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Saboor S, Medina A, Marciano L. Application of Positive Psychology in Digital Interventions for Children, Adolescents, and Young Adults: Systematic Review and Meta-Analysis of Controlled Trials. JMIR Ment Health 2024; 11:e56045. [PMID: 39141906 PMCID: PMC11358669 DOI: 10.2196/56045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The rising prevalence of mental health issues in children, adolescents, and young adults has become an escalating public health issue, impacting approximately 10%-20% of young people on a global scale. Positive psychology interventions (PPIs) can act as powerful mental health promotion tools to reach wide-ranging audiences that might otherwise be challenging to access. This increased access would enable prevention of mental disorders and promotion of widespread well-being by enhancing self-efficacy, thereby supporting the achievement of tangible objectives. OBJECTIVE We aimed to conduct a comprehensive synthesis of all randomized controlled trials and controlled trials involving children, adolescents, and young adults, encompassing both clinical and nonclinical populations, to comprehensively evaluate the effectiveness of digital PPIs in this age group. METHODS After a literature search in 9 electronic databases until January 12, 2023, and gray literature until April 2023, we carried out a systematic review of 35 articles, of which 18 (51%) provided data for the meta-analysis. We included randomized controlled trials and controlled trials mainly based on web-based, digital, or smartphone-based interventions using a positive psychology framework as the main component. Studies included participants with a mean age of <35 years. Outcomes of PPIs were classified into indicators of well-being (compassion, life satisfaction, optimism, happiness, resilience, emotion regulation and emotion awareness, hope, mindfulness, purpose, quality of life, gratitude, empathy, forgiveness, motivation, and kindness) and ill-being (depression, anxiety, stress, loneliness, and burnout). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for the selection of studies and data extraction. Quality assessment was performed following the CONSORT (Consolidated Standards of Reporting Trials) guidelines. RESULTS For well-being outcomes, meta-analytic results showed that PPIs augmented the feeling of purpose, gratitude, and hope (Hedges g=0.555), compassion (Hedges g=0.447), positive coping behaviors (Hedges g=0.421), body image-related outcomes (Hedges g=0.238), and positive mindset predisposition (Hedges g=0.304). For ill-being outcomes, PPIs reduced cognitive biases (Hedges g=-0.637), negative emotions and mood (Hedges g=-0.369), and stress levels (Hedges g=-0.342). Of note, larger effect sizes were found when a waiting list control group was considered versus a digital control group. A funnel plot showed no publication bias. Meta-regression analyses showed that PPIs tended to show a larger effect size on well-being outcomes in studies including young adults, whereas no specific effect was found for ill-being outcomes. CONCLUSIONS Revised evidence suggests that PPIs benefit young people's well-being and mitigate ill-being symptoms. Digital platforms offer a unique way to address their mental health challenges, although not without limitations. Future research should explore how they work for the needs of the young population and further examine what specific PPIs or combination of interventions is most beneficial with respect to other digital control groups. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42023420092; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=420092.
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Affiliation(s)
- Sundas Saboor
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Adrian Medina
- Deptartment of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Laura Marciano
- Lee Kum Sheung Center for Health and Happiness, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Escuadra CJ, Chiong Maya A, Nava JBP, Vergara JA, Bea TC, Javier AM, Karamihan F, Padilla DP, Reyes AJ, Samonte J, Serrano SI. Students' perceptions and experiences of an online well-being programme: a phenomenological study protocol. BMJ Open 2024; 14:e075910. [PMID: 38458784 DOI: 10.1136/bmjopen-2023-075910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The pandemic has ensued challenges across all sections of the human population such as livelihood and educational changes, which involve the abrupt shift to online learning, immensely affecting the students' well-being. Negative health consequences of e-learning among students stem from the increased demand for new technological skills, productivity, information overload and restriction of students to spend time with their peers. OBJECTIVE To explore the experiences of the students from the University of Santo Tomas-College of Rehabilitation Sciences (UST-CRS) who participated in the online well-being programme. METHODOLOGY A phenomenological design will be used to determine the participants' perceptions and experiences. Purposive sampling will be used to recruit 8-10 undergraduate students from UST-CRS ages 18-22 years, who participated in the well-being programme, and completed the study's quantitative counterpart. Semistructured, in-depth questions will be used to conduct a focus group discussion. The transcripts will be analysed using thematic analysis via the NVivo V.12 software. ETHICS AND DISSEMINATION The study protocol is approved by the UST-CRS Ethical Review Committee (Protocol Number: SI-2022-034 (V.4)). It will be implemented in accordance with the Declaration of Helsinki and the National Ethical Guidelines for Health and Health-Related Research, and Data Privacy Act. Findings will be published in accredited journals and presented in related scientific fora. REGISTRATION ID PHRR230214-005419; Philippine Health Research Registry.
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Affiliation(s)
| | - Arlene Chiong Maya
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Jordan Barbra P Nava
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Jose Avelino Vergara
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Trisha Coleen Bea
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Angelo Miguel Javier
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Francine Karamihan
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | | | - Albert Josef Reyes
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
| | - Julia Samonte
- College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines
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Ho TQA, Le LKD, Engel L, Le N, Melvin G, Le HND, Mihalopoulos C. Barriers to and facilitators of user engagement with web-based mental health interventions in young people: a systematic review. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02386-x. [PMID: 38356043 DOI: 10.1007/s00787-024-02386-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Abstract
Many young people (YP) are diagnosed with mental illnesses and require support. Web-based mental health interventions (W-MHIs) have been increasingly utilized by YP, healthcare providers, and parents due to reasons including convenience and anonymity. W-MHIs are effective in improving mental health in YP. However, real-world engagement with W-MHIs remains low. Therefore, understanding barriers/facilitators of user engagement with W-MHIs is necessary to promote W-MHIs and help users gain optimal benefits through higher engagement. This review aims to identify barriers/facilitators of user engagement with W-MHIs in YP aged 10-24 years. A systematic search of five databases for English language, peer-reviewed publications was conducted between January 2010 and February 2023. Studies examining factors influencing user engagement with W-MHIs, described as barriers or facilitators, were included. Study quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was performed. Of 4088 articles identified, 69 studies were included. Barriers/facilitators were reported by young people (63 studies), providers (17 studies), and parents/caregivers (8 studies). YP perceived that usefulness and connectedness were the most common facilitators, whereas low-perceived need was the most reported barrier. Both providers and parents reported that perceived usefulness for YP was the most common facilitator, whereas concerns about program effectiveness and privacy were noted as barriers. This review found that program- and individual-related factors were important determinants of engagement with W-MHIs. This review provides guidance on the future design and development of new interventions, narrowing the gap between existing W-MHIs and unmet needs of users.
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Affiliation(s)
- Thi Quynh Anh Ho
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia.
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ngoc Le
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Ha N D Le
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Brinsley J, Singh B, Maher CA. A Digital Lifestyle Program for Psychological Distress, Wellbeing and Return-to-Work: A Proof-of-Concept Study. Arch Phys Med Rehabil 2023; 104:1903-1912. [PMID: 37209933 DOI: 10.1016/j.apmr.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To demonstrate proof-of-concept for a chatbot-led digital lifestyle medicine program in aiding rehabilitation for return-to-work. DESIGN Retrospective cohort study with pre-post measures. SETTING Community setting, Australia. PARTICIPANTS 78 adult participants (mean age 46 years, 32% female) with an active workers' compensation claim (N=78). INTERVENTIONS A 6-week digital lifestyle medicine program led by an artificially intelligent virtual health coach and weekly telehealth calls with a health coach. MAIN OUTCOME MEASURES Adherence (% program completions) and engagement (% of daily and weekly sessions completed), changes in depression, anxiety and distress (K10), psychological wellbeing (WHO-5), return-to-work confidence and anxiety and change in work status. RESULTS Sixty participants completed the program (72%), with improvements in psychological distress (P≤.001, r=.47), depression (P<.001, r=.55), anxiety (P<.001, r=.46) and wellbeing (P<.001, r=.62) were noted, as well as increased confidence about returning to work (P≤.001, r=.51) and improved work status (P≤.001). Anxiety about returning to work remained unchanged. Participants completed an average of 73% of daily virtual coach sessions and 95% of telehealth coaching sessions. CONCLUSIONS Artificial intelligence technology may be able to provide a practical, supportive, and low-cost intervention to improve psychosocial outcomes among individuals on an active workers' compensation claim. Further, controlled research is needed to confirm these findings.
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Affiliation(s)
- Jacinta Brinsley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.
| | - Ben Singh
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Carol A Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
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Pendergrass Boomer TM, Hoerner LA, Fernandes CSF, Maslar A, Aiudi S, Kyriakides TC, Fiellin LE. A digital health game to prevent opioid misuse and promote mental health in adolescents in school-based health settings: Protocol for the PlaySmart game randomized controlled trial. PLoS One 2023; 18:e0291298. [PMID: 37683047 PMCID: PMC10490848 DOI: 10.1371/journal.pone.0291298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/10/2023] Open
Abstract
Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions. We describe the protocol for a randomized controlled trial designed to assess the efficacy of an original digital health game, PlaySmart. Five hundred and thirty-two adolescents aged 16-19 years old, who are at greater risk for initiating opioid misuse are recruited from 10 Connecticut school-based health sites. Participants are randomized to PlaySmart or a set of time/attention control videogames. Randomization was stratified by sex at birth and school grade. Participants play their assigned game or games for up to six weeks (300 minutes) and complete assessment questions over a 12-month period (baseline, post-gameplay, 3, 6, and 12 months). The primary outcome is perception of risk of harm of opioid misuse at 3 months. Secondary outcome measures specific to opioid misuse include intentions, self-efficacy, attitudes, knowledge, and perceived norms. Mental health outcomes include measures of depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7), help-seeking behaviors, stigma, measures of self-regulation, self-efficacy to seek professional help for mental health, and knowledge around coping skills. PlaySmart has the potential to significantly reduce the risk of initiation of opioid misuse, improve mental health outcomes, and given its high levels of engagement and accessibility, holds the promise for extensive reach, scale, and impact for adolescents. Trial registration: ClinicalTrials.gov: NCT04941950. Registered on 23 June 2021.
