Evaluation of a pilot implementation of a digital cognitive behavioral therapy platform for isolated older adults in county mental health services

• Published in: Implementation research and practice 2024-01, Vol.5, p.26334895241288571
• Main Authors: Hernandez-Ramos, Rosa, Schueller, Stephen M., Borghouts, Judith, Palomares, Kristina, Eikey, Elizabeth, Schneider, Margaret, Stadnick, Nicole A., Zheng, Kai, Mukamel, Dana B., Sorkin, Dara H.
• Format: Article
• Language: English
• Subjects: Short Report
• ISSN: 2633-4895; 2633-4895
• DOI: 10.1177/26334895241288571

Background Technology-enabled services (TESs) have the potential to increase access to mental healthcare. However, little research has focused on how TESs can be integrated into publicly funded service settings. As part of the state-wide Help@Hand project, Marin County conducted a pilot implementation of myStrength, a digital cognitive behavioral therapy platform, to explore its potential to reduce loneliness among isolated older adults. We evaluated the pilot impact using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Method A single-site 6-month pilot implementation recruited English (n = 15) and Spanish-speaking (n = 15) isolated older adults who received a digital literacy course followed by 8 weeks of myStrength access and human support. We evaluated factors related to reach, effectiveness, adoption, and implementation using the perspectives of users and County staff. Descriptive statistics were used to examine reach, adoption, and implementation. Nonparametric tests, including Friedman and Wilcoxon signed-rank, were used to examine effectiveness. Results Reach: Compared to overall county demographics, platform users were majority female (93.1% vs. 50.5%), ethnoracialized (62.1% vs. 24.2%), and of lower socioeconomic status (Mdn = $35,000 vs. $131,008). Effectiveness: Users reported a significant (z = −2.62, p