Gennaro Di Tosto, Daniel M Walker, Cynthia J Sieck, Lorraine Wallace, Sarah R MacEwan, Megan E Gregory, Seth Scarborough, Timothy R Huerta, Ann Scheck McAlearney
Examining the Relationship between Health Literacy, Health Numeracy, and Patient Portal Use
Applied clinical informatics
recent times digital mental health interventions dmhis proven efficacious however available english speakers leaving limited options nonenglish languages like spanish research shows mental health services ones dominant language show better outcomes conversational agents cas offer promise supporting mental health nonenglish populations study compared culturally adapted version artificial intelligence ailed mental health app called wysa spanish english compare user engagement patterns wysaspanish wysaenglish understand expressions distress preferred language versions wysa adopted crosssectional retrospective exploratory design mixed methods analyzing users 10 spanishspeaking countries 1 february 1 august 2022 quantitative sample n 2767 used descriptive statistics including user engagement metrics wilcoxon test subset qualitative sample b n 338 examined word count differences based valence content analysis conducted examine idioms distress compared wysaenglish wysaspanish sessions p 001 018 greater volume disclosure distress wysaspanish average length conversation significantly longer wysaenglish p 001 044 users preferred interventions free text responses thought recording spanish p 01 041 spanish messages significantly longer p 01 024 wysaspanish saw frequent expressions negative emotions feelings selfharm suicide given high engagement within spanish version wysa findings demonstrate need culturally adapted dmhis among nonenglish populations emphasizing importance considering linguistic cultural differences development dmhis improve accessibility diverse populations