Selected Publications

Therapy for People Who Can’t Go to Therapy

Adrian Aguilera
2022

The way Americans receive mental health care has never changed as quickly as it has since the spring of 2020. When the Covid pandemic forced so many of us into our homes and onto Zoom, psychiatrists, psychotherapists and social workers followed. What started as a short-term fix is now becoming permanent. Today, nearly 40 percent of mental health and substance use outpatient treatment visits at hospitals and clinics are offered remotely,...

Applying the Digital Health Social Justice Guide

Caroline A. Figueroa
Hikari Murayama
Priscila Carcamo Amorim
Alison White
Ashley Quintero
Tiffany Luo
Adrian Aguilera
Angela D. R. Smith
Courtney R. Lyles
Victoria Robinson
Claudia von Vacano
2022
Introduction

Digital health, the use of apps, text-messaging, and online interventions, can revolutionize healthcare and make care more equitable. Currently, digital health interventions are often not designed for those who could benefit most and may have unintended consequences. In this paper, we explain how privacy vulnerabilities and power imbalances, including racism and sexism, continue to influence health app design and research. We provide guidelines for researchers to design, report and evaluate digital health studies to maximize social justice in health....

Cultural Responsivity in Technology-Enabled Services: Integrating Culture Into Technology and Service Components

Elizabeth H. Eustis
Jessica LoPresti
Adrian Aguilera
Stephen M. Schueller
2022

Technology-enabled services (TESs) are clinical interventions that combine technological and human components to provide health services. TESs for mental health are efficacious in the treatment of anxiety and depression and are currently being offered as frontline treatments around the world. It is hoped that these interventions will be able to reach diverse populations across a range of identities and ultimately decrease disparities in mental health treatment. However, this hope is largely unrealized. TESs include both technology and human service components, and we argue that...

Multilevel Determinants of Digital Health Equity: A Literature Synthesis to Advance the Field

Courtney R. Lyles
Oanh Kieu Nguyen
Elaine C. Khoong
Adrian Aguilera
Urmimala Sarkar
2022

Current digital health approaches have not engaged diverse end users or reduced health or health care inequities, despite their promise to deliver more tailored and personalized support to individuals at the right time and the right place. To achieve digital health equity, we must refocus our attention on the current state of digital health uptake and use across the policy, system, community, individual, and intervention levels. We focus here on (a) outlining a multilevel framework underlying digital health equity; (b)...

The need for a new generation of digital mental health tools to support more accessible, effective and equitable care

John Torous
Keris Myrick
Adrian Aguilera
2023

The potential of digital mental health to increase access to and quality of care has gained traction with the rise of smartphones and accelerated with the spread of telehealth during the COVID‐19 pandemic. With at least 80% of the global population now owning a device able to capture digital phenotyping signals, analyze data, and run mental health apps, excitement about the imminent arrival of personalized, preventive and precision psychiatry is understandable.

Yet, by nearly all outcome metrics, digital mental health is not transforming care...