Department of Psychology, Georgia State University.
Department of Psychology, Lawrence University.
J Consult Clin Psychol. 2022 Oct;90(10):717-733. doi: 10.1037/ccp0000759. Epub 2022 Oct 13.
Digital mental health interventions (DMHIs) are typically designed as "one-size fits all" which may perpetuate health disparities for racialized minorities. This systematic review identified culturally adapted DMHIs and examined their efficacy and acceptability among racial and ethnic minorities.
PsycINFO, Web of Science, and Pubmed databases were searched between 2000 and 2021. Studies that examined the development or impact of a culturally adapted DMHI for racial or ethnic minority populations using quantitative and/or qualitative methodologies were included. Meta-analyses explored the efficacy of DMHIs, and moderator analyses were used to identify differences in effect sizes due to study quality, clinical outcomes, therapist support, and attrition.
Thirty-two studies met inclusion criteria and were reviewed. DMHIs were deemed acceptable and feasible in most studies ( = 24). Among eligible randomized controlled studies ( = 12) comprising 653 participants, results indicated that culturally adapted DMHIs produced a large, positive, significant effect ( = 0.90) across a range of outcomes when compared to wait-list and treatment as usual control conditions. The average attrition rate per study was 42%, and most participants did not complete all modules despite reporting high satisfaction.
Culturally adapted DMHIs are efficacious and acceptable. Such interventions represent a powerful opportunity to circumvent barriers to mental health treatment and improve mental health equity among racially and ethnically minoritized communities. However, the prevalence of feasibility studies, lack of active comparison treatments-and limited research for Black and Indigenous populations-indicate that more research is needed to achieve this purpose. Recommendations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
数字心理健康干预（DMHIs）通常设计为“一刀切”，这可能会使少数族裔的健康差距永久存在。本系统评价确定了文化适应性 DMHI，并研究了它们在种族和族裔少数群体中的疗效和可接受性。
在 2000 年至 2021 年期间，在 PsycINFO、Web of Science 和 Pubmed 数据库中进行了搜索。纳入了使用定量和/或定性方法研究文化适应性 DMHI 对种族或族裔少数群体发展或影响的研究。元分析探讨了 DMHIs 的疗效，采用调节分析来识别由于研究质量、临床结局、治疗师支持和脱落而导致的效应大小差异。
32 项研究符合纳入标准并进行了审查。大多数研究（n=24）认为 DMHIs 是可以接受和可行的。在符合条件的包括 653 名参与者的 12 项随机对照研究中，结果表明，与等待名单和常规治疗对照组相比，文化适应性 DMHIs 在一系列结局上产生了较大的、积极的、显著的效果（n=12，效应量=0.90）。每个研究的平均脱落率为 42%，尽管大多数参与者报告满意度较高，但他们并未完成所有模块。
文化适应性 DMHIs 是有效的和可接受的。这种干预措施代表了一个克服心理健康治疗障碍和改善少数族裔社区心理健康公平的有力机会。然而，可行性研究的流行、缺乏积极的对照治疗-以及针对黑人和土著人口的有限研究-表明，需要进行更多的研究来实现这一目标。讨论了建议。