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Affiliation(s)
- Tyra M. Pendergrass Boomer
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Lily A. Hoerner
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Claudia-Santi F. Fernandes
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
- Department of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States of America
| | - Amber Maslar
- Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Sherry Aiudi
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Tassos C. Kyriakides
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Lynn E. Fiellin
- play2PREVENT Lab at the Yale Center for Health & Learning Games, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Yale Child Study Center, New Haven, CT, United States of America
- Yale School of Public Health, New Haven, CT, United States of America
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Bevan Jones R, Hussain F, Agha SS, Weavers B, Lucassen M, Merry S, Stallard P, Simpson SA, Rice F. Digital technologies to support adolescents with depression and anxiety: review. BJPSYCH ADVANCES 2023; 29:239-253. [PMID: 37521105 PMCID: PMC10374830 DOI: 10.1192/bja.2022.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 01/21/2023]
Abstract
Depression and anxiety are common in adolescents, but most affected will not get any formal help. Digital mental health technologies (i.e. resources and interventions to support and improve mental health) are a potential way to extend the reach and increase adolescents' access to therapies, at a relatively low cost. Many young people can access the internet and mobile technologies, including in low- and middle-income countries. There has been increased interest in integrating technologies in a range of settings, especially because of the effect of the COVID-19 pandemic on adolescent mental health, at a time when services are under pressure. This clinical review gives an overview of digital technologies to support the prevention and management of depression and anxiety in adolescence. The technologies are presented in relation to their technological approaches, underlying psychological or other theories, setting, development, evaluations to date and how they might be accessed. There is also a discussion of the potential benefits, challenges and future developments in this field.
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Affiliation(s)
- Rhys Bevan Jones
- Senior Clinical Research Fellow in the Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, and a psychiatrist with Cwm Taf Morgannwg University Health Board, Wales, UK
| | - Faris Hussain
- Academic Foundation Year 2 doctor with Cwm Taf Morgannwg University Health Board, Wales, UK
| | - Sharifah Shameem Agha
- Lecturer with Cwm Taf Morgannwg University Health Board and an honorary lecturer in the Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Bryony Weavers
- Research assistant in the Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Mathijs Lucassen
- Senior lecturer in mental health in the Department of Health and Social Care, The Open University, UK, and an honorary senior lecturer in psychological medicine at the University of Auckland, New Zealand
| | - Sally Merry
- Professor in Child and Adolescent Mental Health in the Faculty of Medical and Health Sciences at the University of Auckland, New Zealand
| | - Paul Stallard
- Professor of Child and Family Mental Health in the Department for Health at the University of Bath, England, UK
| | - Sharon Anne Simpson
- Professor of Behavioural Sciences and Health in the Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Scotland, UK
| | - Frances Rice
- Professor of Developmental Psychopathology in the Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
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Subotic-Kerry M, Braund TA, Gallen D, Li SH, Parker BL, Achilles MR, Chakouch C, Baker S, Werner-Seidler A, O'Dea B. Examining the impact of a universal positive psychology program on mental health outcomes among Australian secondary students during the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2023; 17:70. [PMID: 37308960 DOI: 10.1186/s13034-023-00623-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND This study aimed to examine the impact of a web-based positive psychology program delivered universally to secondary school students during school closures caused by the COVID-19 pandemic in New South Wales, Australia. METHODS Using a quasi-experimental design conducted in 2020, 438 students aged 12-15 years (73% male) from 4 secondary schools were invited to complete the 'Bite Back Mental Fitness Challenge'. This web-based program consisted of 7 self-directed modules that targeted 5 key domains of positive psychology. Self-reported symptoms of anxiety and depression and help-seeking intentions for mental health were assessed at baseline prior to school closures (February to March 2020) and at post-test after the return to school (July to August 2020). At post-test, students also reported on their perceived changes in mental health and help-seeking behavior for mental health during the pandemic. Completion of the program modules was recorded. RESULTS A total of 445 students consented and 336 (75.5%) completed both assessments. On average, participants completed 2.31 modules (SD: 2.38, range: 0 to 7). There was no change in symptoms of anxiety and depression or help-seeking intentions between baseline and post-test, with no significant effects for gender and history of mental illness. Students who were symptomatic for anxiety and depression at baseline reported lower symptoms at post-test, but this change was not significant. Ninety-seven students (27.5%) reported that their mental health had worsened during the pandemic, and a significant increase in anxiety and depressive symptoms was found in this subsample at post-test. Only 7.7% of students reported a change in their help-seeking behavior, with increased mental health support sought from the Internet, parents, and friends. CONCLUSIONS The universal delivery of a web-based positive psychology program during school closures did not appear to be associated with improved mental health symptoms; however, completion of the modules was low. Different effects may emerge when selectively delivered to students with mild or greater symptoms. The findings also suggest that broader measures of mental health and wellbeing, including perceived change, are key to the mental health surveillance of students during periods of remote learning.
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Affiliation(s)
- Mirjana Subotic-Kerry
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia.
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Taylor A Braund
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Dervla Gallen
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Sophie H Li
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Belinda L Parker
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Melinda R Achilles
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Cassandra Chakouch
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
| | - Simon Baker
- Orygen, University of Melbourne, Melbourne, VIC, Australia
| | - Aliza Werner-Seidler
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Bridianne O'Dea
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Lepage S, Conway A, Goodson N, Wicks P, Flight L, Devane D. Online randomised trials with children: A scoping review. PLoS One 2023; 18:e0280965. [PMID: 37228143 PMCID: PMC10212186 DOI: 10.1371/journal.pone.0280965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Paediatric trials must contend with many challenges that adult trials face but often bring additional obstacles. Decentralised trials, where some or all trial methods occur away from a centralised location, are a promising strategy to help meet these challenges. This scoping review aims to (a) identify what methods and tools have been used to create and conduct entirely online-decentralised trials with children and (b) determine the gaps in the knowledge in this field. This review will describe the methods used in these trials to identify their facilitators and the gaps in the knowledge. METHODS The methods were informed by guidance from the Joanna Briggs Institute and the PRISMA extension for scoping reviews. We systematically searched MEDLINE, CENTRAL, CINAHL, and Embase databases, trial registries, pre-print servers, and the internet. We included randomised and quasi-randomised trials conducted entirely online with participants under 18 published in English. A risk of bias assessment was completed for all included studies. RESULTS Twenty-one trials met our inclusion criteria. The average age of participants was 14.6 years. Social media was the most common method of online recruitment. Most trials employed an external host website to store and protect their data. Duration of trials ranged from single-session interventions up to ten weeks. Fourteen trials compensated participants. Eight trials involved children in their trial design process; none reported compensation for this. Most trials had a low risk of bias in "random sequence generation", "selective reporting", and "other". Most trials had a high risk of bias in "blinding participants and personnel", "blinding of outcome assessment", and "incomplete outcome data". "Allocation concealment" was unclear in most studies. CONCLUSIONS There was a lack of transparent reporting of the recruitment, randomisation, and retention methods used in many of the trials included in this review. Patient and public involvement (PPI) was not common, and the compensation of PPI partners was not reported in any study. Consent methods and protection against fraudulent entries to trials were creative and thoroughly discussed by some trials and not addressed by others. More work and thorough reporting of how these trials are conducted is needed to increase their reproducibility and quality. ETHICS AND DISSEMINATION Ethical approval was not necessary since all data sources used are publicly available.
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Affiliation(s)
- Simone Lepage
- Health Research Board–Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Aislinn Conway
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
| | - Noah Goodson
- Data & Analytics, Thread Research, Tustin, California, United States of America
| | - Paul Wicks
- Wicks Digital Health, Lichfield, Staffordshire, United Kingdom
| | - Laura Flight
- National Institute for Health and Care Excellence, Piccadilly Plaza, Manchester, United Kingdom
| | - Declan Devane
- Health Research Board–Trials Methodology Research Network (HRB-TMRN), University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland, University of Galway, Galway, Ireland
- Cochrane Ireland, University of Galway, Galway, Ireland
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Wright M, Reitegger F, Cela H, Papst A, Gasteiger-Klicpera B. Interventions with Digital Tools for Mental Health Promotion among 11-18 Year Olds: A Systematic Review and Meta-Analysis. J Youth Adolesc 2023; 52:754-779. [PMID: 36754917 PMCID: PMC9907880 DOI: 10.1007/s10964-023-01735-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/14/2023] [Indexed: 02/10/2023]
Abstract
The availability of digital tools aiming to promote adolescent mental health is rapidly increasing. However, the field lacks an up-to-date and focused review of current evidence. This study thus looked into the characteristics and efficacy of digital, evidence-based mental health programs for youth (11-18 years). The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and resulted in 27 eligible studies. The high heterogeneity of the results calls for careful interpretation. Nevertheless, small, but promising, effects of digital tools were found with respect to promoting well-being, relieving anxiety, and enhancing protective factors. Some important factors influencing overall efficacy include the given setting, the level of guidance and support, and the adherence to the intervention.
