Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses
BackgroundLesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website w...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2025-07-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e67082 |
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| author | Natalia Ramos Skylar Jones Lily Zhang Miriam Nuño Benita Ramsey Dannie Ceseña Alyssa Mireles Kenneth Wells |
| author_facet | Natalia Ramos Skylar Jones Lily Zhang Miriam Nuño Benita Ramsey Dannie Ceseña Alyssa Mireles Kenneth Wells |
| author_sort | Natalia Ramos |
| collection | DOAJ |
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BackgroundLesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website with free well-being resources, developed during the COVID-19 pandemic with partner input, included LGBTQ+ resources. A pilot evaluation among adults (aged ≥18 years) found engagement with and use of the website 4 to 6 weeks before follow-up was associated with reduced (pretest-posttest) depression. Results for LGBTQ+ participants were not reported.
ObjectiveThis study describes baseline depression, anxiety, and website engagement for LGBTQ+ compared with non-LGBTQ+ adults and pretest-posttest changes in depression and anxiety (the primary outcome).
MethodsCommunity partners invited health and social services providers, clients, and partners to visit the website and complete a survey app (Chorus Innovations) at baseline (September 20, 2021-April 4, 2022) and a 4- to 6-week follow-up (October 22, 2021-May 17, 2022). LGBTQ+ adults were compared to non-LGBTQ+ adults in demographics, website use, depression, and anxiety. Sensitivity analyses were adjusted for nonresponse (inverse probability weighting). Regression analyses identified predictors for reduction (pretest-posttest) in depression (2-item Patient Health Questionnaire [PHQ-2]) and anxiety (2-item Generalized Anxiety Disorder scale [GAD-2]).
ResultsOf 315 adults who completed the baseline survey and 193 who completed the follow-up survey, 64 (20.3%) and 37 (19.2%), respectively, were LGBTQ+. At baseline, LGBTQ+ compared to non-LGBTQ+ adults had higher scores on the PHQ-2 (mean 2.4, SD 1.7 vs 1.3, SD 1.3; t294=5.31; P<.001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t295=4.96; P<.001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t298=2.8; P=.003). Before follow-up, LGBTQ+ adults had similar website use (P=.65) and likelihood to recommend the website to others (P=.26) compared to non-LGBTQ+ adults. LGBTQ+ adults had more reduction (pretest-posttest) in mean GAD-2 scores (−0.8, SD 2.0 vs 0.0, SD 1.2; t177=−3.08; P=.002) and mean PHQ-2 scores (−0.7, SD 1.7 vs −0.1, SD 1.4; t180=−2.16; P=.03) compared to non-LGBTQ+ adults. For LGBTQ+ adults, predictors of pretest-posttest decline (adjusting for nonresponse) in mean GAD-2 scores included visiting the website and using resources 4 to 6 weeks before (β=−1.95, 95% CI −3.20 to −0.70; P=.003); for decline in mean PHQ-2, visiting website/using resources had a trend as predictor that was not significant adjusting for nonresponse (β=-.94 (-2.00, 0.013), P=.09).
