{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T15:08:11Z","timestamp":1787324891536,"version":"build-2736575974"},"reference-count":48,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Use of technological resources that provide support for mental health (ie, digital mental health tools) and opportunities to use the internet to communicate with others or receive information about mental health (ie, online mental health communication) are growing in popularity among young adults (aged 18\u201029 y). However, whether exposure to the negative experience of racism online is associated with the use of digital mental health tools and online mental health communication remains an important empirical question for Black young adults, given their frequent online use and engagement.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study sought to examine (1) how the frequency of exposure to online racism is associated with the use of digital mental health tools and engagement in online mental health communication and (2) how these associations differ for Black young adults with either anxiety and depression versus those without.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Conducted from July to September 2024, data came from a larger cross-sectional study of 1005 monoracial Black young adults (\n \n mean age 24.07, SD3.04 y; 50.6% women) who completed an online survey and self-reported measures of exposure to online racism, use of digital mental health tools, frequency of engaging in online mental health communication, and anxiety and depressive symptoms. Two separate path analysis regression models were conducted for the outcomes of depression and anxiety.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Our results showed that more frequent exposure to online racism was associated with a greater likelihood of using digital mental health tools (odds ratio [OR] range 1.72\u20101.84;\n P<\/jats:italic>\n <.001) and a greater engagement in online mental health communication (\n \u03b2<\/jats:italic>\n range=.31-.36;\n P<\/jats:italic>\n <.001). Those with depression and anxiety also had a greater likelihood of using digital mental health tools (depression OR 2.02;\n P<\/jats:italic>\n =.001; and anxiety OR 1.71,\n P<\/jats:italic>\n =.005) and a greater engagement in online mental health communication (depression\n \u03b2<\/jats:italic>\n =.21;\n P<\/jats:italic>\n <.001; and anxiety\n \u03b2<\/jats:italic>\n =.16;\n P<\/jats:italic>\n <.001). Neither anxiety nor depression was a significant moderator.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Exposure to online racism, digital mental health tools use, and online mental health communication are linked for Black young adults. Black young adults may use digital mental health tools and engage in mental health communication online when they experience online racism or may experience online racism when they use these tools and engage online, necessitating further longitudinal analyses of these relationships. Complementary digital intervention implementation strategies that support mental health while mitigating online racism are needed. Ensuring that digital tools and mental health communications opportunities are safe, culturally relevant, and free from online racism is a set of mutually reinforcing priorities for digital interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/80657","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T20:55:07Z","timestamp":1765400107000},"page":"e80657-e80657","source":"Crossref","is-referenced-by-count":1,"title":["Online Racism, Digital Mental Health Tools, and Online Mental Health Communication Among Black Young Adults With and Without Depression or Anxiety: Cross-Sectional Quantitative Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2619-3591","authenticated-orcid":false,"given":"Melissa Christine","family":"Holland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5994-1975","authenticated-orcid":false,"given":"Kyle Aaron","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1198-9366","authenticated-orcid":false,"given":"Oreoluwa Oluwatomisin","family":"Badejoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0679-1160","authenticated-orcid":false,"given":"Vanessa Victoria","family":"Volpe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6018-2094","authenticated-orcid":false,"given":"Brian TaeHyuk","family":"Keum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-5966","authenticated-orcid":false,"given":"Jimi","family":"Huh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8458-8723","authenticated-orcid":false,"given":"Hans","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"7","key":"R1","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/S2215-0366(14)00080-7","article-title":"The new life stage of emerging adulthood at ages 18-29 years: implications for mental health","volume":"1","author":"Arnett","journal-title":"Lancet Psychiatry"},{"key":"R2","unstructured":"Perrin A Atske S . About three-in-ten u.s. adults say they are \u2018almost constantly\u2019 online. Pew Research Center. Mar 26, 2021. URL: https:\/\/www.pewresearch.org\/short-reads\/2021\/03\/26\/about-three-in-ten-u-s-adults-say-they-are-almost-constantly-online\/ [Accessed 20-12-2025]"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.appdev.2008.12.010","article-title":"College students\u2019 social networking experiences on Facebook","volume":"30","author":"Pempek","journal-title":"J Appl Dev Psychol"},{"issue":"3","key":"R4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1002\/wps.20472","article-title":"The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials","volume":"16","author":"Firth","journal-title":"World Psychiatry"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1109\/MTS.2023.3241309","article-title":"AI-based and digital mental health apps: balancing need and risk","volume":"42","author":"Hamdoun","journal-title":"IEEE Technol Soc Mag"},{"issue":"CSCW2","key":"R6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3555203","article-title":"Meeting young adults\u2019 social support needs across the health behavior change journey: implications for digital