Development, implementation, and evaluation of equitable and effective e-mental health care delivery for parents and care givers struggling with anxiety and depression arising during the COVID-19 pandemic: improving access and matching services to need.

Parents, particularly women, are experiencing heightened anxiety and depression during the COVID-19 pandemic. It is unclear which specific stressors faced by parents are overwhelming their coping resources during COVID-19. Evidently though, treatment is needed. E-mental health care has become a necessity during the pandemic. Not all adult e-services, however, provide the necessary content to help parents with pandemic-related distress and needs nor provide options to access care in a way that is flexible to the needs of parents with children at home. To address this problem, we adapted an existing iCBT for anxiety and depression program in an innovative way by integrating COVID-19-specific content and developing three service delivery options: unguided, minimally guided, or fully guided. The present study seeks to: (1) investigate parents' preferences for levels of iCBT service delivery in the context of COVID-19, (2) match access to service with parents' individual needs by enrolling them in a COVID-19-adapted iCBT program with their choice of service delivery method and explore whether levels of iCBT service delivery predict treatment outcome; (3) identify which COVID-19 parent stressors are most prevalent and associated with intervention outcome (by gender), by using machine learning to mine written responses in the iCBT program; and (4) improve rapid access to e-mental health through primary care and mental health and addictions services. Participants will be parents (of children under 18 years) recruited from primary care and mental health and addictions services in the Maritimes. They will choose unguided, minimally-guided or fully-guided iCBT. Guidance will be via phone, video, or in-app messaging (at participant preference) at a time convenient for the parent. Outcomes will be measured pre- and post-intervention. Results will contribute to the development of equitable and effective mental health services for parents, particularly during a pandemic.