{"title":"探索COVID-19大流行期间在线心理健康资源对女同性恋、男同性恋、双性恋、跨性别、酷儿和质疑成年人与异性恋成年人的影响：前测后测调查分析","authors":"Natalia Ramos, Skylar Jones, Lily Zhang, Miriam Nuño, Benita Ramsey, Dannie Ceseña, Alyssa Mireles, Kenneth Wells","doi":"10.2196/67082","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website with free well-being resources, developed during the COVID-19 pandemic with partner input, included LGBTQ+ resources. A pilot evaluation among adults (aged ≥18 years) found engagement with and use of the website 4 to 6 weeks before follow-up was associated with reduced (pretest-posttest) depression. Results for LGBTQ+ participants were not reported.</p><p><strong>Objective: </strong>This study describes baseline depression, anxiety, and website engagement for LGBTQ+ compared with non-LGBTQ+ adults and pretest-posttest changes in depression and anxiety (the primary outcome).</p><p><strong>Methods: </strong>Community partners invited health and social services providers, clients, and partners to visit the website and complete a survey app (Chorus Innovations) at baseline (September 20, 2021-April 4, 2022) and a 4- to 6-week follow-up (October 22, 2021-May 17, 2022). LGBTQ+ adults were compared to non-LGBTQ+ adults in demographics, website use, depression, and anxiety. Sensitivity analyses were adjusted for nonresponse (inverse probability weighting). Regression analyses identified predictors for reduction (pretest-posttest) in depression (2-item Patient Health Questionnaire [PHQ-2]) and anxiety (2-item Generalized Anxiety Disorder scale [GAD-2]).</p><p><strong>Results: </strong>Of 315 adults who completed the baseline survey and 193 who completed the follow-up survey, 64 (20.3%) and 37 (19.2%), respectively, were LGBTQ+. At baseline, LGBTQ+ compared to non-LGBTQ+ adults had higher scores on the PHQ-2 (mean 2.4, SD 1.7 vs 1.3, SD 1.3; t<sub>294</sub>=5.31; P<.001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t<sub>295</sub>=4.96; P<.001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t<sub>298</sub>=2.8; P=.003). Before follow-up, LGBTQ+ adults had similar website use (P=.65) and likelihood to recommend the website to others (P=.26) compared to non-LGBTQ+ adults. LGBTQ+ adults had more reduction (pretest-posttest) in mean GAD-2 scores (-0.8, SD 2.0 vs 0.0, SD 1.2; t<sub>177</sub>=-3.08; P=.002) and mean PHQ-2 scores (-0.7, SD 1.7 vs -0.1, SD 1.4; t<sub>180</sub>=-2.16; P=.03) compared to non-LGBTQ+ adults. For LGBTQ+ adults, predictors of pretest-posttest decline (adjusting for nonresponse) in mean GAD-2 scores included visiting the website and using resources 4 to 6 weeks before (β=-1.95, 95% CI -3.20 to -0.70; P=.003); for decline in mean PHQ-2, visiting website/using resources had a trend as predictor that was not significant adjusting for nonresponse (β=-.94 (-2.00, 0.013), P=.09).</p><p><strong>Conclusions: </strong>LGBTQ+ adults reported higher baseline depression, anxiety, and COVID-19 stressors than non-LGBTQ+ adults. Among LGBTQ+ but not among non-LGBTQ+ adults, higher website use was associated with reduced anxiety over time. Findings suggest that online resources may promote well-being for LGBTQ+ adults in pandemics.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":"9 ","pages":"e67082"},"PeriodicalIF":2.0000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses.\",\"authors\":\"Natalia Ramos, Skylar Jones, Lily Zhang, Miriam Nuño, Benita Ramsey, Dannie Ceseña, Alyssa Mireles, Kenneth Wells\",\"doi\":\"10.2196/67082\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website with free well-being resources, developed during the COVID-19 pandemic with partner input, included LGBTQ+ resources. A pilot evaluation among adults (aged ≥18 years) found engagement with and use of the website 4 to 6 weeks before follow-up was associated with reduced (pretest-posttest) depression. Results for LGBTQ+ participants were not reported.