mental health tools","volume":"6","author":"Meyerhoff","journal-title":"Proc ACM Hum Comput Interact"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2017.05.023","article-title":"Beyond symptom monitoring: consumer needs for bipolar disorder self-management using smartphones","volume":"44","author":"Nicholas","journal-title":"Eur Psychiatry"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/13524","article-title":"Young people seeking help online for mental health: cross-sectional survey study","volume":"6","author":"Pretorius","journal-title":"JMIR Ment Health"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.lisr.2010.07.015","article-title":"\u201cI did not realize so many options are available\u201d: cognitive authority, emerging adults, and e-mental health","volume":"33","author":"Neal","journal-title":"Libr Inf Sci Res"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1001\/archpsyc.62.6.593","article-title":"Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication","volume":"62","author":"Kessler","journal-title":"Arch Gen Psychiatry"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.21037\/mhealth-22-19","article-title":"Developing culturally-adapted mobile mental health interventions: a mixed methods approach","volume":"9","author":"Willis","journal-title":"mHealth"},{"issue":"2","key":"R12","doi-asserted-by":"publisher","first-page":"200","DOI":"10.2105\/ajph.93.2.200","article-title":"Racial\/ethnic discrimination and health: findings from community studies","volume":"93","author":"Williams","journal-title":"Am J Public Health"},{"issue":"6","key":"R13","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1037\/vio0000201","article-title":"Racism on the internet: conceptualization and recommendations for research","volume":"8","author":"Keum","journal-title":"Psychol Violence"},{"issue":"2","key":"R14","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1177\/21676968241298023","article-title":"From microaggressions to viral trends: a qualitative examination of Black emerging adults\u2019 experiences with online racial discrimination","volume":"13","author":"Banks","journal-title":"Emerg Adulthood"},{"issue":"Suppl 1","key":"R15","doi-asserted-by":"publisher","first-page":"311","DOI":"10.18865\/ed.31.S1.311","article-title":"Anti-Black structural racism goes online: a conceptual model for racial health disparities research","volume":"31","author":"Volpe","journal-title":"Ethn Dis"},{"issue":"2","key":"R16","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1093\/swr\/svaa002","article-title":"Exposure to community-based violence on social media among Black male emerging adults involved with the criminal justice system","volume":"44","author":"Motley","journal-title":"Soc Work Res"},{"issue":"5","key":"R17","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1002\/jts.22640","article-title":"Liberatory media literacy as protective against posttraumatic stress for emerging adults of color","volume":"34","author":"Volpe","journal-title":"J Trauma Stress"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1177\/0011000006292033","article-title":"Racism and psychological and emotional injury: recognizing and assessing race-based traumatic stress","volume":"35","author":"Carter","journal-title":"Couns Psychol"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1080\/07448481.2022.2034833","article-title":"Online racial discrimination and mental health among Black undergraduates: the moderating role of gender","volume":"72","author":"Grapin","journal-title":"J Am Coll Health"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1177\/14614448231191542","article-title":"Black representation in social media well-being research: a scoping review of social media experience and psychological well-being among Black users in the United States","volume":"26","author":"Park","journal-title":"New Media Soc"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1111\/jora.12717","article-title":"Gender and racial identity moderate the effects of online and offline discrimination on mental health: dismantling systems of racism and oppression during adolescence","volume":"32","author":"Perkins","journal-title":"J Res Adolesc"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2022.101305","article-title":"Social media use, stress, and coping","volume":"45","author":"Wolfers","journal-title":"Curr Opin Psychol"},{"issue":"5","key":"R23","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1027\/1864-1105\/a000387","article-title":"\"Speak[ing] my mind\u201d: reasons for using Twitter and the online experiences, critical media literacy, and racial identity of Black American emerging adults","volume":"35","author":"Volpe","journal-title":"J Media Psychol"},{"issue":"2","key":"R24","doi-asserted-by":"publisher","DOI":"10.1177\/2056305120928488","article-title":"\u201cGood social media?\u201d: underrepresented youth perspectives on the ethical and equitable design of social media platforms","volume":"6","author":"Brough","journal-title":"Soc Media Soc"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1037\/dhe0000054","article-title":"Collegians creating (counter)space online: a critical discourse analysis of the I, too, am social media movement","volume":"11","author":"George Mwangi","journal-title":"J Divers High Educ"},{"issue":"5","key":"R26","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1037\/cou0000674","article-title":"Resisting and countering online racial hate: antiracism advocacy and coping online with racism as moderators of distress associated with online racism","volume":"70","author":"Keum","journal-title":"J Couns Psychol"},{"issue":"9","key":"R27","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1037\/pas0000558","article-title":"The online social support scale: measure development and validation","volume":"30","author":"Nick","journal-title":"Psychol Assess"},{"issue":"12","key":"R28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0278763","article-title":"Coping with online racism: Patterns of online social support seeking and anti-racism advocacy associated with online racism, and correlates of ethnic-racial socialization, perceived health, and alcohol use severity","volume":"17","author":"Keum","journal-title":"PLoS ONE"},{"issue":"CSCW1","key":"R29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3392828","article-title":"\u201cThey just don\u2019t get it\u201d: towards social technologies for coping with interpersonal racism","volume":"4","author":"To","journal-title":"Proc ACM Hum-Comput Interact"},{"key":"R30","doi-asserted-by":"crossref","unstructured":"Musgrave T Cummings A Schoenebeck S . Experiences of harm, healing, and joy among black women and femmes on social media. Presented at: CHI \u201922: Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems; Apr 29 to May 5, 2022; New Orleans LA USA. Apr 29, 2022.