ConclusionsLGBTQ+ adults reported higher baseline depression, anxiety, and COVID-19 stressors than non-LGBTQ+ adults. Among LGBTQ+ but not among non-LGBTQ+ adults, higher website use was associated with reduced anxiety over time. Findings suggest that online resources may promote well-being for LGBTQ+ adults in pandemics. |
| format | Article |
| id | doaj-art-589daa3ef312418cb9a5fb490ee77db9 |
| institution | DOAJ |
| issn | 2561-326X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj-art-589daa3ef312418cb9a5fb490ee77db92025-08-20T03:17:47ZengJMIR PublicationsJMIR Formative Research2561-326X2025-07-019e6708210.2196/67082Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey AnalysesNatalia Ramoshttps://orcid.org/0000-0001-8688-9426Skylar Joneshttps://orcid.org/0009-0003-2162-9553Lily Zhanghttps://orcid.org/0000-0002-6251-6913Miriam Nuñohttps://orcid.org/0000-0003-2089-7276Benita Ramseyhttps://orcid.org/0009-0007-9762-5451Dannie Ceseñahttps://orcid.org/0009-0006-1215-9045Alyssa Mireleshttps://orcid.org/0009-0003-4957-3408Kenneth Wellshttps://orcid.org/0000-0002-7454-6589 BackgroundLesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) individuals faced greater mental health challenges during the COVID-19 pandemic than binary-gender heterosexual (non-LGBTQ+) adults. The Together for Wellness/Juntos por Nuestro Bienestar website with free well-being resources, developed during the COVID-19 pandemic with partner input, included LGBTQ+ resources. A pilot evaluation among adults (aged ≥18 years) found engagement with and use of the website 4 to 6 weeks before follow-up was associated with reduced (pretest-posttest) depression. Results for LGBTQ+ participants were not reported. ObjectiveThis study describes baseline depression, anxiety, and website engagement for LGBTQ+ compared with non-LGBTQ+ adults and pretest-posttest changes in depression and anxiety (the primary outcome). MethodsCommunity partners invited health and social services providers, clients, and partners to visit the website and complete a survey app (Chorus Innovations) at baseline (September 20, 2021-April 4, 2022) and a 4- to 6-week follow-up (October 22, 2021-May 17, 2022). LGBTQ+ adults were compared to non-LGBTQ+ adults in demographics, website use, depression, and anxiety. Sensitivity analyses were adjusted for nonresponse (inverse probability weighting). Regression analyses identified predictors for reduction (pretest-posttest) in depression (2-item Patient Health Questionnaire [PHQ-2]) and anxiety (2-item Generalized Anxiety Disorder scale [GAD-2]). ResultsOf 315 adults who completed the baseline survey and 193 who completed the follow-up survey, 64 (20.3%) and 37 (19.2%), respectively, were LGBTQ+. At baseline, LGBTQ+ compared to non-LGBTQ+ adults had higher scores on the PHQ-2 (mean 2.4, SD 1.7 vs 1.3, SD 1.3; t294=5.31; P<.001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t295=4.96; P<.001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t298=2.8; P=.003). Before follow-up, LGBTQ+ adults had similar website use (P=.65) and likelihood to recommend the website to others (P=.26) compared to non-LGBTQ+ adults. LGBTQ+ adults had more reduction (pretest-posttest) in mean GAD-2 scores (−0.8, SD 2.0 vs 0.0, SD 1.2; t177=−3.08; P=.002) and mean PHQ-2 scores (−0.7, SD 1.7 vs −0.1, SD 1.4; t180=−2.16; P=.03) compared to non-LGBTQ+ adults. For LGBTQ+ adults, predictors of pretest-posttest decline (adjusting for nonresponse) in mean GAD-2 scores included visiting the website and using resources 4 to 6 weeks before (β=−1.95, 95% CI −3.20 to −0.70; P=.003); for decline in mean PHQ-2, visiting website/using resources had a trend as predictor that was not significant adjusting for nonresponse (β=-.94 (-2.00, 0.013), P=.09). ConclusionsLGBTQ+ adults reported higher baseline depression, anxiety, and COVID-19 stressors than non-LGBTQ+ adults. Among LGBTQ+ but not among non-LGBTQ+ adults, higher website use was associated with reduced anxiety over time. Findings suggest that online resources may promote well-being for LGBTQ+ adults in pandemics.https://formative.jmir.org/2025/1/e67082 |
| spellingShingle | Natalia Ramos Skylar Jones Lily Zhang Miriam Nuño Benita Ramsey Dannie Ceseña Alyssa Mireles Kenneth Wells Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses JMIR Formative Research |
| title | Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses |
| title_full | Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses |
| title_fullStr | Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses |
| title_full_unstemmed | Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses |
| title_short | Exploring the Impact of Online Mental Health Resources During the COVID-19 Pandemic on Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Adults Compared to Heterosexual Adults: Pretest-Posttest Survey Analyses |
| title_sort | exploring the impact of online mental health resources during the covid 19 pandemic on lesbian gay bisexual transgender queer and questioning adults compared to heterosexual adults pretest posttest survey analyses |
| url | https://formative.jmir.org/2025/1/e67082 |
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