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Affiliation(s)
- Michaela Wright
- Research Center for Inclusive Education (RCIE), University of Graz, Graz, Austria.
| | - Franziska Reitegger
- Institute of Education Research and Teacher Education, University of Graz, Graz, Austria
| | - Herald Cela
- Institute of Psychology, University of Graz, Graz, Austria
| | - Andrea Papst
- Institute of Education Research and Teacher Education, University of Graz, Graz, Austria
| | - Barbara Gasteiger-Klicpera
- Research Center for Inclusive Education (RCIE), University of Graz, Graz, Austria
- Institute of Education Research and Teacher Education, University of Graz, Graz, Austria
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Beck MS, Juul L, Frydenberg M, Fjorback LO. On Top of Everything: a study protocol for a cluster-randomised controlled trial testing a teacher training programme to teach mindfulness among students in Danish upper secondary schools and schools of health and social care. Trials 2023; 24:17. [PMID: 36609335 PMCID: PMC9824979 DOI: 10.1186/s13063-022-06920-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/11/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Mental health is decreasing among young people in Denmark. Our primary aim is to evaluate the effectiveness of a teacher training programme to teach mindfulness as part of regular classroom teaching in Danish upper secondary schools and schools of health and social care on students' self-reported mental well-being 6 months from baseline. Secondary aims are (1) to evaluate the effectiveness in a vulnerable subgroup as well as in the total population of students 3 and 6 months from baseline using other outcome measures on mental health and (2) to investigate the facilitators and barriers among teachers to implement mindfulness in schools. METHODS This pragmatic cluster-randomised two-arm superiority trial includes 30 upper secondary schools, 13 schools of health and social care, 76 teachers, and approximately 1100 students aged 16 to 24 years. Our intervention is multi-level and consists of (a) a teacher training programme and (b) a mindfulness programme delivered to students. Students in control schools receive education as usual. Our primary study population is the total population of students. The primary outcome is changes in the short version of the Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). We also evaluate the effectiveness in a vulnerable subgroup (the 15% with the lowest SWEMWBS score), as well as in the total population of students 3 and 6 months from baseline using other outcome measures on mental health. Data will be analysed using repeated measurement models taking clusters into account. Facilitators and barriers among teachers to implement mindfulness in schools will be investigated through qualitative focus group interviews. DISCUSSION The trial will estimate the effectiveness of a population-based strategy on mental health in Danish young people enrolled in education. TRIAL REGISTRATION ClinicalTrials.gov NCT04610333 . Registered on October 10 2020.
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Affiliation(s)
- Michelle Sand Beck
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Danish Center for Mindfulness, Aarhus University, Hack Kampmanns Plads 1-3, 4Th Floor, 8000 Aarhus C, Denmark
| | - Lise Juul
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Danish Center for Mindfulness, Aarhus University, Hack Kampmanns Plads 1-3, 4Th Floor, 8000 Aarhus C, Denmark
| | | | - Lone Overby Fjorback
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Danish Center for Mindfulness, Aarhus University, Hack Kampmanns Plads 1-3, 4Th Floor, 8000 Aarhus C, Denmark
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11
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Marinucci A, Grové C, Allen KA. Australian School Staff and Allied Health Professional Perspectives of Mental Health Literacy in Schools: a Mixed Methods Study. EDUCATIONAL PSYCHOLOGY REVIEW 2023; 35:3. [PMID: 36712917 PMCID: PMC9869299 DOI: 10.1007/s10648-023-09725-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 01/24/2023]
Abstract
Schools are an ideal setting to base mental health literacy programs as the learning environment is already established. Mental health literacy represents how to obtain and maintain good mental health and should be incorporated into the school curriculum. Collaboration with key stakeholders in youth mental health, such as school staff and allied health professionals, is critical in ensuring needs are addressed, and programs are sustainable. This study aimed to understand the perspectives of school staff and allied health professionals towards mental health literacy within Australian schools. An exploratory qualitative and quantitative survey was completed by 88 participants across Australia. Results indicated that school staff feel less competent to deliver mental health literacy content and perceive their training did not address mental health education compared to allied health professionals. Most mental health programs reported to be implemented within schools were social and emotional learning programs. School staff viewed mental health programs to strengthen academic performance less than allied health professionals. Thematic analysis of qualitative data identified that participants viewed mental health knowledge, where and how to seek help, and coping skills as vital content to cover in a school-based mental health literacy program. This study reveals that school staff need sufficient training and resources to address youth mental health literacy. Though mental health literacy is lacking in the Australian school system, the perspectives of school staff and allied health professionals in this study provide key ideas and considerations for the future development of school-based mental health literacy programs for youth. Supplementary Information The online version contains supplementary material available at 10.1007/s10648-023-09725-5.
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Affiliation(s)
- Alexandra Marinucci
- grid.1002.30000 0004 1936 7857Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC 3800 Australia
| | - Christine Grové
- grid.1002.30000 0004 1936 7857Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC 3800 Australia
| | - Kelly-Ann Allen
- grid.1002.30000 0004 1936 7857Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC 3800 Australia
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12
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Lam LT, Lam MK. Child and adolescent mental well-being intervention programme: A systematic review of randomised controlled trials. Front Psychiatry 2023; 14:1106816. [PMID: 37091697 PMCID: PMC10116571 DOI: 10.3389/fpsyt.2023.1106816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Background There has been an increasing awareness and recognition of mental well-being as one of the main outcome measures in national mental health policy and service provision in recent years. Many systemic reviews on intervention programmes for mental health or general well-being in young people have been conducted; however, these reviews were not mental well-being specific. Objective This study aims to examine the effectiveness of child and adolescent mental well-being intervention programmes and to identify the approach of effective intervention by reviewing the available Randomised Controlled Trials. Methods This systematic review study followed the PRISMA guidelines for systematic reviews ensuring a methodical and structured approach for the literature search and the subsequent review processes. The systematic literature search utilised major medical and health databases. Covidence, an online application for conducting systematic reviews, was used to assemble the titles, abstracts and full articles retrieved from the initial literature search. To examine the quality of the included trials for determining the strength of the evidence provided, the JBI Critical Appraisal Tool for Randomised Controlled Trial was used. Results There were 34 studies identified after an extensive search of the literature following the PRISMA guidelines. Seven (7) fulfilled all selection criteria and provided information on the effect of an intervention programme on mental well-being in adolescence. Data were extracted and analysed systematically with key information summarised. The results suggested that two (2) programmes demonstrated significant intervention effects, but with a small effect size. The quality of these trials was also assessed using the JBI Critical Appraisal Tool for Randomised Controlled Trials and identified some methodological issues. Conclusion In conclusion, activity-based and psychoeducation are shown to be potentially effective approaches for future programme development. More research on a well-designed programme is urgently needed, particularly in developing countries, to provide good evidence in supporting the mental health policy through the enhancement of mental well-being in young people.
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Affiliation(s)
- Lawrence T. Lam
- Faculty of Medicine, Macau University of Science and Technology, Macau, Macao SAR, China
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- *Correspondence: Lawrence T. Lam,
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13
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Dallinger VC, Krishnamoorthy G, du Plessis C, Pillai-Sasidharan A, Ayres A, Waters L, Groom Y, Alston O, Anderson L, Burton L. Utilisation of Digital Applications for Personal Recovery Amongst Youth with Mental Health Concerns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16818. [PMID: 36554700 PMCID: PMC9779003 DOI: 10.3390/ijerph192416818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
There is an increasing population of youths that report mental health issues. Research has shown that youths are reluctant to seek help for various reasons. A majority of those who do seek help are using digital mental health supports. Subsequently, efforts to promote youth mental health have focused on the use of digital applications as a means of overcoming barriers related to factors including stigma and lack of available services. The worldwide move toward recovery-oriented care led to emerging research on personal recovery amongst youths with mental health concerns. This study sought to address the need for recovery-oriented digital resources for youths. It utilised a qualitative design methodology to develop a rich interpretation of how youths are using digital interventions to support their mental health recovery journey. It sought to understand how existing digital applications are useful for youth recovery and identified characteristics associated with recovery and engagement. The content analysis generated five categories that represent facilitators of youth recovery and the thematic analysis identified key elements of digital applications that support youth recovery. The results offer complimentary support and guidance for recovery-oriented care and the use of digital mental health interventions in the promotion of personal recovery amongst youths.
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Affiliation(s)
- Vicki C. Dallinger
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Govind Krishnamoorthy
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Carol du Plessis
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Arun Pillai-Sasidharan
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Alice Ayres
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Lillian Waters
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Yasmin Groom
- Child and Youth Mental Health, Children’s Health Queensland, Queensland Health, Queensland Government, Brisbane, QLD 4000, Australia
| | - Olivia Alston
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Linda Anderson
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
| | - Lorelle Burton
- School of Psychology and Wellbeing, University of Southern Queensland (UniSQ), Darling Heights, QLD 4350, Australia
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14
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Dallinger VC, Krishnamoorthy G, Burton LJ, du Plessis C, Pillai-Sasidharan A, Ayres A. Internet-based interventions to support recovery in youth: A systematic review. Digit Health 2022; 8:20552076221129094. [PMID: 36211796 PMCID: PMC9537499 DOI: 10.1177/20552076221129094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 09/11/2022] [Indexed: 11/30/2022] Open
Abstract
Personal recovery represents a paradigm shift in how individuals are seen to benefit from mental health interventions, from a narrow view of symptom reduction to a holistic, multi-dimensional view of well-being, functional gains and rehabilitation. Although there is a large body of evidence supporting the use of recovery-oriented care in adults, research on personal recovery amongst youth with mental health concerns is an emerging area of research. Efforts to promote youth mental health have also focussed on the use of digital applications and platforms as a means of overcoming barriers related to factors including stigma and lack of available services. This systematic review aims to review the literature on existing internet-based, youth mental health interventions with regard to (a) identifying elements of the programs that align with the personal recovery and (b) outcome measures utilised in assessing personal recovery. Eleven papers were identified that met the inclusion criteria. Five of the programs reviewed from these eleven papers showed efficacy for recovery processes. The results offer preliminary support and guidance for the use of internet-based mental health interventions in the promotion of personal recovery amongst youth. Future research and practice are suggested to further develop understanding in this area.
