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Accepted for/Published in: JMIR Formative Research

Date Submitted: Jul 2, 2025
Open Peer Review Period: Jul 9, 2025 - Sep 3, 2025
Date Accepted: Nov 18, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Reach, Engagement, and Acceptability of a Subclinical Telehealth Service for Spanish-Speaking Adults: Retrospective Mixed Methods Pilot Study

Arévalo Avalos M, Fu J, Suarez L

Reach, Engagement, and Acceptability of a Subclinical Telehealth Service for Spanish-Speaking Adults: Retrospective Mixed Methods Pilot Study

JMIR Form Res 2025;9:e80026

DOI: 10.2196/80026

PMID: 41474647

PMCID: 12755293

Warning: This is an author submission that is not peer-reviewed or edited.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.

Innovating Mental Health Support for Spanish-Speaking Communities: A Mixed-Methods Retrospective Pilot Study of Sanarai a Digital Mental Health Company

  • Marvyn Arévalo Avalos; 
  • Julio Fu; 
  • Luis Suarez

ABSTRACT

Background:

There is a gap in mental health care among Latino/x and Spanish speaking communities and the care that is available is often difficult to access, lacks cultural nuance, and results in low engagement and satisfaction.

Objective:

This mixed-methods retrospective pilot study is to evaluate the reach, adoption, and acceptability of digital Spanish-language psychosocial and emotional wellness services among Latino/x adults offered by the digital health company Sanarai.

Methods:

Data included in this study were collected between Aug 2020 – Sept 2024 by Sanarai as part of its ongoing services. Quantitative data sources included individual customer’s appointments data, individual sessions payment data, and customer satisfaction data. Qualitative data were obtained from transcribed notes of telephone or video-based user interviews conducted by Sanarai staff between Aug 2020 – May 2024.

Results:

Sanarai served 6,163 users (59.4% female) across all 50 U.S. states with the highest concentration of participants in Texas and California. Results showed 94% of users scheduled a first appointment within one week, with 43% doing so within one day. Over 62% of participants engaged in two or more sessions, attending an average of 8.94 sessions over 110 days. The platform delivered a total of 36,858 appointments, including individual and couples’ sessions. Session satisfaction was high with an average satisfaction rating of 4.88/5.0 and a Net Promoter Score of +85. Nearly all respondents (95.1%) expressed intent to schedule another session. Qualitative interviews with 30 users (70% female) revealed a diverse user base. Many users reported prior mental health service experiences, while one-third were new to care. Participants cited cost, cultural fit, language access, and convenience as key reasons for choosing Sanarai over local services. Users highlighted the platform’s affordability, scheduling flexibility, and provider professionalism as central to their positive experiences.

Conclusions:

These findings underscore the value of culturally responsive, accessible online mental health care for Spanish-speaking communities. Clinical Trial: n/a


 Citation

Please cite as:

Arévalo Avalos M, Fu J, Suarez L

Reach, Engagement, and Acceptability of a Subclinical Telehealth Service for Spanish-Speaking Adults: Retrospective Mixed Methods Pilot Study

JMIR Form Res 2025;9:e80026

DOI: 10.2196/80026

PMID: 41474647

PMCID: 12755293

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