Usability, Relevance, and User Engagement of a Government-Sponsored and Community Co-Designed Digital Mental Health Website During the COVID-19 Pandemic: A Pilot Study on Latino/a/x Adults.

内容摘要

Latino/a/x adults have higher rates of unmet mental health needs than other racial and ethnic groups. One promising solution to help bridge this gap in care is digital mental health tools. Digital tools, such as self-help websites, have demonstrated the ability to enhance mental health literacy, reduce stigma, and improve mental health symptoms. Despite the potential benefits, engagement remains a critical challenge, and there has been a large oversight of unique considerations for Latino/a/x adults as end users. Guided by the Technology Acceptance Model and the Behavioral Model for Vulnerable Populations, the study's overarching objective is to characterize within-group variation of Latino/a/x adults' engagement with a government-funded, prevention-focused mental health website that was co-designed with community partners during the COVID-19 pandemic. The Together for Wellness/Juntos Por Nuestro Bienestar (T4W/Juntos) website offered free digital mental health resources to help Californians cope with the COVID-19 pandemic. A pilot evaluation of the website involved baseline and 4-week follow-up surveys about demographics, behavioral health needs, and overall website user experience. This current subanalysis focused on a stratified sample of Latino/a/x adult participants (baseline N=131; baseline and follow-up n=68). The baseline sample was mostly female (106/130, 81.5%); 66.9% (87/130) preferred to use the website in English and 30% (39/130) preferred Spanish. Behavioral health needs were assessed using the Patient Health Questionnaire-2, Generalized Anxiety Disorder 2-item scale, and a COVID-19 stressors checklist. We measured usability, comfort using the website, relevance of the website, and past-month use of resources. Data were analyzed using ordered and standard logistic regression methods. Latino/a/x adults who preferred using the website in English (odds ratio [OR] 13.76, P<.001) compared with Spanish were more comfortable using the website. Compared with adults aged 18-30 years, adults aged 41-50 years had significantly lower odds of agreeing that the website was easy to use. Sensitivity analyses revealed that participants who found the website easier to use (OR 2.22, P=.001) and those with greater behavioral health needs (OR 1.22, P=.045) were more likely to perceive the website's topics as relevant. Participants with higher behavioral health needs at baseline were more likely to use the website and engage with resources for anxiety or stress at follow-up (OR 1.42, P=.047). This study addresses gaps in understanding Latino/a/x adults' experiences with a prevention-focused mental health website. The language-based disparity in comfort highlights the need to significantly improve the user experience for Latino/a/x Spanish speakers. Still, the website can be a helpful resource for Latino/a/x adults with high behavioral health needs, bridging a critical gap in support. A collaborative approach to developing resource-rich websites with trusted community organizations is vital for effectively reaching Latino/a/x communities and tailoring resources to address their unique needs.