(PS6-91) Understanding Health Service Use and Preferences of Black Americans using an Ecological Systems Approach: Findings from a Scoping Review

Saturday, November 22, 2025

11:30 AM - 12:30 PM CST

Location: Elite Hall A, Level 1

Author(s)

KG

Kaylyn A. Garcia, M.A.

Graduate Student
University of South Carolina
Columbia, South Carolina, United States

Co-Author(s)

Savannah B. Simpson, M.S.

Graduate Student
University of South Carolina
Columbia, South Carolina, United States
TM

Thrisha Mote, None

Undergraduate Research Assistant
University of South Carolina
Columbia, South Carolina, United States
EC

Elliot Chadwell, None

Undergraduate Research Assistant
University of South Carolina
Columbia, South Carolina, United States
GW

Guillermo Wippold, Ph.D.

Associate Professor
University of South Carolina
Columbia, South Carolina, United States

Abstract Text: There is an urgent need to expand the accessibility and impact of evidence-based therapies (EBTs) through culturally tailored care. Though this expansion is stymied by research indicating that Black Americans often face barriers to accessing therapy and may distrust mental health services due to their lack of cultural relevance and failure to consider contextual factors influencing mental well-being. As a result, many Black Americans seek informal sources of mental health support—such as peer support and church groups—rather than services provided by licensed mental health professionals. Thus, understanding Black Americans' mental health needs, use, and preferences is crucial for tailoring services. Accordingly, this scoping review was conducted to explore Black American adults’ formal and informal mental health service use and preferences across ecological systems to develop a comprehensive understanding of how mental health service use and preferences span across and are influenced by individual, interpersonal, community, and societal-level factors. Articles were identified through searches in PubMed, EMBASE, PsycINFO, CINAHL, and Web of Science. A total of 1,570 articles were collected and screened using Rayyan. Titles and abstracts were independently reviewed in a blinded process by two reviewers, with a third reviewer resolving any discrepancies. Full-text articles from included studies were retrieved and further assessed for inclusion/exclusion. Two reviewers independently conducted data extraction for the remaining articles, which resulted in 39 studies that were included in this review. Findings from this review indicate that Black American adults utilize and prefer mental health services across all ecological systems. The results indicate that there is a preference for a blended approach that incorporates both formal (e.g., individual psychotherapy) and informal (e.g., religion) sources of mental health support. These findings also challenge conventional models that primarily position mental health services at the individual and interpersonal levels as Black American adults report utilizing and favoring mental health support beyond these levels - highlighting the importance of broader, community-centered and societal/political approaches to improving mental health. Moreover, the results underscore the need to integrate formal and informal mental health services, such as EBTs that incorporate religious, spiritual, community, or other cultural elements. This presentation will offer clinicians and program developers practical strategies to enhance the cultural relevance of EBTs and other mental health services, ultimately fostering more effective and meaningful mental health support for Black American communities.