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

Jonassaint, Charles R.; Belnap, Bea Herbeck; Huang, Yan; Karp, Jordan F.; Abebe, Kaleab Z.; Rollman, Bruce L.

doi:10.1007/s11606-019-05542-1

Cited by 13 publications

(8 citation statements)

References 40 publications

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“…Twenty-six trials (reported in 36 publications) among primary care patients (eTables 8-9 in the Supplement) and 18 existing systematic reviews (not limited to primary care populations) (eTables 10-11 in the Supplement) addressed treatment for anxiety. Twenty-four of the included RCTs (n = 5307) examined psychological interventions and 2 (n = 423) examined pharmacological interventions.…”

Section: Resultsmentioning

confidence: 99%

Anxiety Screening

O’Connor

Henninger

Perdue

et al. 2023

JAMA

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ImportanceAnxiety is commonly seen in primary care and associated with substantial burden.ObjectiveTo review the benefits and harms of screening and treatment for anxiety and the accuracy of instruments to detect anxiety among primary care patients.Data SourcesMEDLINE, PsychINFO, Cochrane library through September 7, 2022; references of existing reviews; ongoing surveillance for relevant literature through November 25, 2022.Study SelectionEnglish-language original studies and systematic reviews of screening or treatment compared with control conditions and test accuracy studies of a priori–selected screening instruments were included. Two investigators independently reviewed abstracts and full-text articles for inclusion. Two investigators independently rated study quality.Data Extraction and SynthesisOne investigator abstracted data; a second checked accuracy. Meta-analysis results were included from existing systematic reviews where available; meta-analyses were conducted on original research when evidence was sufficient.Main Outcomes and MeasuresAnxiety and depression outcomes; global quality of life and functioning; sensitivity and specificity of screening tools.ResultsOf the 59 publications included, 40 were original studies (N = 275 489) and 19 were systematic reviews (including ≈483 studies [N≈81 507]). Two screening studies found no benefit for screening for anxiety. Among test accuracy studies, only the Generalized Anxiety Disorder (GAD) GAD-2 and GAD-7 screening instruments were evaluated by more than 1 study. Both screening instruments had adequate accuracy for detecting generalized anxiety disorder (eg, across 3 studies the GAD-7 at a cutoff of 10 had a pooled sensitivity of 0.79 [95% CI, 0.69 to 0.94] and specificity of 0.89 [95% CI, 0.83 to 0.94]). Evidence was limited for other instruments and other anxiety disorders. A large body of evidence supported the benefit of treatment for anxiety. For example, psychological interventions were associated with a small pooled standardized mean difference of −0.41 in anxiety symptom severity in primary care patients with anxiety (95% CI, −0.58 to −0.23]; 10 RCTs [n = 2075]; I2 = 40.2%); larger effects were found in general adult populations.Conclusions and RelevanceEvidence was insufficient to draw conclusions about the benefits or harms of anxiety screening programs. However, clear evidence exists that treatment for anxiety is beneficial, and more limited evidence indicates that some anxiety screening instruments have acceptable accuracy to detect generalized anxiety disorder.

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Section: Resultsmentioning

confidence: 99%

Anxiety Screening

O’Connor

Henninger

Perdue

et al. 2023

JAMA

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“…Previous research outlines that Black individuals are likely to struggle to apply CBT skills despite being the leading modality in mental health treatment. 94 Studies suggest that most intervention approaches fail to teach in a culturally sensitive manner. 95 However, the BBB SOS intervention created a sense of sisterhood akin to those already present in the Black community, which likely made learning new CBT approaches and techniques less daunting for group members, given participants’ perceived helpfulness.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the feasibility and acceptability of sister circles as an anxiety intervention for pregnant Black women

Somerville

Rowell

Stadulis

et al. 2023

Womens Health (Lond Engl)

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Background: Black women and their infants face heightened health risks during pregnancy, labor, and delivery that, for many, cost them their lives. Such health risks during this critical period are linked to increased rates of anxiety among Black pregnant and postpartum women. Black women also endure racism when seeking support from mental health and healthcare providers, which further contributes to pregnancy and postpartum-related anxiety. Evidence on sister circles has demonstrated that this indigenous form of healing may provide Black pregnant and postpartum women with the support and skills needed to cope with stressors associated with mental and physical health concerns and racism. Objective: Our study aimed to evaluate the feasibility and acceptability of the Birthing Beautiful Babies Sisters Offering Support, a sister circle cognitive behavioral therapy-based stress and anxiety intervention for Black pregnant and postpartum women. Design: Our study employed a mixed-methods framework. Methods: Descriptive analyses, paired samples t-test, and open and selective coding were conducted. We utilized the following measures: Penn State Worry Questionnaire–Abbreviated, Kessler Psychological Distress Scale, Pregnancy-Related Anxiety Scale, focus booklet, and focus group discussion. Results: Participants reported experiencing moderate levels of worry and distress and low levels of pregnancy-related anxiety prior to the start of the Birthing Beautiful Babies Sisters Offering Support intervention. Eighty women participated in Birthing Beautiful Babies Sisters Offering Support. Eleven focus groups were conducted to assess their experience. Participants reported a perceived increase in their knowledge about panic attacks and stress and ability to manage stressors effectively. They found that all completed activities contributed to their development and application of skills. They reported they enjoyed Birthing Beautiful Babies Sisters Offering Support because of the supportive environment, openness, and emphasis on sisterhood. Participants provided helpful feedback about the structure and flow of the intervention. Conclusion: Limitations of the present study and future directions are discussed.

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“…Furthermore, although research has widely supported the efficacy and effectiveness of iCBT interventions in reducing mental health symptoms for majority populations (Andrews et al, 2018;Hedman et al, 2012) it has largely neglected examining the efficacy and acceptability of these treatments for Black populations, save for select few studies (Jonassaint et al, 2017(Jonassaint et al, , 2020. Even less attention has been given to understanding the extent to which communities of color perceive the benefit of internet-delivered therapies in mitigating barriers to therapy such as stigma, lack of faith in treatment, affordability, and convenience.…”

Section: Future Directionsmentioning

confidence: 99%

“…However, research on iCBT among Black Americans is virtually nonexistent. The only study to explicitly examine attitudes toward iCBT among Black Americans (Jonassaint et al, 2017(Jonassaint et al, , 2020 found that, compared to Whites, Black participants were less likely to start and complete iCBT, although those who do complete report similar levels of improvement. A recent metaanalysis of randomized controlled trials investigating the efficacy and acceptability of iCBT (Andrews et al, 2018) supported the appeal and perceived benefits of iCBT, but the majority of studies (97%) did not report the racial/ethnic make-up of their sample.…”

mentioning

confidence: 99%