A systematic review of telehealth interventions for managing anxiety and depression in African American adults

McCall, Terika; Bolton, Clinton S.; Carlson, Rebecca; Khairat, Saif

doi:10.21037/mhealth-20-114

Cited by 9 publications

(8 citation statements)

References 31 publications

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“…Designing culturally appropriate tools and technology that enable and improve access requires adaptations to systems predominantly designed for White, English-speaking individuals. To that end, health systems can collect and incorporate input on telehealth tools and technologies from racialized groups and those with limited English proficiency [ 64 ], as evidence indicates that cultural and linguistic tailoring can improve healthcare access and outcomes [ 58 , 65 – 67 ]. Data collection and user testing should be done in a participatory manner in which cultural adaptations, and knowledge and language translation are co-designed with patients and/or research participants [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Differences in access to virtual and in-person primary care by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system

Govier

Cohen-Cline

Marsi

et al. 2022

BMC Health Serv Res

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Background Research exploring telehealth expansion during the COVID-19 pandemic has demonstrated that groups disproportionately impacted by COVID-19 also experience worse access to telehealth. However, this research has been cross-sectional or short in duration; geographically limited; has not accounted for pre-existing access disparities; and has not examined COVID-19 patients. We examined virtual primary care use by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system. We also assessed use of in-person primary care to understand whether disparities in virtual access may have been offset by improved in-person access. Methods Using a cohort design, electronic health records, and Centers for Disease Control and Prevention Social Vulnerability Index, we compared changes in virtual and in-person primary care use by race/ethnicity and community social vulnerability in the year before and after COVID-19 diagnosis. Our study population included 11,326 adult patients diagnosed with COVID-19 between March and July 2020. We estimated logistic regression models to examine likelihood of primary care use. In all regression models we computed robust standard errors; in adjusted models we controlled for demographic and health characteristics of patients. Results In a patient population of primarily Hispanic/Latino and non-Hispanic White individuals, and in which over half lived in socially vulnerable areas, likelihood of virtual primary care use increased from the year before to the year after COVID-19 diagnosis (3.6 to 10.3%); while in-person use remained stable (21.0 to 20.7%). In unadjusted and adjusted regression models, compared with White patients, Hispanic/Latino and other race/ethnicity patients were significantly less likely to use virtual care before and after COVID-19 diagnosis; Hispanic/Latino, Native Hawaiian/Pacific Islander, and other race/ethnicity patients, and patients living in socially vulnerable areas were also significantly less likely to use in-person care during these time periods. Conclusions Newly expanded virtual primary care has not equitably benefited individuals from racialized groups diagnosed with COVID-19, and virtual access disparities have not been offset by improved in-person access. Health systems should employ evidence-based strategies to equitably provide care, including representative provider networks; targeted, empowering outreach; co-developed culturally and linguistically appropriate tools and technologies; and provision of enabling resources and services.

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Section: Discussionmentioning

confidence: 99%

Differences in access to virtual and in-person primary care by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system

Govier

Cohen-Cline

Marsi

et al. 2022

BMC Health Serv Res

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“…The main results showed that both rehabilitation modalities produced significant positive results in terms of decreasing the levels of both psychological variables. In addition to this, the review conducted by McCall et al [ 84 ] found that delivering psychological telematic interventions resulted in a significant decrease in depressive symptoms but could not be proven to be effective in comparison to face-to-face psychological intervention. Anxiety symptoms could not be assessed.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Cuenca‐Martínez

Suso‐Martí

Herranz‐Gómez

et al. 2022

IJERPH

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Anxiety, depressive symptoms and stress have a significant influence on chronic musculoskeletal pain. Behavioral modification techniques have proven to be effective to manage these variables; however, the COVID-19 pandemic has highlighted the need for an alternative to face-to-face treatment. We conducted a search of PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, APA PsychInfo, and Psychological and Behavioural Collections. The aim was to assess the effectiveness of telematic behavioral modification techniques (e-BMT) on psychological variables in patients with chronic musculoskeletal pain through a systematic review with meta-analysis. We used a conventional pairwise meta-analysis and a random-effects model. We calculated the standardized mean difference (SMD) with the corresponding 95% confidence interval (CI). Forty-one randomized controlled trials were included, with a total of 5018 participants. We found a statistically significant small effect size in favor of e-BMT in depressive symptoms (n = 3531; SMD = −0.35; 95% CI −0.46, −0.24) and anxiety (n = 2578; SMD = −0.32; 95% CI −0.42, −0.21) with low to moderate strength of evidence. However, there was no statistically significant effect on stress symptoms with moderate strength of evidence. In conclusion, e-BMT is an effective option for the management of anxiety and depressive symptoms in patients with chronic musculoskeletal pain. However, it does not seem effective to improve stress symptoms.

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“…Also, transparency about who created and owns the app, and how users' data will be used and protected was recommended to establish trust. There is a paucity of peer-reviewed literature on interventions that used culturally-informed telehealth modalities to manage anxiety and depression among Black American adults, irrespective of physical health conditions (eg, HIV positive) or special circumstances (eg, caregiver of patient with dementia) (15). However, the recommendations produced by this study are consistent with those found in previous literature which highlights the need for educational, psychotherapy, and personal development components in a mental health app designed to help users manage anxiety and depression (16,17).…”

Section: Generational Differencesmentioning

confidence: 99%

Recommendations for design of a mobile application to support management of anxiety and depression among Black American women

McCall

Threats

Pillai

et al. 2022

Front. Digit. Health

Self Cite

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Black American women experience adverse health outcomes due to anxiety and depression. They face systemic barriers to accessing culturally appropriate mental health care leading to the underutilization of mental health services and resources. Mobile technology can be leveraged to increase access to culturally relevant resources, however, the specific needs and preferences that Black women feel are useful in an app to support management of anxiety and depression are rarely reflected in existing digital health tools. This study aims to assess what types of content, features, and important considerations should be included in the design of a mobile app tailored to support management of anxiety and depression among Black women. Focus groups were conducted with 20 women (mean age 36.6 years, SD 17.8 years), with 5 participants per group. Focus groups were led by a moderator, with notetaker present, using an interview guide to discuss topics, such as participants' attitudes and perceptions towards mental health and use of mental health services, and content, features, and concerns for design of a mobile app to support management of anxiety and depression. Descriptive qualitative content analysis was conducted. Recommendations for content were either informational (e.g., information to find a Black woman therapist) or inspirational (e.g., encouraging stories about overcoming adversity). Suggested features allow users to monitor their progress, practice healthy coping techniques, and connect with others. The importance of feeling “a sense of community” was emphasized. Transparency about who created and owns the app, and how users' data will be used and protected was recommended to establish trust. The findings from this study were consistent with previous literature which highlighted the need for educational, psychotherapy, and personal development components for mental health apps. There has been exponential growth in the digital mental health space due to the COVID-19 pandemic; however, a one-size-fits-all approach may lead to more options but continued disparity in receiving mental health care. Designing a mental health app for and with Black women may help to advance digital health equity by providing a tool that addresses their specific needs and preferences, and increase engagement.

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A systematic review of telehealth interventions for managing anxiety and depression in African American adults

Cited by 9 publications

References 31 publications

Differences in access to virtual and in-person primary care by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system

Differences in access to virtual and in-person primary care by race/ethnicity and community social vulnerability among adults diagnosed with COVID-19 in a large, multi-state health system

Effectiveness of Telematic Behavioral Techniques to Manage Anxiety, Stress and Depressive Symptoms in Patients with Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis

Recommendations for design of a mobile application to support management of anxiety and depression among Black American women

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