%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 9
%N 
%P e67082
%T 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
%A Ramos,Natalia
%A Jones,Skylar
%A Zhang,Lily
%A Nuño,Miriam
%A Ramsey,Benita
%A Ceseña,Dannie
%A Mireles,Alyssa
%A Wells,Kenneth
%+ Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Suite 17-369b, Los Angeles, CA, 90024, United States, 1 3107943728, kwells@mednet.ucla.edu
%K digital mental health
%K depression
%K anxiety
%K prevention
%K COVID-19
%K lesbian, gay, bisexual, transgender, queer, and questioning
%K LGBTQ+
%K well-being resources
%D 2025
%7 11.7.2025
%9 Original Paper
%J JMIR Form Res
%G English
%X 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; 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). 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. 
%R 10.2196/67082
%U https://formative.jmir.org/2025/1/e67082
%U https://doi.org/10.2196/67082