Background: The COVID-19 pandemic involved a prolonged period of collective trauma and stress during which substantial increases in mental health concerns, like depression and anxiety, were observed across the population. In this context, CHAMindWell was developed as a web-based intervention to improve resilience and reduce symptom severity among a public health care system’s patient population. Objective: This program evaluation was conducted to explore participants’ engagement with and outcomes from CHAMindWell by retrospectively examining demographic information and mental health symptom severity scores throughout program participation. Methods: We examined participants’ symptom severity scores from repeated, web-based symptom screenings through Computerized Adaptive Testing for Mental Health (CAT-MH) surveys, and categorized participants into symptom severity-based tiers (tier 1=asymptomatic to mild; tier 2=moderate; and tier 3=severe). Participants were provided tier-based mindfulness resources, treatment recommendations, and referrals. Logistic regressions were conducted to evaluate associations between demographic variables and survey completion. The McNemar exact test and paired sample t tests were performed to evaluate changes in the numbers of participants in tier 1 versus tier 2 or 3 and changes in depression, anxiety, and posttraumatic stress disorder severity scores between baseline and follow-up. Results: The program enrolled 903 participants (664/903, 73.5% female; 556/903, 61.6% White; 113/903, 12.5% Black; 84/903, 9.3% Asian; 7/903, 0.8% Native; 36/903, 4% other; and 227/903, 25.1% Hispanic) between December 16, 2020, and March 17, 2022. Of those, 623 (69%) completed a baseline CAT-MH survey, and 196 completed at least one follow-up survey 3 to 6 months after baseline. White racial identity was associated with completing baseline CAT-MH (odds ratio [OR] 1.80, 95% CI 1.14-2.84; P=.01). Participants’ odds of having symptom severity below the clinical threshold (ie, tier 1) were significantly greater at follow-up (OR 2.60, 95% CI 1.40-5.08; P=.001), and significant reductions were observed across symptom domains over time. Conclusions: CHAMindWell is associated with reduced severity of mental health symptoms. Future work should aim to address program engagement inequities and attrition and compare the impacts of CHAMindWell to a control condition to better characterize its effects.

中文翻译：

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COVID-19 大流行期间参与者对基于网络的综合人口心理健康计划 (CHAMindWell) 的参与和结果：计划评估研究

背景： COVID-19 大流行带来了长期的集体创伤和压力，在此期间，人们观察到抑郁和焦虑等心理健康问题大幅增加。在此背景下，CHAMindWell 被开发为一种基于网络的干预措施，旨在提高公共卫生保健系统患者群体的恢复能力并减轻症状严重程度。目标：该计划评估旨在通过回顾性检查整个计划参与过程中的人口统计信息和心理健康症状严重程度评分，探讨参与者对 CHAMindWell 的参与度和结果。方法：我们通过计算机心理健康适应性测试 (CAT-MH) 调查，通过重复的、基于网络的症状筛查，检查了参与者的症状严重程度评分，并将参与者分为基于症状严重程度的等级（第 1 级=无症状至轻度；第 2 级=无症状至轻度；第 2 级=无症状至轻度）。 = 中度；第 3 级 = 严重）。参与者获得了分层的正念资源、治疗建议和转诊。进行逻辑回归以评估人口统计变量与调查完成情况之间的关联。进行McNemar 精确检验和配对样本t检验，以评估第 1 级与第 2 级或第 3 级参与者数量的变化，以及基线和随访之间抑郁、焦虑和创伤后应激障碍严重程度评分的变化。结果：该计划招募了 903 名参与者（664/903，73.5% 女性；556/903，61.6% 白人；113/903，12.5% 黑人；84/903，9.3% 亚洲人；7/903，0.8% 土著；36/ 2020 年 12 月 16 日至 2022 年 3 月 17 日期间，903 人（4% 为其他人）；227/903 人（25.1% 为西班牙裔）。其中，623 人（69%）完成了基线 CAT-MH 调查，196 人完成了至少一项后续调查基线后 3 至 6 个月进行后续调查。白人种族身份与完成基线 CAT-MH 相关（优势比 [OR] 1.80，95% CI 1.14-2.84；P =.01）。随访时，参与者症状严重程度低于临床阈值（即 1 级）的几率显着更高（OR 2.60，95% CI 1.40-5.08；P = 0.001），并且在不同症状领域观察到显着降低。时间。结论： CHAMindWell 与心理健康症状严重程度的减轻有关。未来的工作应旨在解决计划参与不平等和人员流失问题，并将 CHAMindWell 的影响与控制条件进行比较，以更好地表征其效果。