Prospective Cohort of Rural US Adults to Definitively Characterize Depression and Suicidal Ideation Burdens, Determinants, and Preferred Intervention Approaches

Modified Project Summary/Abstract Section Limited data exists on adults at higher risk of poor mental health and suicidality across the life course in rural areas of the United States, though where data are available, they suggest higher rates of mental disorders for rural adults affected by social stressors. Technology-delivered mental health interventions are being increasingly explored among the general population and hold promise for use among rural communities, but they must take into account the experiences of this population to be effective. This research team from the Department of Mental Health and Key Populations Program at Johns Hopkins University and Emory University will use online approaches to enroll 2000 adults at heightened risk of poor mental health from rural counties and small cities across the US to follow for 12 months with repeated questionnaires to: 1) examine social, geographic, and economic factors associated with increased prevalent depression and suicide ideation or attempt; 2) determine whether these exposures are associated with incident depression or suicidal ideation or attempt; and, 3) compare the relative acceptability of various technology-delivered interventions for depression and suicide prevention tailored to addressing identified exposures. This study will produce a comprehensive investigation of social, economic, and geographic factors related to prevalent mental health outcomes among rural adults, as well as by what pathways they may predict incident depression, suicidal ideation and attempts. The study will also provide substantive evidence-based recommendations for the development or adaptation of technology- delivered interventions to address mental health among rural communities.