Survey: Black Women With Depression Open to Mobile Health Tools

Black women with depression are open to the idea of using mobile technology to facilitate mental health care, according to a new survey.

The study also found that patients had more favorable attitudes toward the use of voice and video calls compared with the use of text-messaging or mobile apps. The report was published in the Journal of Medical Internet Research.

Black women in America have a high rate of depression, with previous reports estimating that more than one-quarter (27%) of non-Hispanic Black women will experience depression during the course of their lives. The study authors noted that several factors have been associated with the risk of depression in this population, including low socioeconomic status, racial and gender discrimination, cardiometabolic conditions, and other complex life demands.

For those with mental illness, stigma can often be a barrier to receiving care, as can other concerns, such as lack of health insurance, mistrust of health care providers, and limited health literacy, they said.

Some of those barriers can be mitigated through the use of digital health technologies, the authors said, such as phone calls and text messaging. For instance, such tools can eliminate the need for travel and may also be more affordable, the investigators said.

Given the high rate of smartphone ownership among Black women (around 80%), the technology itself appears to be widely accessible, and patients in general seem to be increasingly comfortable using mobile technology in their health care, they added.

Yet, most of the existing literature regarding the use of mobile health (mHealth) technology to manage depression is based on study populations that were predominantly made up of White participants, the authors noted.

“Therefore, the results may not be generalizable to all racial groups,” they wrote. “Further exploration of the use of mobile technology to provide mental health resources and services to Black American women is necessary.”

The investigators created a web-based questionnaire and invited women 18 years and older who identified as Black, African American, or multiracial (Black or African American plus another race) to complete the questionnaire, which included screening questions designed to identify symptoms of depression.

A total of 395 people completed the survey during the survey window, which lasted from October 2019 through January 2020. All but 4 of the participants said they owned a mobile phone.

“The results of the survey revealed that respondents were most comfortable with the use of voice call followed by video call, mobile app, and SMS text messaging to communicate with a professional to receive help for managing depression,” the authors said.

Seven in 10 participants said they would use a voice call to help manage depression, and nearly two-thirds (64.3%) said they would use a video call for the same. For both SMS text messaging and mobile app usage, the acceptance rates were 45.1%.

The investigators found a number of factors had an impact on a participant’s willingness to try mobile health modalities. People with a higher help-seeking propensity were notably more likely to approve of voice and video calls as a treatment option, though the same was not true for text messages and app usage. Patients with moderate to severe symptoms were 43% more likely to use mobile apps, but that did not extend to other treatment modalities.

When asked about their concerns about using these technologies, participants said privacy, the possibility of message misinterpretation, and the impersonal feeling associated with device-based communication were the primary concerns, the authors reported.

The investigators noted that the survey was conducted just before the COVID-19 pandemic. They said the rapid expansion of digital health technologies that came as a result of the pandemic would likely increase the accessibility of mHealth technologies for Black women.

“However, future engagement strategies should seek to provide information, establish trust, and provide accessible and affordable culturally relevant options for mental health support,” they said.

Reference

McCall T, Foster M, Schwartz TA. Attitudes toward seeking mental health services and mobile technology to support the management of depression among Black American women: cross-sectional survey study. J Med Internet Res. 2023;25:e45766. doi:10.2196/45766