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数字健康能否改善灾难后拉丁裔心理健康的公平性?来自一项针对2017年和2018年飓风幸存者的随机试验的证据。

Does digital health improve equity for Latine mental health after a disaster? Evidence from a randomized trial with 2017 and 2018 hurricane survivors.

作者信息

Andrews Arthur R, Acosta Laura M, Perez Villagomez Laura, Davison Tatiana M, Galea Sandro, Ruggiero Kenneth J

机构信息

Department of Psychology, University of Nebraska-Lincoln.

College of Nursing, Medical University of South Carolina.

出版信息

Psychol Trauma. 2025 Aug 7. doi: 10.1037/tra0001980.

DOI:10.1037/tra0001980
PMID:40773341
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12333541/
Abstract

OBJECTIVE

Despite experiencing traumatic events at a higher rate, Latine populations receive mental health services at a lower rate than non-Latine Whites (Center for Behavioral Statistics & Quality, 2018). Digital mental health tools, including mobile applications ("apps") are frequently proposed as solutions for addressing care access disparities, but significant research gaps remain to identify if and how existing tools may be used to address disparities.

METHOD

We utilized data from a randomized clinical trial of Bounce Back Now (BBN), a mobile self-help app with 1,357 hurricane survivors from the 2017 and 2018 hurricane seasons. The resulting sample was 49.5% Latine, offering unique opportunities for important comparisons.

RESULTS

Across multiple components of the BBN, use was not significantly different between Latine and non-Latine participants ( > .05). Efficacy was also similar based on latent change score models ( > .05). Latine participants reported higher education, similar rates of past-month mental health access, and higher rates of past-month counseling/therapy compared with non-Latine Whites. Approximately, half of Latine and non-Latine participants with significant symptoms had not received mental health care in the last month.

CONCLUSIONS

Together, results suggest that BBN resulted in similar rates of use and efficacy, and BBN reached a substantial proportion of those who were not receiving care across both non-Latine White and Latine participants. We outline additional suggestions for enhancing the capacity for tools like BBN to help address mental health equity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

尽管拉丁裔人群经历创伤事件的比例更高,但他们接受心理健康服务的比例低于非拉丁裔白人(行为统计与质量中心,2018年)。包括移动应用程序(“应用”)在内的数字心理健康工具经常被提议作为解决医疗服务获取差距的解决方案,但在确定现有工具是否以及如何用于解决差距方面仍存在重大研究空白。

方法

我们利用了“立即恢复”(BBN)这一移动自助应用程序的随机临床试验数据,该应用程序的参与者为来自2017年和2018年飓风季节的1357名飓风幸存者。最终样本中49.5%为拉丁裔,这为进行重要比较提供了独特机会。

结果

在BBN的多个组成部分中,拉丁裔和非拉丁裔参与者的使用情况没有显著差异(p>.05)。基于潜在变化分数模型,疗效也相似(p>.05)。与非拉丁裔白人相比,拉丁裔参与者报告的教育程度更高,过去一个月获得心理健康服务的比例相似,过去一个月接受咨询/治疗的比例更高。大约一半有明显症状的拉丁裔和非拉丁裔参与者在上个月没有接受心理健康护理。

结论

总体而言,结果表明BBN的使用和疗效比例相似,并且BBN覆盖了相当比例的未接受护理的非拉丁裔白人和拉丁裔参与者。我们概述了其他建议,以增强像BBN这样的工具帮助解决心理健康公平问题的能力。(《心理学文摘数据库记录》(c)2025美国心理学会,保留所有权利)

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本文引用的文献

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Randomized Controlled Trial of "Bounce Back Now," a Mobile App to Reduce Post-Disaster Symptoms of Posttraumatic Stress, Depressed Mood, and Sleep Disturbance.“立即恢复”移动应用程序用于减轻灾后创伤后应激、情绪低落和睡眠障碍症状的随机对照试验。
Am J Psychiatry. 2025 May 1;182(5):463-472. doi: 10.1176/appi.ajp.20240232.
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Posttraumatic stress among trauma-exposed Hispanic/Latinx adults: relations to mental health.创伤后应激障碍在创伤暴露的西班牙裔/拉丁裔成年人中的表现:与心理健康的关系。
Cogn Behav Ther. 2023 Jul;52(4):317-330. doi: 10.1080/16506073.2023.2176783. Epub 2023 Feb 14.
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Impact of guidance on intervention adherence in computerised interventions for mental health problems: a meta-analysis.计算机化干预措施治疗心理健康问题时,指导对干预依从性的影响:一项荟萃分析。
Psychol Med. 2022 Jan;52(2):229-240. doi: 10.1017/S0033291721004621. Epub 2021 Nov 22.
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Marketplace and Literature Review of Spanish Language Mental Health Apps.西班牙语心理健康应用程序的市场与文献综述
Front Digit Health. 2021 Feb 15;3:615366. doi: 10.3389/fdgth.2021.615366. eCollection 2021.
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