Racial Differences in the Effectiveness of Internet-Delivered Mental Health Care

被引:6
|
作者
Jonassaint, Charles R. [1 ,2 ]
Belnap, Bea Herbeck [1 ,3 ]
Huang, Yan [4 ,5 ]
Karp, Jordan F. [5 ,6 ]
Abebe, Kaleab Z. [4 ]
Rollman, Bruce L. [1 ]
机构
[1] Univ Pittsburgh, Ctr Behav Hlth & Smart Technol, Pittsburgh, PA USA
[2] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA
[3] Univ Gottingen, Med Ctr, Dept Psychosomat Med & Psychotherapy, Gottingen, Germany
[4] Univ Pittsburgh, Ctr Res Hlth Care, Ctr Data, Pittsburgh, PA USA
[5] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA
[6] VA Pittsburgh Hlth Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA
基金
美国医疗保健研究与质量局;
关键词
anxiety; cognitive behavioral therapy; depression; eHealth; healthcare disparities; mental health; minority health; COGNITIVE-BEHAVIORAL THERAPY; PSYCHOLOGICAL TREATMENTS; NATIONAL-SURVEY; DEPRESSION; ANXIETY; DISORDERS; INTERVENTION; DISPARITIES; PREVALENCE; RACE;
D O I
10.1007/s11606-019-05542-1
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Computerized cognitive behavioral therapy (cCBT) can improve mental health outcomes in White populations; however, it is unknown whether racial and ethnic minority populations receive clinical benefits from cCBT. Objective To study race differences in the impact of cCBT use on mental health outcomes among White and African American primary care patients. Design Secondary analysis of a three-arm randomized controlled clinical trial. Participants Primary care physicians (PCPs) referred 2,884 patients aged 18-75; 954 met eligibility criteria (including elevated mood and/or anxiety symptoms indicated as a score >= 10 on Patient Health Questionnaire or Generalized Anxiety Disorder scale); 704 were randomized in 3:3:1 ratio to receive either (1) the cCBT program (cCBT-only), (2) cCBT plus access to an Internet Support Group (cCBT+ISG), or (3) their PCP's usual care (UC). After exclusions, this study analyzed 689 patients: 590 receiving cCBT, in the combined cCBT-only and cCBT+ISG groups (91 African American, 499 White), and 99 receiving UC (22 African American, 77 White). Intervention(s) We used the Beating the Blues cCBT program that consisted of eight 50-min Internet-delivered interactive sessions and "homework" assignments to complete between weekly sessions. College graduate-level care coaches provided six months of remote support. Main Measure(s) After prior analyses demonstrated no effect of the ISG program, we combined the cCBT-only and cCBT+ISG groups (cCBT) to compare to UC at 6-month follow-up. Controlling for sociodemographic factors, baseline symptoms, and treatment arm, we examined race differences for impact of cCBT versus UC on the mental health-related quality-of-life (Short-form 12 Health Survey), and Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety, and depression. Results Compared to UC, cCBT had no effect on quality of life (d = 0.10; p = 0.40), depression (d = - 0.19; p = 0.10), or anxiety (d = - 0.16; p = 0.18) for Whites. However, for African American patients, cCBT was associated with significant 6-month decrease in depression (d = - 0.47, p < 0.01) and anxiety scores (d = - 0.54, p < 0.01). Conclusions cCBT may be an efficient and scalable first step to eliminating disparities in mental health care.
引用
收藏
页码:490 / 497
页数:8
相关论文
共 50 条
  • [31] Internet-delivered psychotherapy for depression in adults
    Titov, Nickolai
    CURRENT OPINION IN PSYCHIATRY, 2011, 24 (01) : 18 - 23
  • [32] Internet-delivered psychological intervention for insomnia
    Shih, Pei-Chun
    Marchena, Carlos
    Montoro, Alejandra
    Calero Elvira, Ana
    INTERNATIONAL JOURNAL OF PSYCHOLOGY, 2012, 47 : 437 - 437
  • [33] Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial
    Risor, Bettina Wulff
    Frydendal, Ditte Hoffmann
    Villemoes, Marie Konge
    Nielsen, Camilla Palmhoj
    Rask, Charlotte Ulrikka
    Frostholm, Lisbeth
    PHARMACOECONOMICS-OPEN, 2022, 6 (02) : 179 - 192
  • [34] INFORMING THE DEVELOPMENT OF AN INTERNET-DELIVERED MENTAL HEALTH PROGRAM FOR HEALTHY SIBLINGS OF CHILDREN WITH CYSTIC FIBROSIS: A QUALITATIVE STUDY
    Shivak, S. M.
    Power, H. A.
    Schmitz, T.
    Switzer, H.
    Genoe, R.
    Sharpe, D.
    Wright, K. D.
    PEDIATRIC PULMONOLOGY, 2019, 54 : S418 - S418
  • [35] Cost Effectiveness of Internet-Delivered Acceptance and Commitment Therapy for Patients with Severe Health Anxiety: A Randomised Controlled Trial
    Bettina Wulff Risør
    Ditte Hoffmann Frydendal
    Marie Konge Villemoes
    Camilla Palmhøj Nielsen
    Charlotte Ulrikka Rask
    Lisbeth Frostholm
    PharmacoEconomics - Open, 2022, 6 : 179 - 192
  • [36] The impact of internet-delivered cognitive behavioural therapy for health anxiety on cyberchondria
    Newby, Jill M.
    McElroy, Eoin
    JOURNAL OF ANXIETY DISORDERS, 2020, 69
  • [37] Internet-delivered mindfulness-based interventions for mental health outcomes among perinatal women: A systematic review
    Mao, Fangxiang
    Sun, Yaoyao
    Li, Yang
    Cui, Naixue
    Cao, Fenglin
    ASIAN JOURNAL OF PSYCHIATRY, 2023, 80
  • [38] RACIAL DIFFERENCES IN THE EFFECTIVENESS OF COMPUTERIZED COGNITIVE BEHAVIORAL THERAPY FOR MENTAL HEALTH DISORDERS
    Jonassaint, Charles R.
    Belnap, Bea
    Rollman, Bruce L.
    PSYCHOSOMATIC MEDICINE, 2019, 81 (04): : A142 - A142
  • [39] The effectiveness of internet-delivered cognitive behavioural therapy for those with bulimic symptoms: A systematic review
    Pittock A.
    Hodges L.
    Lawrie S.M.
    BMC Research Notes, 11 (1)
  • [40] Initial findings on RESTORE for healthcare workers: an internet-delivered intervention for COVID-19-related mental health symptoms
    Kathryn Trottier
    Candice M. Monson
    Debra Kaysen
    Anne C. Wagner
    Rachel E. Liebman
    Susan E. Abbey
    Translational Psychiatry, 12