Blended Care Therapy for Depression and Anxiety: Outcomes across Diverse Racial and Ethnic Groups
Open accessAbstract
Background: Studies have reported positive outcomes of blended care therapy (BCT), which combines face-to-face care with internet modules. However, there is insufficient evidence of its effectiveness across racial and ethnic groups. This study evaluated outcomes of a BCT program, which combined video psychotherapy with internet cognitive-behavioral modules, across race and ethnicity. Methods: Participants were 6492 adults, with elevated anxiety (Generalized Anxiety Disorder-7 [GAD-7] ≥ 8) and/or depression (Patient Health Questionnaire-9 [PHQ-9] ≥ 10) symptoms, enrolled in employer-offered BCT. Changes in anxiety (GAD-7) and depression (PHQ-9) symptoms during treatment were evaluated using individual growth curve models. Interaction terms of time with race and ethnicity tested for between-group differences. Treatment satisfaction was assessed using a Net Promoter measure (range = 1 (lowest satisfaction) to 5 (greatest satisfaction)). Results: Participants’ self-reported race and ethnicity included Asian or Pacific Islander (27.5%), Black or African American (5.4%), Hispanic or Latino (9.3%), and White (47.2%). Anxiety symptoms decreased during treatment (p < 0.01), with greater reductions among Hispanic or Latino participants compared to White participants (p < 0.05). Depressive symptoms decreased across treatment (p < 0.01), with significantly greater decreases among some racial and ethnic groups compared to White participants. Declines in anxiety and depressive symptoms slowed across treatment (p’s < 0.01), with statistically significant differences in slowing rates of depressive symptoms across some racial and ethnic groups. Among participants with responses (28.45%), average treatment satisfaction ranged from 4.46 (SD = 0.73) to 4.67 (SD = 0.68) across race and ethnicity (p = 0.001). Racial and ethnic differences in outcomes were small in magnitude. Conclusions: BCT for anxiety and depression can be effective across diverse racial and ethnic groups.
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Past research evaluating this specific blended care model has demonstrated its effectiveness for reducing symptoms of anxiety and depression, including across diverse racial and ethnic groups and in large samples of up to approximately 6000 participants.
“Past research evaluating this specific blended care model has demonstrated its effectiveness for reducing symptoms of anxiety and depression, including across diverse racial and ethnic groups and in large samples of up to approximately 6000 participants [18,21].”
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- Authors
- Owusu, J. T., Wang, P., Wickham, R. E., Cottonham, D. P., Varra, A. A., Chen, C., & Lungu, A.
- Affiliations
- Northern Arizona University (US)
- Corresponding author
- Owusu, Jocelynn T.
- Venue
- Journal of Racial and Ethnic Health Disparities
- Published
- 2022-12-02
- Volume
- 10
- Issue
- 6
- Pages
- 2731-2743
- ISSN
- 2196-8837 (ISSN-L)
- 2197-3792
- PMC
- PMC9717563
- OpenAlex
- W4310578968
- Cited by
- 14
- References
- 46
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 1
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Racial and Ethnic Health Disparities (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, anxiety, generalized anxiety disorder, racial and ethnic disparities, internet-based cognitive behavioral therapy, treatment satisfaction, ethnic minority mental health
- MeSH terms
- Adult, Anxiety, Depression, Ethnicity, Humans, Psychotherapy, Cognitive Behavioral Therapy, Racial Groups
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