Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 8, 2023
Open Peer Review Period: Jun 8, 2023 - Aug 3, 2023
Date Accepted: Jan 2, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Race and socioeconomic status as predictors of willingness to use internet-based treatments or face-to-face psychotherapy: Nationally representative survey study
ABSTRACT
Background:
There is an ongoing debate about whether digital mental health interventions (DMHIs) can reduce racial and socioeconomic inequities in access to mental health care. One key factor in this debate involves the extent to which racial and ethnic minoritized and socioeconomically disadvantaged individuals are willing to use, and pay for, DMHIs.
Objective:
We examined racial and ethnic as well as socioeconomic differences in participants’ willingness-to-pay (WTP) for DMHIs vs. face-to-face (F2F) therapy.
Methods:
We conducted a nationally representative survey of people in the United States (N = 423, women: n = 203, age: M = 45.36, SD = 16.25, Non-Hispanic White: n = 291) via Prolific. After reading descriptions of DMHIs and F2F-therapy, participants rated their willingness-to-try each treatment for 1) free, 2) for a small fee, 3) for a large fee (for F2F-therapy only), 4) as a maximum dollar amount, and 5) as a percentage of their total monthly income. At the end of the study there was a decision task to potentially receive more information about DMHIs and F2F-therapyWe conducted a nationally representative survey of people in the United States (N = 423, women: n = 203, age: M = 45.36, SD = 16.25, Non-Hispanic White: n = 291) via Prolific. After reading descriptions of DMHIs and F2F-therapy, participants rated their willingness-to-try each treatment for 1) free, 2) for a small fee, 3) for a large fee (for F2F-therapy only), 4) as a maximum dollar amount, and 5) as a percentage of their total monthly income. At the end of the study there was a decision task to potentially receive more information about DMHIs and F2F-therapy.
Results:
Race and ethnicity were associated with willingness to pay higher amounts of one’s income, as a percent or the dollars, and was also associated with information-seeking for DMHIs in the behavioral task. By and large, race and ethnicity was not associated with willingness to try F2F-therapy. Greater educational attainment was associated to willingness to try DMHIs for free, the decision to learn more about DMHIs, and willingness to pay for F2F therapy. Income was inconsistently associated to willingness to try DMHIs and F2F-therapy.
Conclusions:
DMHIs may reduce inequities by expanding access to mental healthcare for racial and ethnic minoritized individuals and economically disadvantaged groups, especially if they are available for free or at very low costs. Clinical Trial: N/A
Citation
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