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Affiliation(s)
- Vicki C Dallinger
- University of Southern Queensland
(USQ), Toowoomba, QLD 4350, Australia,Vicki C Dallinger, Department of Psychology
and Counselling, University of Southern Queensland, West Street Toowoomba QLD
4350, Australia.
| | | | - Lorelle J Burton
- University of Southern Queensland
(USQ), Toowoomba, QLD 4350, Australia
| | - Carol du Plessis
- University of Southern Queensland
(USQ), Ipswich, QLD 4350, Australia
| | - Arun Pillai-Sasidharan
- Jacaranda Place Queensland Adolescent Extended Treatment Centre,
Chermside, QLD 4032, Australia
| | - Alice Ayres
- Jacaranda Place Queensland Adolescent Extended Treatment Centre,
Chermside, QLD 4032, Australia
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15
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Houck C, Modrowski CA, Hadley W, Barker D, Myers V, Bala K, Wickham B, Jerrod T. A Pilot Study of a Tablet-Based Emotion Regulation Intervention for Early Adolescents. J Dev Behav Pediatr 2022; 43:e505-e514. [PMID: 35943380 PMCID: PMC9560987 DOI: 10.1097/dbp.0000000000001094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/25/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study examined the feasibility, acceptability, and preliminary outcomes of internet-based Talking About Risk and Adolescent Choices (iTRAC), a tablet intervention designed to promote emotion regulation (ER) skills among middle schoolers as a strategy for reducing risk behaviors. METHODS Adolescents (12-14 years) were recruited from 3 urban US schools for advisory groups (n = 15), acceptability testing (n = 11), and pilot testing (n = 85). Youth advisory boards and expert panels tailored content, resulting in an animated intervention of instructional videos, games, and activities designed to teach ER strategies to young adolescents. Eighty-five adolescents were randomized to the 4-module digital iTRAC intervention or a wait-list control group. Adolescents and 1 parent completed baseline and 3-month follow-up questionnaires examining ER attitudes and behaviors; adolescents also completed behavioral tasks related to distress tolerance. RESULTS Among those randomized to iTRAC, 88% completed all modules. Moderate effect sizes ( d ≥ 0.36) were found from baseline to follow-up on adolescents' beliefs in the controllability of emotions, awareness of emotions, self-efficacy for managing emotions, perceived access to ER strategies, and use of ER strategies. Parent measures of adolescent regulation showed mixed results. CONCLUSION A digital intervention to enhance ER skills for youth in early adolescence was feasible and demonstrated promising indicators of impact on emotional competence. Increasing adolescents' awareness of and access to ER strategies could reduce decisions driven by transient emotions, which in turn may reduce engagement in risk behaviors and resultant negative health outcomes. This brief tablet-based intervention has the potential to be self-administered and used to increase emotional competency.
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Affiliation(s)
- Christopher Houck
- Department of Child and Adolescent Psychiatry, Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Crosby A Modrowski
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Wendy Hadley
- College of Education, University of Oregon, Eugene, OR
| | - David Barker
- Department of Child and Adolescent Psychiatry, Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | | | - Kelsey Bala
- Department of Child and Adolescent Psychiatry, Children's Research Center, Rhode Island Hospital, Providence, RI
| | - Brittany Wickham
- Department of Child and Adolescent Psychiatry, Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI
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16
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Straka K, Blacketer AR, Martinez RL, Glover A, Winiarski DA, Karnik NS, Schueller SM, Zalta AK. Rates and correlates of well-being among youth experiencing homelessness. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3746-3759. [PMID: 35460583 PMCID: PMC9464689 DOI: 10.1002/jcop.22869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
Mental health concerns have been well studied among youth experiencing homelessness, yet few studies have explored factors that contribute to well-being in this population. The current cross-sectional study examined rates and correlates of well-being among youth experiencing homelessness. This is a descriptive, secondary analysis of the baseline data from a clinical intervention study. Ninety-nine youth (aged 16-25) who were experiencing homelessness were recruited in Chicago. Approximately 40% of the sample reported average or above average well-being relative to existing benchmarks. Having medical insurance, a mobile phone, and a history of more severe childhood trauma were unique cross-sectional predictors of worse well-being (all ps < 0.034). A significant portion of our sample experienced well-being. Having access to certain resources may be counterintuitive indicators of poorer well-being among youth experiencing homelessness, perhaps because they are indicators of greater need or increased social comparison among these youth.
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Affiliation(s)
- Kelci Straka
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Alexis R. Blacketer
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Ramona L. Martinez
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Angela Glover
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Dominika A. Winiarski
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Stephen M. Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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17
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AboZayed A, Elsalamony OK, ElKholy M, Enaba DA, Yousof HZ. Online Multicomponent Program for Mental Health Promotion of Medical Students: An Intervention Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Youth mental health is a significant public health concern. Mental health issues are increasing in severity and number in college campuses. Improving adolescent mental well-being remains a challenge for most societies.
Aim: Promote the well-being and mental health outcomes of Kasr Al-Ainy medical school students.
Methods: An intervention study conducted at Kasr Al-Ainy Faculty of medicine. Study Participants (n=664) from 4th and 5th graders were assigned to either of two conditions: Fourth graders (n=325) to intervention (Horizon Egypt) website which provided information across positive psychology domains and Fifth graders (n=312) to control neutral entertainment-based website. Participants were assessed pre- and post-intervention on Depression Anxiety Stress Scale-Short form (DASS-21) and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS).
Results: There was no pre-intervention statistically significant differences between Horizon Egypt and control group on demographic variables, DASS-21, or WEMWBS scores. Qualitative data indicated that all participants reported that Horizon Egypt website was easy to use, 85% agreed the program was fun, 91% agreed the activities were interesting and 77% agreed they would continue to use it after study completion. Compared to the control condition, participants in the Horizon Egypt condition with high levels of adherence reported significant decrease in depression, anxiety, stress and improvements in well-being score.
Conclusion & Recommendations: Acceptability of Horizon Egypt website was high. The online delivery of positive psychology programs may be an alternative way to address mental health issues and improve youth well-being.
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De la Barrera U, Postigo-Zegarra S, Mónaco E, Gil-Gómez JA, Montoya-Castilla I. Serious game to promote socioemotional learning and mental health ( emoTIC): a study protocol for randomised controlled trial. BMJ Open 2021; 11:e052491. [PMID: 34972764 PMCID: PMC8720981 DOI: 10.1136/bmjopen-2021-052491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The development of emotional competences may be a protective factor for mental health problems, promoting well-being at such a complex age as adolescence. Technologies may be used to carry out this empowerment because adolescents are attracted to them. The purpose of the study is to design a serious game based on the Mayer et al's emotional intelligence ability model and analyse the effectiveness of the emoTIC programme to develop emotional competences, well-being, mental health, and personal strengths immediately after completion and at 12 months. METHODS AND ANALYSIS The new version of emoTIC will be designed following the suggestions of the adolescents who participated in the pilot study and the results obtained from the statistical analysis. The participants will be 385 adolescents aged 11-16 years who will be randomly assigned to the control group and the experimental group. The experimental group will complete the emoTIC programme. The primary outcomes include emotional competences and subjective well-being. The secondary outcomes are self-esteem; general self-efficacy; personality; social and personal responsibility; school social climate; somatic complaints; depression, anxiety and stress symptoms; emotional and behavioural difficulties; suicidal behaviour; and subjective happiness. Data will be collected at three moments: baseline (T1), immediately post-intervention (T2) and 12-month follow-up (T3). The effectiveness of the programme will be analysed using different statistical packages. ETHICS AND DISSEMINATION The study has been approved by the Ethics Commission of the University of Valencia (H152865096049), and the standards of the Declaration of Helsinki to collect the data will be followed. Results will be disseminated across the scientific community. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT04414449). TRIAL SPONSOR University of Valencia. Principal investigator: Inmaculada Montoya-Castilla.
