Neighborhood disadvantage moderates the effect of a mobile health intervention on adolescent depression. (January 2022)

• Record Type: Journal Article
• Authors: Mennis, Jeremy; McKeon, Thomas P.; Coatsworth, J. Douglas; Russell, Michael A.; Coffman, Donna L.; Mason, Michael J.
• Is Part Of: Health & place. Volume 73(2022)
• Publication Date: 2022-01
• Subjects: mHealth -- Intervention -- Youth -- Mental health -- Neighborhood disadvantage -- Activity space; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2021.102728
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: This study leverages data from a pilot randomized controlled trial to investigate whether the effectiveness of a text-delivered mHealth intervention targeting adolescent depression and anxiety differs according to residential- and activity space-based measures of exposure to community-level socioeconomic disadvantage. For depression, we find that intervention efficacy is significantly stronger for youth residing in more disadvantaged neighborhoods, even after controlling for individual level socioeconomic status, as well as marginal moderating effects of activity space-based neighborhood disadvantage on treatment efficacy. We do not find evidence of treatment efficacy moderation by neighborhood disadvantage regarding anxiety. While the generalizability of our findings is restricted to this sample and for this intervention, this research serves as a motivating example and initial evidence for how mHealth intervention efficacy can vary by characteristics of the environment, in particular community-level disadvantage. Future clinical research should investigate whether the effectiveness of mHealth interventions may be enhanced by personalization based on an individual's contextual environmental exposures. Highlights: Intervention efficacy for depression is moderated by neighborhood disadvantage. Intervention effects on depression are stronger in disadvantaged neighborhoods. Moderation was observed for residential and activity space neighborhood disadvantage. mHealth interventions may be enhanced by personalization to environmental exposures.