</p><p><strong>Objective: </strong>This study describes baseline depression, anxiety, and website engagement for LGBTQ+ compared with non-LGBTQ+ adults and pretest-posttest changes in depression and anxiety (the primary outcome).</p><p><strong>Methods: </strong>Community partners invited health and social services providers, clients, and partners to visit the website and complete a survey app (Chorus Innovations) at baseline (September 20, 2021-April 4, 2022) and a 4- to 6-week follow-up (October 22, 2021-May 17, 2022). LGBTQ+ adults were compared to non-LGBTQ+ adults in demographics, website use, depression, and anxiety. Sensitivity analyses were adjusted for nonresponse (inverse probability weighting). Regression analyses identified predictors for reduction (pretest-posttest) in depression (2-item Patient Health Questionnaire [PHQ-2]) and anxiety (2-item Generalized Anxiety Disorder scale [GAD-2]).</p><p><strong>Results: </strong>Of 315 adults who completed the baseline survey and 193 who completed the follow-up survey, 64 (20.3%) and 37 (19.2%), respectively, were LGBTQ+. At baseline, LGBTQ+ compared to non-LGBTQ+ adults had higher scores on the PHQ-2 (mean 2.4, SD 1.7 vs 1.3, SD 1.3; t<sub>294</sub>=5.31; P<.001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t<sub>295</sub>=4.96; P<.001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t<sub>298</sub>=2.8; P=.003). Before follow-up, LGBTQ+ adults had similar website use (P=.65) and likelihood to recommend the website to others (P=.26) compared to non-LGBTQ+ adults. LGBTQ+ adults had more reduction (pretest-posttest) in mean GAD-2 scores (-0.8, SD 2.0 vs 0.0, SD 1.2; t<sub>177</sub>=-3.08; P=.002) and mean PHQ-2 scores (-0.7, SD 1.7 vs -0.1, SD 1.4; t<sub>180</sub>=-2.16; P=.03) compared to non-LGBTQ+ adults. For LGBTQ+ adults, predictors of pretest-posttest decline (adjusting for nonresponse) in mean GAD-2 scores included visiting the website and using resources 4 to 6 weeks before (β=-1.95, 95% CI -3.20 to -0.70; P=.003); for decline in mean PHQ-2, visiting website/using resources had a trend as predictor that was not significant adjusting for nonresponse (β=-.94 (-2.00, 0.013), P=.09).</p><p><strong>Conclusions: </strong>LGBTQ+ adults reported higher baseline depression, anxiety, and COVID-19 stressors than non-LGBTQ+ adults. Among LGBTQ+ but not among non-LGBTQ+ adults, higher website use was associated with reduced anxiety over time. Findings suggest that online resources may promote well-being for LGBTQ+ adults in pandemics.</p>\",\"PeriodicalId\":14841,\"journal\":{\"name\":\"JMIR Formative Research\",\"volume\":\"9 \",\"pages\":\"e67082\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JMIR Formative Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2196/67082\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Formative Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2196/67082","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
