Talk to the Veterans Crisis Line now
An official website of the United States government
Search | Search by Center | Search by Source | Keywords in Title
Ramos N, Jones S, Zhang L, Nuño M, Ramsey B, Ceseña D, Mireles A, Wells K. 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. 2025 Jul 11; 9:e67082, DOI: 10.2196/67082.
Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects. BACKGROUND: Lesbian, 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. OBJECTIVE: This 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). METHODS: Community 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]). RESULTS: Of 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; t = 5.31; P < .001) and GAD-2 (mean 2.7, SD 1.7 vs 1.6, SD 1.5; t = 4.96; P < .001) and more COVID-19 stressors (mean score 8.1, SD 4.4 vs 6.5, SD 4.0; t = 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; t = -3.08; P = .002) and mean PHQ-2 scores (-0.7, SD 1.7 vs -0.1, SD 1.4; t = -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 ( = -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 ( = -.94 (-2.00, 0.013), P = .09). CONCLUSIONS: LGBTQ+ 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.
