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UBC Theses and Dissertations

Exploring cultural responsiveness of e-mental health resources for depressive and anxiety disorders Narayan, Shawna Kumari


Background: Canada’s culturally diverse populations (CDPs) experience difficulties such as language barriers, difficulty navigating the healthcare system, and lack of culturally tailored resources compared to the general population when accessing mental health services. These surmountable barriers may be addressed by e-mental health (eMH) technologies that allow for mental healthcare to be delivered through the Internet and related technologies. However, little attention has been devoted to understanding the cultural responsiveness of these services among CDPs. Objectives: This study investigates the use of eMH among CDPs for anxiety and depressive disorders in an urban area. Our objectives are to (1) explore the experience of eMH services and gauge their cultural responsiveness, (2) examine participants’ digital health literacy, mental health status, and usage of eMH; and (3) develop recommendations based on participants’ experiences to improve eMH services. Methods: Participants (N=136) completed a survey regarding their eMH use, the severity of their depression and anxiety symptoms, and socio-demographic characteristics. Participants (N=14) shared experiences through semi-structured focus group discussions. From this, we developed a set of guidelines based on the experiences and recommendations from participants for future eMH resources. Participants (N=5) were invited to provide feedback through one-on-one interviews. Results: Survey participants’ ages ranged from 19 to 74 years, with 43% within young adult ages of 19 to 24. Of these participants, 65% were women, 22% were men, while 3% identified as Trans Male, Non-Binary, or Other. Most survey participants identified as South Asian (40%) or Chinese (28%). The majority of participants (68%) indicated that the eMH resources they used, overall, were not culturally tailored. However, most participants (65%) agreed that the resource was available in their preferred language. Focus group discussions revealed themes of facilitators and barriers of help-seeking behaviours and sociocultural contexts. eMH recommendations suggested by participants’ responses focused on including culturally tailored content, graphics and phrases, and lived experiences of CDPs while reducing culturally linked stigma. Conclusion: The findings showcase the need for more culturally responsive eMH beyond language translation, while providing healthcare professionals with a greater and nuanced understanding of treatment needs in cultural groups.

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