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Evaluation ViewAttendees 9

Technology/Digital Health
Symposia

Symposium 33 - Using Digital Interventions to Reduce Healthcare Access and Disparities Gaps

Friday, November 15, 2024
12:00 PM – 1:30 PM EST
Location: 305/306, Level 3, Downtown Marriott
CE: 1.5

Keywords: Telehealth/m-health, Treatment/ Program Design, Dissemination
Level of Familiarity: Moderate to advanced
Recommended Readings: Wilhelm, S., Weingarden, H., Ladis, I., Braddick, V., Shin, J., & Jacobson, N. C. (2020). Cognitive-behavioral therapy in the digital age: presidential address. Behavior Therapy, 51(1), 1-14.,   Schueller, S. M., Hunter, J. F., Figueroa, C., & Aguilera, A. (2019). Use of digital mental health for marginalized and underserved populations. Current Treatment Options in Psychiatry, 6, 243-255.,   Friis-Healy, E. A., Nagy, G. A., & Kollins, S. H. (2021). It is time to REACT: opportunities for digital mental health apps to reduce mental health disparities in racially and ethnically minoritized groups. JMIR mental health, 8(1), e25456,   ,  

Low access to mental healthcare is a leading public health concern. Treatment gaps are approximately 50-80%, and even larger for evidence-based care. These disparities are especially striking for those with clinical presentations requiring specialized, expert care; those within the sexual and gender minority (SGM) community; and those with historically minoritized racial and ethnic identities. Major barriers to care include lack of trained clinicians, structural barriers that disproportionately affect minoritized individuals, and limited evidence bases for culturally responsive treatments. Digital interventions offer one promising way to reduce healthcare disparities; however, they may only be useful insofar as they are tailored to the populations they aim to serve and are developed through community stakeholder involvement. This symposium will present new work from five scholars leveraging digital technology and multiple stakeholders' perspectives to reduce the healthcare access and disparities gaps for specialty clinical populations and historically minoritized individuals.
Consistent with this year’s conference theme, presenters will emphasize how principles of community engagement, advocacy, and innovation guide advancements in digital CBT programs. The first presenter will describe the process of culturally tailoring an online CBT for insomnia treatment for Black women through community-based partnerships. This RCT of 218 Black women highlights opportunities for how to avoid perpetuating healthcare disparities in digital spaces. The second and third presenters will then each present work from recent trials examining the efficacy and acceptability of coach-guided CBT apps for obsessive compulsive disorder (OCD; N = 120) and body dysmorphic disorder (BDD; N = 80), respectively. Among the first app-treatments for OCD and BDD—two conditions that are often turned away by non-specialist providers—their presentations highlight promising opportunities for reaching specialty and traditionally hard to reach, minoritized clinical populations with high fidelity digital treatments. The fourth presenter will then describe the skills impact and international reach of Psychiatry Academy's online, low-intensity training program for community clinicians new to CBT for BDD. This work reminds us that digital tools can also reduce barriers to BDD specialty care by increasing availability of trained providers. The fifth presenter will show that even brief, strengths-based interventions can have meaningful impacts with their work which found that adolescents in the LGBTQ+ community reported lower rates of internalized stigma following an online single session intervention. Finally, the discussant will lead a discussion focused on the opportunities and challenges of developing, disseminating, and implementing tailored, empirically supported digital interventions and training programs for specialty populations. This discussion will emphasize considerations for interventionists deciding whether and how to digitize existing full-protocol treatments, leverage a single session intervention framework, or tailor an existing digital intervention to best serve their target population.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Identify how to develop and tailor digital interventions to maximum relevancy and impact for different target populations.
  2. Discuss the multi-systemic factors contributing to disproportionately high rates of insomnia in Black women relative to other races and genders.
  3. Describe the components of app-CBT for Obsessive Compulsive Disorder and Body Dysmorphic Disorder and factors that may impact outcomes.
  4. Name two barriers and facilitators of online training for specialist clinical care.
  5. Compare and contrast the benefits and drawbacks of single session interventions versus full protocol app-based interventions.

