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Urban and Rural Differences in the Efficacy of a Mobile Health Depression Treatment for Young Adults

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  • Jeremy Mennis

    (Department of Geography, Environment and Urban Studies, Temple University, Philadelphia, PA 19122, USA)

  • J. Douglas Coatsworth

    (College of Social Work, University of Tennessee, Knoxville, TN 37996, USA)

  • Michael Russell

    (Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA)

  • Nikola Zaharakis

    (Center for Behavioral Health Research, University of Tennessee, Knoxville, TN 37996, USA)

  • Aaron R. Brown

    (College of Social Work, University of Kentucky, Lexington, KY 40506, USA)

  • Michael J. Mason

    (Center for Behavioral Health Research, University of Tennessee, Knoxville, TN 37996, USA)

Abstract

Depression among young adults represents a growing health problem in the U.S., but access to effective treatment remains a challenge. Mobile health (mHealth) approaches promise to deliver accessible and effective depression treatment; however, questions remain regarding how mHealth depression treatment efficacy may vary geographically based on urban and rural environmental contexts. The present study addresses this knowledge gap by leveraging data from a randomized clinical trial of an mHealth depression treatment called Cognitive Behavioral Therapy-text (CBT-txt) as applied to a sample of 103 U.S. young adults (ages 18–25). Prior research has demonstrated the efficacy of CBT-txt to reduce depressive symptoms. In the present study, we conduct an exploratory, post hoc analysis employing moderated growth curve modeling to investigate whether observed treatment efficacy differed between study participants residing in rural versus urban areas. The findings indicate that CBT-txt treatment effects in terms of reducing depression symptoms were significantly stronger for young adults residing in rural, as compared to urban, regions (β = 13.759, 95% CI = 0.796, 26.723, p < 0.038). We speculate that this is because of the lack of mental healthcare resources in rural, as compared to urban areas, as well as the greater level of environmental stressors, such as artificial light and noise, found in cities, which may mitigate treatment effects.

Suggested Citation

  • Jeremy Mennis & J. Douglas Coatsworth & Michael Russell & Nikola Zaharakis & Aaron R. Brown & Michael J. Mason, 2024. "Urban and Rural Differences in the Efficacy of a Mobile Health Depression Treatment for Young Adults," IJERPH, MDPI, vol. 21(12), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:12:p:1572-:d:1530308
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    References listed on IDEAS

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    1. Daniel W. Belsky & Avshalom Caspi & Louise Arseneault & David L. Corcoran & Benjamin W. Domingue & Kathleen Mullan Harris & Renate M. Houts & Jonathan S. Mill & Terrie E. Moffitt & Joseph Prinz & Kare, 2019. "Genetics and the geography of health, behaviour and attainment," Nature Human Behaviour, Nature, vol. 3(6), pages 576-586, June.
    2. Ngo, V.K. & Sherbourne, C. & Chung, B. & Tang, L. & Wright, A.L. & Whittington, Y. & Wells, K. & Miranda, J., 2016. "Community engagement compared with technical assistance to disseminate depression care among low-income, minority women: A randomized controlled effectiveness study," American Journal of Public Health, American Public Health Association, vol. 106(10), pages 1833-1841.
    3. Young-Shin Park & Barbara J. McMorris & Lisiane Pruinelli & Ying Song & Merrie J. Kaas & Jean F. Wyman, 2021. "Use of Geographic Information Systems to Explore Associations between Neighborhood Attributes and Mental Health Outcomes in Adults: A Systematic Review," IJERPH, MDPI, vol. 18(16), pages 1-28, August.
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