[doi: 10.1145\/3491102.3517608]","DOI":"10.1145\/3491102.3517608"},{"issue":"4","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/26994","article-title":"Rise in use of digital mental health tools and technologies in the United States during the COVID-19 pandemic: survey study","volume":"23","author":"Sorkin","journal-title":"J Med Internet Res"},{"issue":"2","key":"R32","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1089\/tmj.2018.0316","article-title":"Mental health-related digital use by university students: a systematic review","volume":"26","author":"Montagni","journal-title":"Telemed J E Health"},{"issue":"4","key":"R33","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1037\/pha0000575","article-title":"The validity of qualtrics panel data for research on video gaming and gaming disorder","volume":"30","author":"Belliveau","journal-title":"Exp Clin Psychopharmacol"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1016\/j.chbr.2021.100082","article-title":"Development and validation of the Perceived Online Racism Scale short form (15 items) and very brief (six items)","volume":"3","author":"Keum","journal-title":"Comput Human Behav Rep"},{"issue":"9","key":"R35","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","journal-title":"J Gen Intern Med"},{"issue":"10","key":"R36","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","journal-title":"Arch Intern Med"},{"issue":"3","key":"R37","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1093\/aje\/kwy250","article-title":"Some desirable properties of the bonferroni correction: is the Bonferroni correction really so bad?","volume":"188","author":"VanderWeele","journal-title":"Am J Epidemiol"},{"issue":"3","key":"R38","doi-asserted-by":"publisher","DOI":"10.1177\/25152459231187531","article-title":"Tutorial: power analyses for interaction effects in cross-sectional regressions","volume":"6","author":"Baranger","journal-title":"Adv Methods Pract Psychol Sci"},{"issue":"6","key":"R39","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1037\/ort0000730","article-title":"Online xenophobia and mental health among Venezuelan migrant youth in Colombia: the interplay with \u201cin-person\u201d discrimination","volume":"94","author":"Salas-Wright","journal-title":"Am J Orthopsychiatry"},{"issue":"3","key":"R40","doi-asserted-by":"publisher","DOI":"10.1177\/20563051241277607","article-title":"Young Black American women\u2019s social media use and online victimization","volume":"10","author":"Onuoha","journal-title":"Soc Media Soc"},{"issue":"2","key":"R41","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1177\/2332649220948179","article-title":"Discrimination and Black social media use: sites of oppression and expression","volume":"7","author":"Miller","journal-title":"Sociol Race Ethn"},{"issue":"8","key":"R42","doi-asserted-by":"publisher","first-page":"2062","DOI":"10.1007\/s10964-025-02177-w","article-title":"Race and anti-racist online coping as moderators of college adjustment associated with exposure to social media racism among Asian, Black, and Hispanic\/Latine students","volume":"54","author":"Park","journal-title":"J Youth Adolesc"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231216559","article-title":"Intention to use digital mental health solutions: A cross-sectional survey of university students attitudes and perceptions toward online therapy, mental health apps, and chatbots","volume":"9","author":"Gbollie","journal-title":"Digit Health"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","first-page":"73","DOI":"10.5172\/jamh.9.1.73","article-title":"Universal online interventions might engage psychologically distressed university students who are unlikely to seek formal help","volume":"9","author":"Ryan","journal-title":"Adv Ment Health"},{"issue":"103972","key":"R45","doi-asserted-by":"publisher","first-page":"103972","DOI":"10.1016\/j.brat.2021.103972","article-title":"The effect of depression and anxiety symptom severity on clinical outcomes and app use in digital mental health treatments: Meta-regression of three trials","volume":"147","author":"Mohr","journal-title":"Behav Res Ther"},{"issue":"6","key":"R46","doi-asserted-by":"publisher","first-page":"3958","DOI":"10.1007\/s11469-023-01093-z","article-title":"Problematic internet use, online racism, and mental health issues among racially minoritized emerging adults in the United States","volume":"22","author":"Keum","journal-title":"Int J Ment Health Addiction"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1037\/hea0001408","article-title":"Online and offline gendered racial microaggressions and sleep quality for Black women","volume":"44","author":"Volpe","journal-title":"Health Psychol"},{"key":"R48","unstructured":"Volk J Palanker D O\u2019Brien M Goe CL . States\u2019 actions to expand telemedicine access during COVID-19 and future policy considerations. The Commonwealth Fund. Jun 23, 2021. URL: https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2021\/jun\/states-actions-expand-telemedicine-access-covid-19 [Accessed 24-06-2025]"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e80657","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:14:14Z","timestamp":1782843254000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e80657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":48,"URL":"https:\/\/doi.org\/10.2196\/80657","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]},"article-number":"v10i7e80657"}}