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Telehealth/m-Health

Predictors of engagement in stepped mHealth mental health care in patients with elevated psychological distress.

(PS10-A23) Predictors of Engagement in Stepped Mhealth Mental Health Care in Patients with Elevated Psychological Distress

Saturday, November 18, 2023
1:00 PM – 2:00 PM PST
Location: Regency Ballroom, Level 7


Introduction: Less than half of individuals affected by mental illness in the United States receive mental health services due to a variety of interpersonal, socioeconomic and environmental factors. Stepped mental healthcare encourages access to treatment by offering specific, scalable resources based on patients’ perceived needs and preferences. Mobile delivery (mHealth) further expands access and flexibility to engage in care.


Methods: This study examined predictors of mHealth engagement for individuals with elevated GAD-7 or PHQ-9 scores enrolled in an employer-sponsored mental health platform of self-directed digital tools, telecoaching, and teletherapy. The primary outcome was number of “touches,” defined by the number of times a participant accessed any of the platform’s resources.


Results: Using an adjusted Poisson regression analysis with an alpha level of p < 0.001, we analyzed 417 participants with an average age of 32.5 years (sd=8.06) who were mostly women (66%) with bachelor’s degrees (59%). 58.5% of the sample identified as white, and 41.2% were non-white (n=27 Black, n=42 Hispanic, n=76 Asian, n=27 other). We found age, patient activation, use of teletherapy or telecoaching, and primary concerns of physical well-being or professional life to be significantly associated with self-directed resources touches.


Discussion: Increase in age by year was associated with a 3.6% increase in touches, and every unit increase in patient activation was associated with a 98.5% increase in touches. Having any use of coaching was associated with a 101% increase in the number of touches and any therapist visit was associated with a 77.8% increase in the number of mHealth touches. Finally, having a primary concern of either physical well-being or professional life were associated with a 140% and 130% increase in self-directed resources touches, respectively, compared to those whose primary concern was “their emotions.”


Conclusion: These findings highlight the demographic and clinical factors associated with increased mHealth self-directed resources use in patients with elevated psychological distress. Importantly, use of teletherapy and telecoaching may be driving use of self-directed mental health resources, especially for older age groups. As more mental health treatment options and modalities become available, additional research is needed to better understand how these modalities are being used individually and in concert with one another.