Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 20, 2024
Date Accepted: Oct 27, 2025
Warning: This is an author submission that is not peer-reviewed or edited.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.
Addressing the need for culturally-tailored telemental healthcare linkage for Indigenous populations: Protocol for a pilot evaluation of Shocktalk
ABSTRACT
Background:
Urban Indigenous populations face disproportionate mental health challenges, including high rates of PTSD, depression, and substance use disorders, yet they have limited access to health services, especially culturally relevant care. The mechanism for providing care to Indigenous people in the US, the Indian Health Service (IHS), is significantly underfunded. and only accessible to certain Indigenous people. With over 70% of Indigenous individuals in the U.S. living in urban settings, there is a growing need for innovative healthcare solutions.
Objective:
This manuscript presents a protocol for evaluating ShockTalk, a culturally tailored telemental health linkage application designed to improve mental health care access for urban Indigenous populations. This study outlines the development and pilot study of ShockTalk.
Methods:
The conceptual framework is based on the Behavioral Model of Health Care Utilization. ShockTalk uses AI to connect clients with Indigenous or culturally aligned therapists and facilitates access to care via Facebook Messenger. Using a pre/post waitlist design, 5 participant clients will be admitted to the study at first and 5 additional at 3months. Data collection includes pre/post surveys on client attitudes towards mental health treatment and trust in the ShockTalk platform at baseline and 3 month follow up, followed by in-depth qualitative interviews at 3 months. A cost-effectiveness analysis will assess the impact of varying levels of treatment engagement on client outcomes.
Results:
This pilot study will offer insights into optimizing technology-based, culturally relevant mental health care. By examining varying levels of engagement and associated costs, the research seeks to identify the most effective and cost-efficient strategies for improving mental health outcomes in urban Indigenous populations. ShockTalk has the potential to shape future healthcare innovations in this field.
Conclusions:
Findings are expected to contribute significantly to Indigenous mental health care by offering insights into sustainable, accessible, and culturally appropriate telehealth interventions, guiding future policy and practice.
Citation
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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.