JMIR Publications

ABSTRACT

Background:

Latino/a/x adults have higher rates of unmet mental health needs compared to other racial and ethnic groups. One promising solution to help bridge this gap in care are digital mental health tools. Digital tools, such as self-help websites and videos, have demonstrated the ability to enhance mental health literacy, reduce stigma, and improve mental health symptoms. Despite the potential benefits, participant engagement remains a critical challenge, and there has been a large oversight of unique considerations for Latino/a/x adults as end users.

Objective:

Guided by the Technology Acceptance Model and Behavioral Model for Vulnerable Populations, the study’s overarching objective is to characterize within-group variation of engagement among Latino/a/x adults with a government-funded, prevention-focused mental health website that was co-designed, in part, with community partners during the COVID-19 pandemic.

Methods:

The Together for Wellness/Juntos Por Nuestro Bienestar (T4W/Juntos) website offers free digital mental health resources to help Californians cope with the COVID-19 pandemic and maintain their mental well-being. A pilot evaluation of the website involved baseline and 4-week follow-up surveys about participants’ demographics, behavioral health needs, and overall website user experience. The current sub-analysis 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, 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.

Results:

Latino/a/x adults who preferred using the website in English (OR 13.76, P<.001) compared to Spanish were more comfortable using the website. Compared to adults aged 18-30 years, adults aged 41-50 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/stress at follow-up (OR 1.42, P=.047).

Conclusions:

The current 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.