Digital mental health interventions for college students of color: Understanding uptake and enhancing engagement

ABSTRACT

College students of color have significant mental health needs, but they are less likely to receive treatment than their white counterparts (Lin et al., 2022). Given students of color are a high need, understudied, and underserved group, increased attention to their mental health and strategies targeting mental health equity are imperative. Digital mental health interventions (DMHI) have been proposed as mechanisms for disparity reduction, and research indicates DMHI are effective in college student populations (Lattie et al., 2019). However, less is known about DMHI preferences, needs, and usage among students of color. Addressing pertinent questions about DMHI reach and uptake for this population can support efforts to advance health equity. This dissertation comprised two studies that explored the following research questions Can DMHI enhance racial/ethnic equity in college student mental health treatment receipt? (Study 1) What are key barriers to DMHI uptake for college students of color and what strategies might enhance DMHI uptake in this population? (Study 2). Study 1 evaluated racial/ethnic differences in mental health problems and treatment enrollment within a largescale screening and treatment research initiative on a diverse college campus. Results illustrated racial/ethnic differences in student depression, anxiety, and suicidality. Students of color were less likely to have received prior mental health treatment compared to white students but were no less likely to initiate digital and face-to-face treatment through the research initiative. DMHI uptake rates were comparable to prior studies, with just 8.7% of those eligible initiating use of the DMHI. Given these findings, Study 2 employed a modified Delphi design to generate expert consensus on barriers to DMHI uptake and strategies to improve uptake among college students of color. Cross-disciplinary experts (n=35) participated in a three-round survey. Results revealed important barriers to uptake, including factors associated with the user, program, technology, and environment. Strategies were coded within four implementation levels, including DMHI design, marketing and outreach, orientation and onboarding, and campus/community-level efforts. Analyses yielded a subset of promising strategies rated highly important and feasible. These findings provide guidance for future efforts focused on tailoring and implementing DMHI uptake strategies through co-creation with students of color. (PsycInfo Database Record (c) 2022 APA, all rights reserved)