Bridging Rural Health Disparities Through Culturally- Responsive Telebehavioral Interventions: A Mixed-Methods Study in Healthcare Deserts

Abstract

This study investigates the effectiveness of culturally-adapted telebehavioral interventions in addressing mental health disparities in rural healthcare deserts. Using a mixed-methods design, we analyzed survey data from 850 participants across three rural U.S. states and conducted 42 in-depth interviews with patients, providers, and community stakeholders. Quantitative results revealed that broadband access (β=0.34, p<0.001) and cultural tailoring (β=0.28, p<0.01) were significant predictors of intervention adherence, while rural residents with limited digital literacy showed 43% lower engagement (p<0.05). Qualitative findings identified key barriers including technological anxiety and mistrust of standardized care, alongside facilitators such as community health worker mediation and locally-relevant content. Integrating social cognitive theory with ecological models, this study demonstrates that successful telebehavioral interventions in rural areas require simultaneous addressing of digital infrastructure gaps and cultural responsiveness. These findings inform policy recommendations for equitable digital health implementation in resource-constrained settings.

Previous article in issue Next article in issue