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Affiliation(s)
- Usue De la Barrera
- Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología y Logopedia, Universitat de València, Valencia, Spain
| | - Silvia Postigo-Zegarra
- Departamento de Psicología, Facultad de Ciencias de la Salud, Universidad Europea de Valencia, Valencia, Spain
| | - Estefanía Mónaco
- Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología y Logopedia, Universitat de València, Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Investigación en Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
| | - Inmaculada Montoya-Castilla
- Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología y Logopedia, Universitat de València, Valencia, Spain
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Krifa I, Hallez Q, van Zyl LE, Braham A, Sahli J, Ben Nasr S, Shankland R. Effectiveness of an online positive psychology intervention among Tunisian healthcare students on mental health and study engagement during the Covid-19 pandemic. Appl Psychol Health Well Being 2021; 14:1228-1254. [PMID: 34939332 DOI: 10.1111/aphw.12332] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Imen Krifa
- Mental illness Epidemiology Research Laboratory, University of Sousse, Sousse, Tunisia.,Higher School of Sciences and Techniques of Health of Sousse, Department of Psychiatry LR12ES04, Farhat Hached University Hospital, Sousse, Tunisia
| | - Quentin Hallez
- Laboratory DIPHE, Department of Psychology, Education and Vulnerabilities, Université Lumière Lyon 2, Lyon, France
| | - Llewellyn Ellardus van Zyl
- Department of Industrial Engineering and Innovation Sciences, University of Eindhoven, Eindhoven, Netherlands.,Optentia Research Unit, North-West University, South Africa.,Department of Human Resource Management, University of Twente, the Netherlands.,Department of Social Psychology, Goethe University, Frankfurt am Main, Germany
| | - Amel Braham
- Mental illness Epidemiology Research Laboratory, University of Sousse, Sousse, Tunisia.,Faculty of Medicine of Sousse, Department of Psychiatry LR12ES04, Farhat Hached University Hospital, Sousse, Tunisia
| | - Jihene Sahli
- Laboratory of Research Quality of Care and Management of Maternal Health Services, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Selma Ben Nasr
- Mental illness Epidemiology Research Laboratory, University of Sousse, Sousse, Tunisia.,Faculty of Medicine of Sousse, Department of Psychiatry LR12ES04, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rebecca Shankland
- Laboratory DIPHE, Department of Psychology, Education and Vulnerabilities, Université Lumière Lyon 2, Lyon, France
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Newton AS, March S, Gehring ND, Rowe AK, Radomski AD. Establishing a Working Definition of User Experience for eHealth Interventions of Self-reported User Experience Measures With eHealth Researchers and Adolescents: Scoping Review. J Med Internet Res 2021; 23:e25012. [PMID: 34860671 PMCID: PMC8686463 DOI: 10.2196/25012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/27/2021] [Accepted: 09/23/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Across eHealth intervention studies involving children, adolescents, and their parents, researchers have measured user experience to assist with intervention development, refinement, and evaluation. To date, no widely accepted definitions or measures of user experience exist to support a standardized approach for evaluation and comparison within or across interventions. OBJECTIVE We conduct a scoping review with subsequent Delphi consultation to identify how user experience is defined and measured in eHealth research studies, characterize the measurement tools used, and establish working definitions for domains of user experience that could be used in future eHealth evaluations. METHODS We systematically searched electronic databases for published and gray literature available from January 1, 2005, to April 11, 2019. We included studies assessing an eHealth intervention that targeted any health condition and was designed for use by children, adolescents, and their parents. eHealth interventions needed to be web-, computer-, or mobile-based, mediated by the internet with some degree of interactivity. We required studies to report the measurement of user experience as first-person experiences, involving cognitive and behavioral factors reported by intervention users. We appraised the quality of user experience measures in included studies using published criteria: well-established, approaching well-established, promising, or not yet established. We conducted a descriptive analysis of how user experience was defined and measured in each study. Review findings subsequently informed the survey questions used in the Delphi consultations with eHealth researchers and adolescent users for how user experience should be defined and measured. RESULTS Of the 8634 articles screened for eligibility, 129 articles and 1 erratum were included in the review. A total of 30 eHealth researchers and 27 adolescents participated in the Delphi consultations. On the basis of the literature and consultations, we proposed working definitions for 6 main user experience domains: acceptability, satisfaction, credibility, usability, user-reported adherence, and perceived impact. Although most studies incorporated a study-specific measure, we identified 10 well-established measures to quantify 5 of the 6 domains of user experience (all except for self-reported adherence). Our adolescent and researcher participants ranked perceived impact as one of the most important domains of user experience and usability as one of the least important domains. Rankings between adolescents and researchers diverged for other domains. CONCLUSIONS Findings highlight the various ways in which user experience has been defined and measured across studies and what aspects are most valued by researchers and adolescent users. We propose incorporating the working definitions and available measures of user experience to support consistent evaluation and reporting of outcomes across studies. Future studies can refine the definitions and measurement of user experience, explore how user experience relates to other eHealth outcomes, and inform the design and use of human-centered eHealth interventions.
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Affiliation(s)
- Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Sonja March
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Nicole D Gehring
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Arlen K Rowe
- School of Psychology and Counselling, Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Ashley D Radomski
- Knowledge Institute for Child and Youth Mental Health and Addictions, Ottawa, ON, Canada.,CHEO (Children's Hospital of Eastern Ontario) Research Institute, Ottawa, ON, Canada
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Tang J, Yao X, Yu G. Exploring the Online Behavior of Users of Online Depression-Focused Communities: Comparing Communities with Different Management Types. Psychol Res Behav Manag 2021; 14:1707-1724. [PMID: 34703334 PMCID: PMC8524253 DOI: 10.2147/prbm.s323027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/01/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction Online depression-focused communities (ODCs) are popular avenues that help people cope with depression. However, to the best of our knowledge, research on online behavior and differences among users from managed and unmanaged ODCs has not been explored. Methods We collected data from the most popular managed depression-focused community (MDC) and unmanaged depression-focused community (UDC) in China. Text classifiers were built using deep-learning methods to identify social support (ie, informational and emotional support) and companionship expressed in the posts of these communities. Based on the content of their posts, community users were clustered into supporters and ordinary members. Econometrics was used to analyze the factors that influence supporters’ contributions and ordinary members’ participation in MDCs and UDCs. Results Community response has a positive impact on supporters’ social support and time span in the UDC, but this impact is not significant in the MDC. Supporters expressing positive emotions provide more social support, and they are more willing to serve in the MDC. Supporters expressing negative emotions tend to have longer engagement with the UDC. In addition, community response has a positive effect on ordinary members’ participation in both communities, and this effect is greater in the UDC. Ordinary members expressing positive emotions are more active in the MDC, and ordinary members expressing negative emotions are more active in the UDC. Conclusion This study improves the understanding of users’ online behaviors in ODCs, provides decision-making support for designers and managers of ODCs, and provides information that can be used to help improve aid for people with depression provided by community and mental health professionals.
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Affiliation(s)
- Jingyun Tang
- School of Management, Harbin Institute of Technology, Harbin, 150001, People's Republic of China
| | - Xiaoxu Yao
- School of Management, Harbin Institute of Technology, Harbin, 150001, People's Republic of China
| | - Guang Yu
- School of Management, Harbin Institute of Technology, Harbin, 150001, People's Republic of China
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Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:196-215. [PMID: 33979106 DOI: 10.1097/hrp.0000000000000294] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). METHODS We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. RESULTS 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. CONCLUSION Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.
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23
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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24
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Shim Y, Scotney VS, Tay L. Conducting mobile-enabled ecological momentary intervention research in positive psychology: key considerations and recommended practices. THE JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2021.1913642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Yerin Shim
- Department of Psychology, Chungnam National University, Daejeon, South Korea
| | | | - Louis Tay
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
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25
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Dominguez-Rodriguez A, De La Rosa-Gómez A, Hernández Jiménez MJ, Arenas-Landgrave P, Martínez-Luna SC, Alvarez Silva J, García Hernández JE, Arzola-Sánchez C, Acosta Guzmán V. A Self-Administered Multicomponent Web-Based Mental Health Intervention for the Mexican Population During the COVID-19 Pandemic: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e23117. [PMID: 33196449 PMCID: PMC7704282 DOI: 10.2196/23117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has become a public health emergency of international concern; it has not only threatened people's physical health but has also affected their mental health and psychological well-being. It is necessary to develop and offer strategies to reduce the psychological impact of the outbreak and promote adaptive coping. OBJECTIVE This study protocol aims to describe a self-administered web-based intervention (Mental Health COVID-19) based on the principles of positive psychology supported by elements of cognitive behavioral therapy and behavioral activation therapy to reduce the symptoms of anxiety and depression and increase positive emotions and sleep quality during and after the COVID-19 outbreak through a telepsychology system. METHODS A randomized controlled clinical superiority trial with two independent groups will be performed, with intrasubject measures at four evaluation periods: pretest, posttest, 3-month follow-up, and 6-month follow-up. Participants will be randomly assigned to one of two groups: self-administered intervention with assistance via chat or self-administered intervention without assistance via chat. The total required sample size will be 166 participants (83 per group). RESULTS The clinical trial is ongoing. This protocol was approved by the Research Ethics Board of the Free School of Psychology-University of Behavioral Sciences (Escuela libre de Psicología-Universidad de Ciencias del Comportamiento). The aim is to publish the preliminary results in December 2020. A conservative approach will be adopted, and the size effect will be estimated using the Cohen d index with a significance level (α) of .05 (95% reliability) and a conventional 80% power statistic. CONCLUSIONS The central mechanism of action will be to investigate the effectiveness of an intervention based on positive psychology through a web platform that can be delivered through computers and tablets, with content that has been rigorously contextualized to the Mexican culture to provide functional strategies to help the target users cope with the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/ct2/show/NCT04468893. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23117.
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Affiliation(s)
| | - Anabel De La Rosa-Gómez
- Coordinación de Educación a Distancia, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | | | | | | | - Carlos Arzola-Sánchez
- Institute of Social Sciences, Autonomous University of Ciudad Juárez, Juarez, Mexico
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26
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Zippan N, Stephenson KR, Brotto LA. Feasibility of a Brief Online Psychoeducational Intervention for Women With Sexual Interest/Arousal Disorder. J Sex Med 2020; 17:2208-2219. [PMID: 32919927 PMCID: PMC7480645 DOI: 10.1016/j.jsxm.2020.07.086] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/14/2020] [Accepted: 07/31/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Low sexual desire and arousal are the most common sexual concerns in women, but most women lack access to effective treatment such as cognitive behavioral therapy. Web-based psychological interventions, which are economical, private, easily accessible, and potentially effective, may increase the reach of evidence-based treatment. AIM To determine the feasibility of translating cognitive behavioral therapy for the most common female sexual dysfunction, Female Sexual Interest/Arousal Disorder, into an online format. The present study examined the feasibility of an introductory psychoeducational module of eSense, an online program currently being developed that is based on existing empirically supported in-person treatments, which delivers content to the user in a visually appealing and interactive manner. METHODS Sixteen cisgender women (M age = 31.9) with female sexual arousal/interest disorder worked through a pilot module of eSense inperson at a sexual health laboratory. OUTCOMES Qualitative semistructured interviews and online questionnaires were used to assess participants' experiences of usability of the platform, clarity/relevance of the content, satisfaction with the experience, and any changes in clinical outcomes of sexual function and distress. RESULTS Participants reported a high level of satisfaction with the website's functionality and presentation. They reported greater knowledge, felt validated and more hopeful, and were eager to continue the remaining modules. Participants also reported notable prepost improvements in sexual desire, arousal, and satisfaction. CLINICAL IMPLICATIONS Initial user-experience assessment may represent a method of simultaneously improving online interventions and providing therapeutic education to participants. STRENGTHS & LIMITATIONS This is one of the first studies, to our knowledge, to test a graphics-rich, interactive online intervention for sexual difficulties that does not require direct contact with expert providers or support groups. Limitations include the high level of education, motivation, and technical fluency of the sample and the potentially confounding effect of the researcher's presence during interviews. Because this was a feasibility study, the sample size was small, and no control group was included, limiting conclusions about efficacy and generalizability. CONCLUSION The format of eSense appears to be feasible and usable, lending support to the growing evidence that it is possible to take in-person therapeutic interventions online. Zippan N, Stephenson KR, Brotto LA, Feasibility of a Brief Online Psychoeducational Intervention for Women With Sexual Interest/Arousal Disorder. J Sex Med 2020;17:2208-2219.
