COVIDsmart Study: Evaluation of Statewide Mental Health Disparities in Digital Research. (Preprint)

BACKGROUND As digital health research is becoming a critical element of population health during the COVID-19 pandemic, efforts to recognize and integrate the digital research needs of individuals at risk for mental health disparities have lagged. This could result in poor community health outcomes and increased mental health disparities. OBJECTIVE We evaluated the digital COVIDsmart study for inclusiveness of populations at risk for mental health disparities. Additionally, we identified demographic and clinical characteristics of participants with higher rates of anxiety and/or depression during COVID-19, and potential emerging mental health disparities in the context of COVID-19 METHODS Using multiple recruitment strategies, a total of 782 participants were enrolled in the Virginia COVIDsmart prospective study. A HIPAA compliant digital platform was used to collect data on demographics, COVID-19 clinical parameters, health perceptions, mental and physical health, resilience, vaccination status, education/work functioning, social/family functioning, and economic impact. We assessed differences in frequencies of individuals at risk for mental health disparities and in demographic/clinical characteristics of participants with anxiety and/or depression. RESULTS The majority of participants enrolled in the COVIDsmart study were White (628/771, 81.5%), female (577/734, 78.6%), with at least a Master’s degree (483/771, 62.6%), an annual household income of at least $100,000 (389/771, 51%), living in non-rural areas (758/771, 98%), with health insurance (718/728, 98.6%), and between ages 36 and 65 years (471/736, 64%). Although anxiety and/or depression rates were high for all groups, significant differences were found among age groups (P<.001), gender (P<.001), annual household income (P=.014), and comorbid cancer and neurological disorders (P<.05). CONCLUSIONS Digital research methods may provide opportunities to rapidly study the numerous health impacts of COVID-19, which are currently not fully understood. However, digital health research inclusiveness remains challenging. COVIDsmart study did not achieve expected representation of individuals at risk for mental health disparities. Nevertheless, we found substantial anxiety and/or depression across all demographic and clinical groups. Areas of potential emerging mental health disparities in digital research may include low resiliency, low health literacy, and being a woman between 18 and 35 years. Further research is necessary to understand participation barriers and emerging mental health disparities during COVID-19, which impact digital research practices.