Equity in Digital Mental Health Interventions for Marginalized Populations: Lessons from the Mind-Us Study

In the US, racially and ethnically minoritized (REM) groups are less likely to seek or receive mental health services compared with White groups. Even when REM are able to access care, it tends to be of lesser quality, and they are more likely to leave treatment prematurely. Digital mental health interventions (DMHIs) hold promise to reduce some of these inequities by addressing the shortage of mental health professionals, mitigating logistic barriers to service utilization, decreasing costs associated with implementation, and engaging individuals in care who may not seek services otherwise. However, DMHIs are rarely designed with the unique needs of REM in mind, which may perpetuate existing inequities or, even worse, create new ones now in the DMHI space.

To address the lack of equitable DMHIs for REM, the Mindfulness for Us (Mind-Us) program—a self-guided, app-based mindfulness meditation intervention for REM who experience elevated levels of discrimination—was specifically designed to meet some of these needs. Despite using a commercially available app, the Mind-Us program used human support to improve the app’s usability, promote engagement with content not explicitly designed for REM, identify the fit of the intervention with users’ needs, and increase knowledge of mindfulness principles. Following this approach, the Mind-Us program had outstanding implementation outcomes, with participants using the app consistently during the 4-week program and less than 8% leaving the trial prematurely. Furthermore, Mind-Us led to clinically significant reductions in stress, anxiety, and depression. Thus, lessons learned from the implementation of this program could help researchers and clinicians design and implement successful DMHIs for REM populations.

Speaker Biography: Dr. Giovanni Ramos received B.A.s in Psychology from Universidad Nacional Autónoma de México and Florida International University. He completed his doctoral training in clinical psychology at the University of California, Los Angeles, including a clinical internship at the Albert Einstein College of Medicine/Montefiore Medical Center. His research program focuses on addressing mental health inequities affecting racially and ethnically minoritized groups in the US. To achieve this goal, To achieve this goal, I focus on two interconnected areas: 1) improving the cultural and contextual fit of evidence-based treatments, and 2) using digital tools to make these interventions available in marginalized communities. He is currently a UC Chancellor’s and Ford Foundation Postdoctoral Fellow in the Department of Psychological Science at the University of California, Irvine.