Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 15, 2023
Date Accepted: Nov 26, 2024
Relative Preference for In-Person, Telehealth, Digital, and Pharmacologic Mental Health Care Post COVID-19: Moderation by Age and Depressed Mood
ABSTRACT
Background:
Most adults and children in the United States fail to receive timely care for mental health symptoms, with even worse rates of care access for individuals who belong to racial and/or ethnic minority groups. Digital (i.e., app-based) care has proven to be an efficacious and empirically-supported treatment option with the potential to address low rates of care and reduce care disparities, yet little is known about the relative preference for such treatment. Furthermore, the rapid adoption of telehealth-based care during the COVID-19 pandemic may have shifted care preferences.
Objective:
The goal of the current study was to examine relative treatment preference for four different types of mental health care: in-person psychological care, virtual psychological care, app-based treatment, or pharmacologic care. Care preferences were also examined relative to potential predictors of care utilization (i.e., gender, race, age, stigma, discrimination, and level of shame).
Methods:
In this cross-sectional online survey study of adults (N=237, mean age 35 years, range 19 to 68 years), we ranked four mental health care modalities based on care preference: (1) in-person care, (2) telehealth care, (3) app-based care, and (4) pharmacologic care. Preference for treatment modality was assessed based on vignette presentation for generalized anxiety disorder (GAD) and insomnia. Additionally, participants completed self-report questionnaires for demographics, symptom severity, and psychological and stigma-related variables.
Results:
We found no difference in overall preference for in-person versus both telehealth and app-based care. For both GAD and insomnia, participants preferred in-person care to telehealth care, although this finding was attenuated amongst older participants for insomnia vignettes. Participants’ depressed mood was associated with greater relative preference for pharmacologic care. There was no evidence of differential preference for app-based care according to demographics, symptom severity, or psychological and stigma-related variables.
Conclusions:
These results support the broader-based acceptability of app-based care relative to in-person or telehealth treatment.
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.