Social Network Factors Associated with the Intention to Use Digital Mental Health Interventions Among AANHPI Emerging Adults: Application and Integration of the Network Episode Model.

BACKGROUND: Asian American, Native Hawaiian, and Pacific Islander (AANHPI) emerging adults face significant mental health disparities yet consistently underutilize formal mental health services. Digital mental health interventions (DMHI) have been proposed as a solution; however, the social network factors shaping intention to use DMHIs in this population remain poorly understood among this highly collectivist population. Prior work has established that individual-level factors derived from the Seeking Mental Health Care model (i.e., perceived need, mental health literacy, and stigma) are associated with intention to use DMHI among AANHPI emerging adults. The present study integrates the Network Episode Model to examine whether social network characteristics are associated with DMHI intention and whether they moderate established associations with individual-level factors.

METHODS: Cross-sectional survey data were drawn from a Qualtrics panel study of AANHPI emerging adults ages 18-29 (N = 1,577). Nested multivariable logistic regression models were estimated: Model 1 replicated the individual-level specification; Model 2 added social network variables; and Models 3a-3c each tested a theoretically motivated interaction term. A Bonferroni-corrected threshold of α = .017 was applied across the three interaction tests.

RESULTS: Adding social network variables significantly improved model fit. Awareness that friends or family use DMHIs and current therapy engagement were strongly associated with DMHI intention. Structural network size and social support quality did not reach significance. All individual-level variables remained significant after social-network variable inclusion. Symptom severity was non-significant across all models. Only the friends and family DMHI use × public stigma interaction was significant: among participants uncertain whether their network used DMHIs, higher public stigma was associated with substantially greater DMHI intention. Significant ethnic heterogeneity persisted across all models.

CONCLUSIONS: Knowledge of peer DMHI use and formal treatment engagement, contribute to DMHI intention beyond individual-level factors, supporting an integrated individual and social network framework. The significant stigma × peer DMHI use interaction suggests stigma may suppress network conversations about digital help-seeking, pointing to distinct intervention approaches for this subgroup. Findings underscore the importance of network-level strategies for increasing DMHI engagement in AANHPI communities.