Author ORCID Identifier

https://orcid.org/0000-0002-9888-1613

Date of Award

8-2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Page Anderson

Second Advisor

Sierra Carter

Third Advisor

Lee Branum-Martin

Fourth Advisor

Charles Jonassaint

Abstract

Mental illness is a leading global cause of disability and persists at disproportionately high rates for Black, Indigenous, and People of Color (BIPOC). This European-style dissertation examines methods for improving user attitudes and treatment-seeking behavior for digital mental health interventions (DMHIs) among BIPOC. This dissertation comprises three studies that are situated within the broader context of efforts to successfully design, implement, and disseminate culturally responsive DMHIs as a mitigation strategy for barriers to mental health treatment. Study 1 is a systematic review and meta-analysis that explored culturally adapted DMHIs and examined the efficacy and acceptability of these interventions among racial and ethnic minorities. Three electronic databases (PsycINFO, Web of Science, PubMed) were searched and thirty-two studies examining the impact of a culturally adapted DMHI among international racial or ethnic minority populations were included. Studies reported significant evidence for the efficacy and acceptability of culturally adapted DMHIs. Study 2 is an experimental study that tested the effects of a treatment rationale and authority endorsement on acceptability and treatment-seeking interest for DMHIs among Black Americans. Results indicated that participants reporting fewer barriers to treatment had more positive attitudes towards DMHIs after reading a treatment rationale than those who read a definition. Participants reported a greater likelihood of using DMHIs when endorsed by a health professional than by a spiritual leader or no authority figure. Study 3 presents a confirmatory factor analysis of the Attitudes towards Psychological Online Interventions Scale (APOI; Schröder et al., 2015) - the first structured measure of acceptability toward DMHIs – among a sample of Black Americans. Results indicated that a bifactor model demonstrated excellent fit (CFI = .96, TLI = .94, SRMR = .03 and RMSEA = .09), suggesting that within a Black American sample there may be greater utility in interpreting the APOI subscales as attitudinal constructs distinct from a global “acceptability” factor. All three studies aim to inform clinical research initiatives and implementation frameworks for addressing unmet mental health needs among minoritized communities by leveraging advancements in telemedicine and DMHIs.

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