Engagement, Use and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation (Preprint)

BACKGROUND The COVID-19 pandemic increased disparities for communities burdened by structural barriers, such as shortage of affordable housing or work opportunities, with mental health consequences. These impacts are noted across age groups, with mental health consequences. OBJECTIVE To evaluate engagement in and impact of free, digital mental health resources, Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) developed with stakeholder input to support well-being during COVID-19 in California. METHODS T4W/Juntos was evaluated by stakeholder groups inviting providers, clients and partners to visit website and complete surveys at baseline (9/20/21-4/4/22) and 4-6 week follow-up (10/22/21-5/17/22). Engagement in website use was assessed by mean of three items (ease of use, satisfaction, relevance), comfort in use, and actual use (any and across six resource categories). Outcomes at follow up were depression (PHQ2) and anxiety (GHQ2) symptoms (primary); and behavioral health hotlines and services use (secondary). Multiple regression was used to identify predictors. Of 366 eligible, 315 (86.1%) completed baseline and 193 (61.3%) completed follow-up. RESULTS Mean baseline website engagement was associated with Hispanic ethnicity, English language preference for website, and COVID behavior changes; and those with more COVID behavior changes reported greater comfort using the website, each p<=.002. Greater website engagement was associated with less follow-up depression (PHQ2>=3) (p=.01); and website use predicted reduced pre-post PHQ2 score (p=.004). Greater engagement and comfort using the website predicted reduced follow-up hotline use (each p<.05). CONCLUSIONS Ethnicity/language and COVID behavior changes were associated with website engagement, which predicted reduced follow-up depressive symptoms and hotline use. Findings may inform future research and policy on digital resources. CLINICALTRIAL Not applicable