Diversity, Equity and Inclusion (DEI)


“Mental health applications or apps are a promising approach to reduce the pervasive unmet mental health need observed among marginalized groups. However, these groups face unique challenges to engage in and benefit from these interventions, and apps that consider issues of diversity, equity, and inclusion (DEI) may be better positioned to reach them.”


“Marginalized groups who do not see their identities represented in the app content (e.g., POC, SGM, people with non-concealable disabilities) may feel the intervention offered is not relevant to their unique difficulties. Therefore, considering DEI issues within evaluation frameworks is essential to prevent the perpetuation of existing inequities, or even worse, the creation of new intervention-generated disparities.”


Current eMental Health Evaluation Frameworks and DEI Criterion


“This scoping review identified 43 frameworks evaluating mental health apps, of which approximately 58% included at least one DEI criterion. Less than half of frameworks included a criterion on DEI relevant content adaptations—most often assessing whether apps catered to people with visual disabilities. Seventeen frameworks evaluated cost, but other technological barriers that could affect app use were infrequently assessed. Only one framework considered diverse visual representation.


Although having 58% of frameworks include some DEI criteria may seem encouraging at first glance, many of these evaluation tools had only one criterion, suggesting that inclusion of DEI criteria is far from the norm.”


Implications and Recommendations


“The lack of consideration in these popular frameworks is concerning, given their wide use for research and clinical purpose…Sparse consideration for DEI variables related to access, content, and appearance significantly reduces the utility of these assessment tools when employed by researchers, clinicians, and potential users…Diversifying app-based mental health interventions and evaluation frameworks not only affects users’ experience but also directly impacts mental health providers’ ability to deliver appropriate services in marginalized communities.”


“Increasing considerations of DEI in frameworks is immediately relevant as researchers, clinicians, and health care systems rely on existing frameworks to determine which applications to recommend and provide to patients…Implementing feedback from marginalized communities can help researchers and clinicians improve current app evaluation frameworks.”


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