Presentations:

  • 12:00 PM – 1:30 PM EST
    (SYM 33) The Role of Racial Discrimination in Medical Care: A Secondary Analysis into the Effect of Culturally Tailored, Internet-delivered CBT for Insomnia in Black Women

    Speaker: Katharine E. Daniel, M.A. (she/her/hers) – Massachusetts General Hospital / Harvard Medical School

    Co-author: Eric Zhou, PhD – Harvard Medical School

    Co-author: Lee Ritterband, PhD – University of Virginia School of Medicine

    Co-author: Vanessa Volpe, PhD – North Carolina State University

    Co-author: Traci Bethea, PhD – Georgetown University

  • 12:00 PM – 1:30 PM EST
    (SYM 33) Predicting Response to a Smartphone-based Cognitive-behavioral Therapy for Body Dysmorphic Disorder

    Speaker: Jennifer L. L. Greenberg, Psy.D. – Massachusetts General Hospital/Harvard Medical School

    Co-author: Hilary Weingarden, Ph.D. (she/her/hers) – Massachusetts General Hospital

    Co-author: Susanne S. Hoeppner, Ph.D., M.Ap.Stat. – Massachusetts General Hospital

    Co-author: Rebecca Berger-Gutierrez, B.A. – MGH/Harvard Medical School

    Co-author: Dalton Klare, M.A., M.S. (he/him/his) – Massachusetts General Hospital

    Co-author: Ivar Snorrason, PhD (he/him/his) – Massachusetts General Hospital / Harvard Medical School

    Co-author: Omar Costilla-Reyes, PhD – MIT

    Co-author: Morgan Talbot, MD/PhD Candidate – MIT

    Co-author: Katharine Daniel, MA – MGH/Harvard Medical School

    Co-author: Rachel Vanderkruik, PhD – MGH/Harvard Medical School

    Co-author: Armando Solar-Lezama, PhD – MIT

    Co-author: Oliver Harrison, MA, MBBS, MPH – Koa Health

    Co-author: Sabine Wilhelm, Ph.D. (she/her/hers) – Harvard Medical School

  • 12:00 PM – 1:30 PM EST
    (SYM 33) Efficacy of Guided Smartphone-based Cognitive Behavior Therapy vs. Healthwatch for Obsessive-compulsive Disorder: A Randomized Controlled Trial

    Speaker: Sabine Wilhelm, Ph.D. (she/her/hers) – Harvard Medical School

    Co-author: Sabine Wilhelm, Ph.D. (she/her/hers) – Harvard Medical School

    Co-author: Jennifer L. L. Greenberg, Psy.D. – Massachusetts General Hospital/Harvard Medical School

    Co-author: Ryan J. Jacoby, Ph.D. – Massachusetts General Hospital; Harvard Medical School

    Co-author: Hilary Weingarden, Ph.D. (she/her/hers) – Massachusetts General Hospital

    Co-author: Susanne S. Hoeppner, Ph.D., M.Ap.Stat. – Massachusetts General Hospital

    Co-author: Ivar Snorrason, PhD (he/him/his) – Massachusetts General Hospital / Harvard Medical School

    Co-author: Adam Jaroszewski, Ph.D. – Massachusetts General Hospital

    Co-author: Dalton Klare, M.A., M.S. (he/him/his) – Massachusetts General Hospital

    Co-author: Thomas McCoy, MD – Massachusetts General Hospital / Harvard Medical School

    Co-author: Oliver Harrison, MA, MBBS, MPH – Koa Health

  • 12:00 PM – 1:30 PM EST
    (SYM 33) Evaluating an Online Single-session Intervention Addressing Minority Stress Among LGBTQ+ Adolescents

    Speaker: Jenny Shen, M.A. (they/them/theirs) – Stony Brook University

    Co-author: Alex Rubin, M.A. (they/them/theirs) – University of Denver

    Co-author: Katherine Cohen, M.A. (she/her/hers) – Northwestern University Feinberg School of Medicine

    Co-author: Annie Hart, BS – University of Denver

    Co-author: Jenna Sung, M.A. – Stony Brook University

    Co-author: Riley McDanal, M.A. – Stony Brook University

    Co-author: Chantelle Roulston, BA – Northwestern University

    Co-author: Ian Sotomayor, B.A. (he/they) – Stony Brook University

    Co-author: Kathryn R. Fox, Ph.D. – University of Denver

    Co-author: Jessica L. Schleider, Ph.D. (she/her/hers) – Northwestern University

  • 12:00 PM – 1:30 PM EST
    (SYM 33) Disseminating Cognitive Behavioraltherapy for Body Dysmorphic Disorder: Evaluating the Efficacy of Online Therapist Training

    Speaker: Geneva Jonathan, Ph.D. (she/her/hers) – Massachusetts General Hospital

    Co-author: Jennifer L. L. Greenberg, Psy.D. – Massachusetts General Hospital/Harvard Medical School

    Co-author: Ryan J. Jacoby, Ph.D. – Massachusetts General Hospital; Harvard Medical School

    Co-author: Susan Sprich, PhD – Massachusetts General Hospital

    Co-author: Sabine Wilhelm, Ph.D. (she/her/hers) – Harvard Medical School