may inform research and policy on digital mental health prevention resources.https://formative.jmir.org/2022/12/e42031 |
| spellingShingle | Kenneth Wells April Denise Thames Alexander S Young Lily Zhang MarySue V Heilemann Daniela Flores Romero Adrian Oliva Felica Jones Lingqi Tang Melissa Brymer Thomas Elliott Armen Arevian Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation JMIR Formative Research |
| title | Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation |
| title_full | Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation |
| title_fullStr | Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation |
| title_full_unstemmed | Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation |
| title_short | Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation |
| title_sort | engagement use and impact of digital mental health resources for diverse populations in covid 19 community partnered evaluation |
| url | https://formative.jmir.org/2022/12/e42031 |
| work_keys_str_mv | AT kennethwells engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT aprildenisethames engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT alexandersyoung engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT lilyzhang engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT marysuevheilemann engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT danielafloresromero engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT adrianoliva engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT felicajones engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT lingqitang engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT melissabrymer engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT thomaselliott engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation AT armenarevian engagementuseandimpactofdigitalmentalhealthresourcesfordiversepopulationsincovid19communitypartneredevaluation |