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Affiliation(s)
- Natasha Zippan
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | | | - Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
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27
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Kahl BL, Miller HM, Cairns K, Giniunas H, Nicholas M. Evaluation of ReachOut.com, an Unstructured Digital Youth Mental Health Intervention: Prospective Cohort Study. JMIR Ment Health 2020; 7:e21280. [PMID: 33055066 PMCID: PMC7596653 DOI: 10.2196/21280] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/06/2020] [Accepted: 09/09/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Young people experience a disproportionate burden associated with mental illness that Australia's mental health care system is ill-equipped to handle. Despite improvements in the provision of mental health services, the rates of service utilization among young people remain suboptimal, and there are still considerable barriers to seeking help. Digital mental health services can overcome a number of barriers and connect young people requiring support; however, the evidence base of digital interventions is limited. OBJECTIVE The aim of this study is to examine the effectiveness of a brief, self-directed, unstructured digital intervention, ReachOut.com (hereafter ReachOut), in reducing depression, anxiety, stress, and risk of suicide. METHODS A cohort of 1982 ReachOut users participated in a 12-week longitudinal study, with a retention rate of 81.18% (1609/1982) across the duration of the study. Participants completed web-based surveys, with outcome measures of mental health status and suicide risk assessed at 3 time points across the study period. RESULTS The results demonstrated that over the 12-week study period, young people using ReachOut experienced modest yet significant reductions in symptoms of depression, anxiety, and stress. Significant, albeit modest, reductions in the proportion of participants at high risk of suicide were also observed. CONCLUSIONS The findings of this research provide preliminary evidence of the promise of an unstructured digital mental health intervention, ReachOut, in alleviating symptoms of mental ill-health and promoting well-being in young people. These findings are particularly important given that digital services are not only acceptable and accessible but also have the potential to cater to the diverse mental health needs of young people at scale, in a way that other services cannot.
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28
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Yang Q, Millette D, Zhou C, Beatty M, Carcioppolo N, Wilson G. The Effectiveness of Interactivity in Improving Mediating Variables, Behaviors and Outcomes of Web-Based Health Interventions: A Meta-Analytic Review. HEALTH COMMUNICATION 2020; 35:1334-1348. [PMID: 31240958 DOI: 10.1080/10410236.2019.1631992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite the increasing amount of research investigating health interventions that applies to interactive computer technology, the effect sizes in Cohen's d obtained across these studies range from -0.32 to 1.74. The lack of systematic review of interactive health interventions leaves their overall effectiveness unknown. To address this, a meta-analysis of 67 studies examining the effects of web-based interactive health interventions was conducted. Results indicated that web-based interactive health interventions were effective in general, but the effects were moderated by health topic, theoretical framework, and design of treatment and control groups. The unique advantage of interactivity was small but significant when comparing to health interventions with comparable information in non-interactive version. Theoretical and practical implications of findings were discussed.
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Affiliation(s)
- Qinghua Yang
- Department of Communication Studies, Texas Christian University
| | - Diane Millette
- Department of Communication Studies, University of Miami
| | - Chun Zhou
- Department of Communication, Florida International University
| | - Michael Beatty
- Department of Communication Studies, University of Miami
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29
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Russell K, Rasmussen S, Hunter SC. Does Mental Well-Being Protect against Self-Harm Thoughts and Behaviors during Adolescence? A Six-Month Prospective Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6771. [PMID: 32957474 PMCID: PMC7558682 DOI: 10.3390/ijerph17186771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 01/05/2023]
Abstract
Mental well-being protects against the emergence of suicidal thoughts. However, it is not clear whether these findings extend to self-harm thoughts and behaviors irrespective of intent during adolescence-or why this relationship exists. The current study aimed to test predictions-informed by the integrated motivational-volitional (IMV) model of suicide-concerning the role of perceived defeat and entrapment within the link between mental well-being and self-harm risk. Young people (n = 573) from secondary schools across Scotland completed an anonymous self-report survey at two time points, six months apart, that assessed mental well-being, self-harm thoughts and behaviors, depressive symptomology and feelings of defeat and entrapment. Mental well-being was associated with reduced defeat and entrapment (internal and external) and a decrease in the likelihood that a young person would engage in self-harm thoughts and behaviors. The relationship between mental well-being and thoughts of self-harm was mediated by perceptions of defeat and entrapment (internal and external). Mental well-being was indirectly related to self-harm behaviors via decreased feelings of defeat and internal (but not external) entrapment. Taken together, these findings provide novel insights into the psychological processes linking mental well-being and self-harm risk and highlight the importance of incorporating the promotion of mental well-being within future prevention and early intervention efforts.
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Affiliation(s)
- Kirsten Russell
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK;
| | - Susan Rasmussen
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1QE, UK;
| | - Simon C. Hunter
- Department of Psychology, Glasgow Caledonian University, Glasgow G4 0BA, UK;
- Faculty of Education, University of Western Australia, Perth, WA 6009, Australia
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30
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Alvarez-Jimenez M, Rice S, D'Alfonso S, Leicester S, Bendall S, Pryor I, Russon P, McEnery C, Santesteban-Echarri O, Da Costa G, Gilbertson T, Valentine L, Solves L, Ratheesh A, McGorry PD, Gleeson J. A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service. J Med Internet Res 2020; 22:e17155. [PMID: 32788151 PMCID: PMC7453330 DOI: 10.2196/17155] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/12/2020] [Accepted: 06/13/2020] [Indexed: 12/20/2022] Open
Abstract
Background Mental ill-health is the leading cause of disability worldwide. Moreover, 75% of mental health conditions emerge between the ages of 12 and 25 years. Unfortunately, due to lack of resources and limited engagement with services, a majority of young people affected by mental ill-health do not access evidence-based support. To address this gap, our team has developed a multimodal, scalable digital mental health service (Enhanced Moderated Online Social Therapy [MOST+]) merging real-time, clinician-delivered web chat counseling; interactive user-directed online therapy; expert and peer moderation; and peer-to-peer social networking. Objective The primary aim of this study is to ascertain the feasibility, acceptability, and safety of MOST+. The secondary aims are to assess pre-post changes in clinical, psychosocial, and well-being outcomes and to explore the correlations between system use, perceived helpfulness, and secondary outcome variables. Methods Overall, 157 young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive online therapy and integrated web chat counseling. Additional access to peer-to-peer social networking was granted to 73 participants (46.5%) for whom it was deemed safe. The intervention was evaluated via an uncontrolled single-group study. Results Overall, 93 participants completed the follow-up assessment. Most participants had moderate (52/157, 33%) to severe (96/157, 61%) mental health conditions. All a priori feasibility, acceptability, and safety criteria were met. Participants provided mean scores of ≥3.5 (out of 5) on ease of use (mean 3.7, SD 1.1), relevancy (mean 3.9, SD 1.0), helpfulness (mean 3.5, SD 0.9), and overall experience (mean 3.9, SD 0.8). Moreover, 98% (91/93) of participants reported a positive experience using MOST+, 82% (70/93) reported that using MOST+ helped them feel better, 86% (76/93) felt more socially connected using it, and 92% (86/93) said they would recommend it to others. No serious adverse events or inappropriate use were detected, and 97% (90/93) of participants reported feeling safe. There were statistically significant improvements in 8 of the 11 secondary outcomes assessed: psychological distress (d=−0.39; P<.001), perceived stress (d=−0.44; P<.001), psychological well-being (d=0.51; P<.001), depression (d=−0.29; P<.001), loneliness (d=−0.23; P=.04), social support (d=0.30; P<.001), autonomy (d=0.36; P=.001), and self-competence (d=0.30; P<.001). There were significant correlations between system use, perceived helpfulness, and a number of secondary outcome variables. Conclusions MOST+ is a feasible, acceptable, and safe online clinical service for young people with mental ill-health. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system use and secondary outcome variables provide initial support for the therapeutic potential of MOST+. MOST+ is a promising and scalable platform to deliver standalone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services.
