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Technology/Digital Health
Usability, Relevance and Uptake of a Government-sponsored and Community Co-Designed Digital Mental Health Website during the COVID-19 Pandemic: A Focus on Latinx Adults
Blanche Wright, Ph.D.
T32 Postdoctoral Fellow
University of California Los Angeles
Los Angeles, California, United States
Lily Zhang, M.S.
Senior Statistician
Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA
Los Angeles, California, United States
Jocelyn Meza, Ph.D.
Assistant Professor In-Residence
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
Los Angeles, California, United States
Alexander Young, M.D., M.S.
Professor
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
Los Angeles, California, United States
Daniela Flores Romero, B.A.
Coordinator
Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA
Los Angeles, California, United States
Miriam Nuño, Ph.D.
Professor
Division of Biostatistics, University of California, Davis
Sacramento, California, United States
Elliott Housman-Turrubiate, M.A.
Program Manager
Center for Reducing Health Disparities, University of California, Davis Health, Sacramento, CA
Sacramento, California, United States
Sergio Aguilar-Gaxiola, M.D., Ph.D.
Professor
Clinical Internal Medicine, School of Medicine, University of California, Davis, Sacramento, CA; Center for Reducing Health Disparities, University of California, Davis Health, Sacramento, CA; Clinical and Translational Science Center, University of California, Davis Health, Sacramento, CA
Sacramento, California, United States
Kenneth Wellls, M.P.H., M.D.
Professor
Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA; Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA
Los Angeles, California, United States
Background: Latinx adults have higher odds of unmet mental health needs compared to other racial and ethnic groups (Thomeer et al., 2023; Walker et al., 2015). One promising solution to address access challenges is digital mental health tools such as self-help websites, which have been shown to enhance mental health knowledge, reduce stigma, and even improve mental health symptoms (Tay et al., 2018; Wells et al., 2022). Despite this early promise, participant engagement remains a critical challenge and there has been a large oversight of unique considerations for Latinx adults as end users (Schueller et al., 2019).
Objective: Guided by the Technology Acceptance Model and Behavioral Model for Vulnerable Populations Model, the study’s overarching objective is to characterize the within-group variation of engagement among Latinx adults with a government-funded, prevention-oriented mental health website that was co-designed with community partners during the COVID-19 pandemic.
Methods: The Together for Wellness/Juntos por Nuestro Bienestar website was co-designed with community organizations and offers free digital mental health resources, including those based on cognitive behavioral therapy, to support California adults in coping with the COVID-19 pandemic and maintaining their mental well-being. A pilot evaluation of the website involved completion of a baseline and 4-week follow-up survey about their background, user experience with the website, and behavioral health needs. The current sub-analysis focused on a stratified sample of Latinx adult participants (baseline n = 132; follow up n = 68). The baseline sample was mostly female (n=107, 81.68%) with 66.41% preferring to use the website in English and 30.53% preferring Spanish. We measured usability, relevance of the website, and past-month engagement with resources. Behavioral health needs were assessed using the Patient Health Questionnaire-2, Generalized Anxiety Disorder-2 and a COVID-19 stressors checklist. We analyzed the data using linear and logistic regression models.
Results: Latinx adults who preferred using the website in Spanish, compared to English (b=-1.64, p< .001), and those aged 50 and above (b=-.68, p=.04), reported lower comfort using the website. Higher perceived ease of using the website (b=.28, p< .001) and greater behavioral health needs (b=.13, p=.03) were positively associated with perceived relevance of website topics. Higher behavioral health needs were associated with greater odds of engaging with specific resources, such as those for anxiety/stress (OR=1.68, p=.02) and family resilience (OR=1.56, p=.02).
Conclusions: The current study addresses gaps in understanding Latinx adults’ experiences with digital mental health tools, and specifically with public mental health prevention-oriented websites. The language disparity in usability underscores the need to further enhance the user experience of Latinx Spanish speakers. Still, collaborative development of resource-rich websites with community organizations familiar with the needs of racial and ethnic minoritized groups can promote perceived relevance and engagement, particularly among Latinx users with higher behavioral health needs.