Corina Benjet1, Andrea Wittenborn2, Raúl A Gutierrez-García3, Yesica Cristina Albor4, Eunice Vargas Contreras5, Sergio Cruz Hernández5, Karla Patricia Valdés-García6, Iris Ruby Monroy6, Alvaro Julio Peláez Cedrés7, Praxedis Cristina Hernández Uribe7, Anabell Covarrubias Díaz-Couder8, Guillermo E Quevedo Chávez9, María Abigal Paz-Peréz3, María Elena Medina-Mora4, Ronny Bruffaerts10. 1. Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. Electronic address: cbenjet@imp.edu.mx. 2. Human Development and Family Studies, Michigan State University, East Lansing. 3. Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Salamanca, Mexico. 4. Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 5. Facultad de Ciencias Administrativas y Sociales, Universidad Autónoma de Baja California, Ensenada, Mexico. 6. Facultad de Psicología, Universidad Autónoma de Coahuila, Saltillo, Mexico. 7. Secretaría de la Unidad Cuajimalpa, Universidad Autónoma Metropolitana, Mexico City, Mexico. 8. Dirección de Investigación, Universidad la Salle Noroeste, Ciudad Obregón, Mexico. 9. Coordinación de psicología, Universidad la Salle Cancún, Cancún, Mexico. 10. Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.
Abstract
PURPOSE: Although Internet-based electronic health (eHealth) interventions could potentially reduce mental health disparities, especially in college students in under-resourced countries, little is known about the relative acceptability of eHealth versus in-person treatment modalities and the treatment barriers associated with a preference for one type over the other. METHODS: Participants were from the 2018-2019 cohort of the University Project for Healthy Students (PUERTAS), a Web-based survey of incoming first-year students in Mexico and part of the World Mental Health International College Student Survey initiative. A total of 7,849 first-year students, 54.73% female, from five Mexican universities participated. We estimated correlates of preference for eHealth delivery over in-person modalities with a multivariate logistic regression. RESULTS: Thirty-eight percent of students prefer in-person services, 36% showed no preference for in-person over eHealth, 19% prefer not to use services of any kind, and 7% preferred eHealth over in-person treatment delivery. Being embarrassed, worried about harm to one's academic career, wanting to handle problems on one's own, beliefs about treatment efficacy, having depression, and having attention-deficient hyperactivity disorder were associated with a clear preference for eHealth delivery methods with odds ratios ranging from 1.47 to 2.59. CONCLUSIONS: Although more students preferred in-person services over eHealth, those reporting attitudinal barriers (i.e., embarrassment, stigma, wanting to handle problems on one's own, and beliefs about treatment efficacy) and with depression or attention-deficit hyperactivity disorder had a greater preference for eHealth interventions suggesting these are students to whom eHealth interventions could be targeted to alleviate symptoms and/or as a bridge to future in-person treatment.
PURPOSE: Although Internet-based electronic health (eHealth) interventions could potentially reduce mental health disparities, especially in college students in under-resourced countries, little is known about the relative acceptability of eHealth versus in-person treatment modalities and the treatment barriers associated with a preference for one type over the other. METHODS:Participants were from the 2018-2019 cohort of the University Project for Healthy Students (PUERTAS), a Web-based survey of incoming first-year students in Mexico and part of the World Mental Health International College Student Survey initiative. A total of 7,849 first-year students, 54.73% female, from five Mexican universities participated. We estimated correlates of preference for eHealth delivery over in-person modalities with a multivariate logistic regression. RESULTS: Thirty-eight percent of students prefer in-person services, 36% showed no preference for in-person over eHealth, 19% prefer not to use services of any kind, and 7% preferred eHealth over in-person treatment delivery. Being embarrassed, worried about harm to one's academic career, wanting to handle problems on one's own, beliefs about treatment efficacy, having depression, and having attention-deficient hyperactivity disorder were associated with a clear preference for eHealth delivery methods with odds ratios ranging from 1.47 to 2.59. CONCLUSIONS: Although more students preferred in-person services over eHealth, those reporting attitudinal barriers (i.e., embarrassment, stigma, wanting to handle problems on one's own, and beliefs about treatment efficacy) and with depression or attention-deficit hyperactivity disorder had a greater preference for eHealth interventions suggesting these are students to whom eHealth interventions could be targeted to alleviate symptoms and/or as a bridge to future in-person treatment.