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Affiliation(s)
- Mario Alvarez-Jimenez
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Simon Rice
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Simon D'Alfonso
- Orygen, Parkville, Australia.,The School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
| | - Steven Leicester
- headspace National Youth Mental Health Foundation, Melbourne, Australia
| | - Sarah Bendall
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Ingrid Pryor
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Penni Russon
- Orygen, Parkville, Australia.,School of Culture and Communications, The University of Melbourne, Melbourne, Australia
| | - Carla McEnery
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | | | - Gustavo Da Costa
- The School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
| | | | - Lee Valentine
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Laia Solves
- Consorci Sanitari del Maresme, Department of Psychiatry, Hospital of Mataro, Mataro, Spain
| | - Aswin Ratheesh
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Patrick D McGorry
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - John Gleeson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.,Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, Australia
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31
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Marshall JM, Dunstan DA, Bartik W. Apps With Maps-Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores. JMIR Ment Health 2020; 7:e16525. [PMID: 32579127 PMCID: PMC7381031 DOI: 10.2196/16525] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/27/2020] [Accepted: 04/12/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Mobile mental health apps have become ubiquitous tools to assist people in managing symptoms of anxiety and depression. However, due to the lack of research and expert input that has accompanied the development of most apps, concerns have been raised by clinicians, researchers, and government authorities about their efficacy. OBJECTIVE This review aimed to estimate the proportion of mental health apps offering comprehensive therapeutic treatments for anxiety and/or depression available in the app stores that have been developed using evidence-based frameworks. It also aimed to estimate the proportions of specific frameworks being used in an effort to understand which frameworks are having the most influence on app developers in this area. METHODS A systematic review of the Apple App Store and Google Play store was performed to identify apps offering comprehensive therapeutic interventions that targeted anxiety and/or depression. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was adapted to guide this approach. RESULTS Of the 293 apps shortlisted as offering a therapeutic treatment for anxiety and/or depression, 162 (55.3%) mentioned an evidence-based framework in their app store descriptions. Of the 293 apps, 88 (30.0%) claimed to use cognitive behavioral therapy techniques, 46 (15.7%) claimed to use mindfulness, 27 (9.2%) claimed to use positive psychology, 10 (3.4%) claimed to use dialectical behavior therapy, 5 (1.7%) claimed to use acceptance and commitment therapy, and 20 (6.8%) claimed to use other techniques. Of the 162 apps that claimed to use a theoretical framework, only 10 (6.2%) had published evidence for their efficacy. CONCLUSIONS The current proportion of apps developed using evidence-based frameworks is unacceptably low, and those without tested frameworks may be ineffective, or worse, pose a risk of harm to users. Future research should establish what other factors work in conjunction with evidence-based frameworks to produce efficacious mental health apps.
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Affiliation(s)
- Jamie M Marshall
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Debra A Dunstan
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Warren Bartik
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, Australia
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Achilles MR, Anderson M, Li SH, Subotic-Kerry M, Parker B, O'Dea B. Adherence to e-mental health among youth: Considerations for intervention development and research design. Digit Health 2020; 6:2055207620926064. [PMID: 32547775 PMCID: PMC7249594 DOI: 10.1177/2055207620926064] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 03/15/2020] [Indexed: 12/20/2022] Open
Abstract
E-mental health programmes have great potential to provide young people with
access to mental health support. However, it is commonly reported that adherence
to these programmes is low. Low adherence can be problematic, particularly if
young people do not receive the full benefits of a programme. In a research
trial setting, non-adherence to treatment recommendations can prevent
researchers from drawing strong conclusions about effectiveness. Although
adherence has been recognised as an issue in need of attention, many of the
reviews available are focused on adults and lack clear direction towards what
strategies to employ. This paper presents a broad review of the adherence
literature, focusing on factors associated with improving adherence to e-mental
health among youth. Our view on the key elements to improve adherence identified
from the existing literature are presented, and key recommendations for e-mental
health intervention design are provided. These include: developing and
communicating adherence guidelines based on individuals’ needs and symptom
severity, including customisable features to provide a tailored experience and
promote a sense of agency, including engagement checks and adopting a
user-centred approach by utilising strategies such as co-design. This paper
provides guidance to intervention designers and researchers by outlining
recommendations and considerations for intervention development and research
design.
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Affiliation(s)
| | | | - Sophie H Li
- Black Dog Institute, Prince of Wales Hospital, Australia.,School of Psychology, University of New South Wales, Australia
| | | | - Belinda Parker
- Black Dog Institute, Prince of Wales Hospital, Australia
| | - Bridianne O'Dea
- Black Dog Institute, Prince of Wales Hospital, Australia.,School of Psychology, University of New South Wales, Australia
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Aktary ML, Caron-Roy S, Sajobi T, O'Hara H, Leblanc P, Dunn S, McCormack GR, Timmins D, Ball K, Downs S, Minaker LM, Nykiforuk CI, Godley J, Milaney K, Lashewicz B, Fournier B, Elliott C, Raine KD, Prowse RJ, Olstad DL. Impact of a farmers' market nutrition coupon programme on diet quality and psychosocial well-being among low-income adults: protocol for a randomised controlled trial and a longitudinal qualitative investigation. BMJ Open 2020; 10:e035143. [PMID: 32371514 PMCID: PMC7228519 DOI: 10.1136/bmjopen-2019-035143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/19/2020] [Accepted: 04/02/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Low-income populations have poorer diet quality and lower psychosocial well-being than their higher-income counterparts. These inequities increase the burden of chronic disease in low-income populations. Farmers' market subsidies may improve diet quality and psychosocial well-being among low-income populations. In Canada, the British Columbia (BC) Farmers' Market Nutrition Coupon Programme (FMNCP) aims to improve dietary patterns and health among low-income participants by providing coupons to purchase healthy foods from farmers' markets. This study will assess the impact of the BC FMNCP on the diet quality and psychosocial well-being of low-income adults and explore mechanisms of programme impacts. METHODS AND ANALYSIS In a parallel group randomised controlled trial, low-income adults will be randomised to an FMNCP intervention (n=132) or a no-intervention control group (n=132). The FMNCP group will receive 16 coupon sheets valued at CAD$21/sheet over 10-15 weeks to purchase fruits, vegetables, dairy, meat/poultry/fish, eggs, nuts and herbs at farmers' markets and will be invited to participate in nutrition skill-building activities. Overall diet quality (primary outcome), diet quality subscores, mental well-being, sense of community, food insecurity and malnutrition risk (secondary outcomes) will be assessed at baseline, immediately post-intervention and 16 weeks post-intervention. Dietary intake will be assessed using the Automated Self-Administered 24-hour Dietary Recall. Diet quality will be calculated using the Healthy Eating Index-2015. Repeated measures mixed-effect regression will assess differences in outcomes between groups from baseline to 16 weeks post-intervention. Furthermore, 25-30 participants will partake in semi-structured interviews during and 5 weeks after programme completion to explore participants' experiences with and perceived outcomes from the programme. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Calgary Conjoint Health Research Ethics Board, Rutgers University Ethics and Compliance, and University of Waterloo Office of Research Ethics. Findings will be disseminated through policy briefs, conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03952338.
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Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | | | - Tolulope Sajobi
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Heather O'Hara
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Peter Leblanc
- British Columbia Association of Farmers' Markets, Vancouver, British Columbia, Canada
| | - Sharlette Dunn
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Gavin R McCormack
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, Canada
| | - Dianne Timmins
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
| | - Shauna Downs
- School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Jenny Godley
- Department of Sociology, University of Calgary, Calgary, Alberta, Canada
| | - Katrina Milaney
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Lashewicz
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Bonnie Fournier
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Charlene Elliott
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Communication Media and Film, University of Calgary, Calgary, Alberta, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Jl Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dana Lee Olstad
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
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Hyun MS, Yun MK, Chae SM, Oh HY, Jung SM. [Effects of a Positive Psychology-based Mental Health Promotion Program for High School Students]. CHILD HEALTH NURSING RESEARCH 2020; 26:154-163. [PMID: 35004460 PMCID: PMC8650933 DOI: 10.4094/chnr.2020.26.2.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/31/2019] [Accepted: 11/02/2019] [Indexed: 11/22/2022] Open
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Ribeiro RM, Bragiola JVB, Eid LP, Ribeiro RDCHM, Sequeira CADC, Pompeo DA. Impact of an intervention through Facebook to strengthen Self-esteem in nursing students. Rev Lat Am Enfermagem 2020; 28:e3237. [PMID: 32074208 PMCID: PMC7021477 DOI: 10.1590/1518-8345.3215.3237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 09/23/2019] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE to evaluate the impact of the "Strengthening Self-Esteem" intervention proposed by the Nursing Interventions Classification, conducted through the use of Facebook, on the self-esteem and self-efficacy levels of nursing undergraduates. METHOD quasi-experimental study carried out in two Higher Education Institutions. The sample consisted of 74 students. Two data collection tools were applied before and after the intervention: Rosenberg Self-Esteem Scale and General and Perceived Self-Efficacy Scale. The students were submitted to the intervention for ten sessions. Posts were made in private profile created on Facebook and consisted of positive messages, reflective texts and pictures, all supported by the persuasive resources of Bandura's theoretical framework. RESULTS of the 264 students who answered the pretest, 74 (28.03%) participated in the interventions and the post-test. Rosenberg self-esteem (p=0.026) and self-efficacy (p=0.001) scores after the intervention were significantly higher than those obtained before, confirming the effectiveness of the intervention. CONCLUSION the "Strengthening Self-Esteem" intervention was effective for improving students' self-esteem and self-efficacy levels. Such interventions help spread knowledge and build mentally healthier individuals.
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Affiliation(s)
| | | | - Letícia Palota Eid
- Universidade Federal de Goiás, Unidade Acadêmica Especial de
Ciências da Saúde, Jataí, GO, Brazil
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Bjerre N, Lillefjell M, Magnus E, Anthun KS. Effective interventions targeting the mental health of children and young adults: A scoping review. Scand J Public Health 2020; 49:333-345. [PMID: 32009546 DOI: 10.1177/1403494820901406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: Children and young adults are in general characterised by good health, but evidence shows increasing mental-health problems. Numerous interventions have been developed to target their mental health, but the effectiveness of these interventions remains varied. In this scoping review, we investigated factors associated with the effectiveness of interventions. Methods: A scoping review based on a three-block search strategy was performed to review the current literature of effective interventions. Each block (interventions, mental health and children and young adults) were operationalised to search terms. Systematic searches were conducted in three electronic databases and supplemented with citation searches, resulting in 51 studies in total. All studies were critically analysed, and a standardised extraction chart was used to systemise the data. Results: Our scoping review revealed a range of factors influencing the effectiveness of interventions. These factors were (a) characteristics of the target group (age, sex and level of baseline symptoms), (b) factors linked to implementation (use of manuals, training of implementers and context) and (c) characteristics of the interventions (universal versus indicated delivery, multiple-domain approaches, level of theory and adjustment to age and socio-economic status). Elements are discussed for each factor. Conclusions: Based on this review, it can be concluded that the use of stepwise, multi-domain approaches incorporating the social networks of the target group, adjusting activities to specific age groups and the social context, training implementers well and using stringent implementation manuals will improve the effectiveness of interventions targeting the mental health of children and young adults.