背景：在2019冠状病毒病大流行期间，女同性恋、男同性恋、双性恋、跨性别、酷儿和质疑（LGBTQ+）个体比二元异性恋（非LGBTQ+）成年人面临更大的心理健康挑战。在2019冠状病毒病大流行期间，在合作伙伴的投入下，开发了提供免费福祉资源的Together for Wellness/Juntos poor Nuestro Bienestar网站，其中包括LGBTQ+资源。在成人（年龄≥18岁）中进行的一项试点评估发现，随访前4至6周参与和使用该网站与减少抑郁（测试前-测试后）相关。LGBTQ+参与者的结果未被报道。目的：本研究描述了LGBTQ+与非LGBTQ+成人的基线抑郁、焦虑和网站参与度，以及抑郁和焦虑（主要结局）的前测后变化。方法：社区合作伙伴邀请卫生和社会服务提供者、客户和合作伙伴访问网站，并在基线（2021年9月20日至2022年4月4日）和4至6周的随访（2021年10月22日至2022年5月17日）完成调查应用程序（Chorus Innovations）。LGBTQ+成年人与非LGBTQ+成年人在人口统计学、网站使用、抑郁和焦虑方面进行了比较。对无反应的敏感性分析进行调整（逆概率加权）。回归分析确定了抑郁（2项患者健康问卷[PHQ-2]）和焦虑（2项广泛性焦虑障碍量表[GAD-2]）减少（前测-后测）的预测因子。结果：在完成基线调查的315名成年人和完成随访调查的193名成年人中，LGBTQ+分别为64名（20.3%）和37名（19.2%）。基线时，LGBTQ+与非LGBTQ+成人相比，PHQ-2得分更高(平均2.4,SD 1.7 vs 1.3, SD 1.3；t294 = 5.31;P295 = 4.96;P298 = 2.8;P = .003)。在随访前，与非LGBTQ+成年人相比，LGBTQ+成年人有相似的网站使用（P= 0.65）和向他人推荐网站的可能性（P= 0.26）。LGBTQ+成人的GAD-2平均得分（前测后测）下降幅度更大(-0.8,SD 2.0 vs 0.0, SD 1.2；t177 = -3.08;P=.002)和PHQ-2平均评分(-0.7,SD 1.7 vs -0.1, SD 1.4；t180 = -2.16;P=.03)与非lgbtq +成年人相比。对于LGBTQ+成人，GAD-2平均得分前测后下降（调整无反应）的预测因子包括在4至6周前访问网站和使用资源(β=-1.95, 95% CI -3.20至-0.70；P = .003);对于平均PHQ-2的下降，访问网站/使用资源有趋势预测，但对无反应没有显著调整（β=- 0.94）（-2.00, 0.013）， p = 0.09)。结论：LGBTQ+成年人报告的基线抑郁、焦虑和COVID-19压力因素高于非LGBTQ+成年人。在LGBTQ+而非LGBTQ+的成年人中，随着时间的推移，更多的网站使用与减少焦虑有关。研究结果表明，在线资源可能会促进LGBTQ+成年人在流行病中的福祉。
Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses.
Background: Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website with free well-being resources, developed during the COVID-19 pandemic with partner input, included LGBTQ+ resources. A pilot evaluation among adults (aged ≥18 years) found engagement with and use of the website 4 to 6 weeks before follow-up was associated with reduced (pretest-posttest) depression. Results for LGBTQ+ participants were not reported.
Objective: This study describes baseline depression, anxiety, and website engagement for LGBTQ+ compared with non-LGBTQ+ adults and pretest-posttest changes in depression and anxiety (the primary outcome).
Methods: Community partners invited health and social services providers, clients, and partners to visit the website and complete a survey app (Chorus Innovations) at baseline (September 20, 2021-April 4, 2022) and a 4- to 6-week follow-up (October 22, 2021-May 17, 2022). LGBTQ+ adults were compared to non-LGBTQ+ adults in demographics, website use, depression, and anxiety. Sensitivity analyses were adjusted for nonresponse (inverse probability weighting). Regression analyses identified predictors for reduction (pretest-posttest) in depression (2-item Patient Health Questionnaire [PHQ-2]) and anxiety (2-item Generalized Anxiety Disorder scale [GAD-2]).
Results: Of 315 adults who completed the baseline survey and 193 who completed the follow-up survey, 64 (20.3%) and 37 (19.2%), respectively, were LGBTQ+. At baseline, LGBTQ+ compared to non-LGBTQ+ adults had higher scores on the PHQ-2 (mean 2.4, SD 1.7 vs 1.3, SD 1.3; t294=5.31; P<.001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t295=4.96; P<.001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t298=2.8; P=.003). Before follow-up, LGBTQ+ adults had similar website use (P=.65) and likelihood to recommend the website to others (P=.26) compared to non-LGBTQ+ adults. LGBTQ+ adults had more reduction (pretest-posttest) in mean GAD-2 scores (-0.8, SD 2.0 vs 0.0, SD 1.2; t177=-3.08; P=.002) and mean PHQ-2 scores (-0.7, SD 1.7 vs -0.1, SD 1.4; t180=-2.16; P=.03) compared to non-LGBTQ+ adults. For LGBTQ+ adults, predictors of pretest-posttest decline (adjusting for nonresponse) in mean GAD-2 scores included visiting the website and using resources 4 to 6 weeks before (β=-1.95, 95% CI -3.20 to -0.70; P=.003); for decline in mean PHQ-2, visiting website/using resources had a trend as predictor that was not significant adjusting for nonresponse (β=-.94 (-2.00, 0.013), P=.09).
Conclusions: LGBTQ+ adults reported higher baseline depression, anxiety, and COVID-19 stressors than non-LGBTQ+ adults. Among LGBTQ+ but not among non-LGBTQ+ adults, higher website use was associated with reduced anxiety over time. Findings suggest that online resources may promote well-being for LGBTQ+ adults in pandemics.
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