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Affiliation(s)
- Natasja Bjerre
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway.,Health Promotion, Steno Diabetes Center, Copenhagen, Denmark
| | - Monica Lillefjell
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway
| | - Eva Magnus
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway
| | - Kirsti S Anthun
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway
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Coelhoso CC, Tobo PR, Lacerda SS, Lima AH, Barrichello CRC, Amaro E, Kozasa EH. A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial. J Med Internet Res 2019; 21:e14269. [PMID: 31697244 PMCID: PMC6873146 DOI: 10.2196/14269] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/25/2019] [Accepted: 08/01/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. OBJECTIVE This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. METHODS Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t1), midintervention (t4=4 weeks after t1) and postintervention (t8=8 weeks after t1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. RESULTS Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t4 and t8 assessments were equally distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F2,426=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F2,426=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F2,426=5.50; P=.004 and F2,426=8.59; P<.001, respectively). CONCLUSIONS The well-being mobile app was effective in reducing employee stress and improving well-being. TRIAL REGISTRATION Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.
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Affiliation(s)
| | | | | | | | | | - Edson Amaro
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
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Anttila K, Anttila M, Välimäki M. A web-based adolescent depression support system: feedback and implications for the future. Inform Health Soc Care 2019; 45:111-129. [PMID: 31684788 DOI: 10.1080/17538157.2019.1656206] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The aim is to describe feedback from the adolescents on their use of a web-based depression support system. Web-based support systems can serve as an alternative to conventional treatment or to complement the current services. Mixed methods were used to approach the topic from multiple perspectives. Feedback was collected from adolescents with symptoms of depression or anxiety. Adolescents (n = 46) responded to a questionnaire after participating on the support system, and 24 adolescents did not provide feedback. The data were analyzed with quantitative descriptive statistics and qualitative thematic analysis. Out of 45 adolescents, 93% agreed that the web-based support system was targeted at them, and 89% felt it was reliable and safe. It was perceived as a good channel for reflecting thoughts. However, some adolescents felt it was difficult to use or that using it did not help them. Ideas for development were also offered. Depis.Net provided the adolescents with a reliable way to ease their condition at home. Using feedback from the adolescents on the support system makes it possible to identify those who are able to use this kind of system in daily practice.
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Affiliation(s)
- Katriina Anttila
- Department of Nursing Science, University of Turku, Turku, Finland.,Child Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Development Unit, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Development Unit, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong, People's Republic of China
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Anttila M, Kurki M, Välimäki M. Sleeping behaviors of adolescents with depressive disorders: adolescent self-description of sleeping reported through a web-based support system. Inform Health Soc Care 2019; 44:338-350. [PMID: 31340708 DOI: 10.1080/17538157.2019.1640223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Depression is the leading health disorder in adolescence and often manifests itself as sleeping problems. A number of quantitative analyses have assessed the quality of adolescents' sleeping, but there is still a lack of information on how adolescents themselves perceive their sleeping behavior. METHOD Using a mixed-methods approach, we describe sleeping behaviors and sleeping habits among adolescents with depressive disorders, who have been referred to psychiatric outpatient services. RESULTS Adolescents monitored their own sleeping patterns (n = 13) and reported on them through self-reflecting writings (n = 16) on a web-based support system for one week. They went to bed to about 23:00, remained awake for around 40 minutes, slept eight and a half hours, woke up at 9:00, and described themselves as being tired after the night. Adolescents were able to self-reflect on their sleeping in various ways and find meanings and interpretations of it. CONCLUSION The results contribute valuable information to health care personnel who work with adolescents, for example school nurses and mental health professionals. More emphasis should be put on adolescents' perceptions of their sleeping behavior and how to increase their insight into their own wellbeing.
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Affiliation(s)
- Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Development Unit, Hospital District of Southwest Finland, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (SAR)
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Grace-Farfaglia P. Social Cognitive Theories and Electronic Health Design: Scoping Review. JMIR Hum Factors 2019; 6:e11544. [PMID: 31325290 PMCID: PMC6676794 DOI: 10.2196/11544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/24/2018] [Accepted: 03/31/2019] [Indexed: 12/30/2022] Open
Abstract
Background There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change. Objective This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications. Methods The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed. Results Expressive interaction tools were found in 48.6% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8%). The vast majority of studies (100%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9%). Conclusions This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution.
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Impact of a Web Program to Support the Mental Wellbeing of High School Students: A Quasi Experimental Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142473. [PMID: 31336738 PMCID: PMC6679030 DOI: 10.3390/ijerph16142473] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 01/10/2023]
Abstract
Little effort has been made to investigate the potential of web programs aimed to support the mental wellbeing of adolescents in school environments in middle-income countries. A quasi-experimental feasibility study was conducted in Thailand with adolescents (N = 180) in three conveniently sampled high schools and with teachers (N = 12) who acted as program tutors. The web program was used in small groups, independently, or it was not used at all. No statistically significant changes were found between the groups regarding depression, stress, or satisfaction. Differences between program users (n = 61) and non-users (n = 48) were not significant. Acceptance was higher among adolescents who used the program independently (n = 40, 73% vs. n = 21, 39%; p = 0.001). Usability feedback did not differ between the groups. Support should be provided in order for programs to be potentially used. More information is needed regarding factors associated with the use of web programs.
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Winsall M, Orlowski S, Vogl G, Blake V, Nicholas M, Antezana G, Schrader G, Bidargaddi N. Designing Online Interventions in Consideration of Young People's Concepts of Well-Being: Exploratory Qualitative Study. JMIR Hum Factors 2019; 6:e10106. [PMID: 30698537 PMCID: PMC6372938 DOI: 10.2196/10106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/24/2018] [Accepted: 10/23/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A key challenge in developing online well-being interventions for young people is to ensure that they are based on theory and reflect adolescent concepts of well-being. OBJECTIVE This exploratory qualitative study aimed to understand young people's concepts of well-being in Australia. METHODS Data were collected via workshops at five sites across rural and metropolitan sites with 37 young people from 15 to 21 years of age, inclusive. Inductive, data-driven coding was then used to analyze transcripts and artifacts (ie, written or image data). RESULTS Young adults' conceptions of well-being were diverse, personally contextualized, and shaped by ongoing individual experiences related to physical and mental health, along with ecological accounts acknowledging the role of family, community, and social factors. Key emerging themes were (1) positive emotions and enjoyable activities, (2) physical wellness, (3) relationships and social connectedness, (4) autonomy and control, (5) goals and purpose, (6) being engaged and challenged, and (7) self-esteem and confidence. Participants had no difficulty describing actions that led to positive well-being; however, they only considered their own well-being at times of stress. CONCLUSIONS In this study, young people appeared to think mostly about their well-being at times of stress. The challenge for online interventions is to encourage young people to monitor well-being prior to it becoming compromised. A more proactive focus that links the overall concept of well-being to everyday, concrete actions and activities young people engage in, and that encourages the creation of routine good habits, may lead to better outcomes from online well-being interventions.
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Affiliation(s)
- Megan Winsall
- Personal Health Informatics, Flinders University, Clovelly Park, Australia
| | | | - Gillian Vogl
- Young and Well Cooperative Research Centre, Abbotsford, Victoria, Australia
| | - Victoria Blake
- Young and Well Cooperative Research Centre, Abbotsford, Victoria, Australia
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Garrido S, Millington C, Cheers D, Boydell K, Schubert E, Meade T, Nguyen QV. What Works and What Doesn't Work? A Systematic Review of Digital Mental Health Interventions for Depression and Anxiety in Young People. Front Psychiatry 2019; 10:759. [PMID: 31798468 PMCID: PMC6865844 DOI: 10.3389/fpsyt.2019.00759] [Citation(s) in RCA: 145] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/20/2019] [Indexed: 12/21/2022] Open
Abstract
Background: A major challenge in providing mental health interventions for young people is making such interventions accessible and appealing to those most in need. Online and app-based forms of therapy for mental health are burgeoning. It is therefore crucial to identify features that are most effective and engaging for young users. Objectives: This study reports a systematic review and meta-analysis of digital mental health interventions and their effectiveness in addressing anxiety and depression in young people to determine factors that relate to outcomes, adherence, and engagement with such interventions. Methods: A mixed methods approach was taken, including a meta-analysis of 9 randomized controlled trials that compared use of a digital intervention for depression in young people to a no-intervention control group, and 6 comparing the intervention to an active control condition. A thematic analysis and narrative synthesis of 41 studies was also performed. Results: The pooled effect size of digital mental health interventions on depression in comparison to a no-intervention control was small (Cohen's d = 0.33, 95% CI 0.11 to 0.55), while the pooled effect size of studies comparing an intervention group to an active control showed no significant differences (Cohen's d = 0.14, 95% CI -.04 to 0.31). Pooled effect sizes were higher when supervision was involved (studies with no-intervention controls: Cohen's d = 0.52, 95% CI 0.23 to 0.80; studies with active control: Cohen's d = 0.49, 95% CI -0.11, 1.01). Engagement and adherence rates were low. Qualitative analysis revealed that users liked interventions with a game-like feel and relatable, interactive content. Educational materials were perceived as boring, and users were put off by non-appealing interfaces and technical glitches. Conclusions: Digital interventions work better than no intervention to improve depression in young people when results of different studies are pooled together. However, these interventions may only be of clinical significance when use is highly supervised. Digital interventions do not work better than active alternatives regardless of the level of support. Future interventions need to move beyond the use of digital educational materials, considering other ways to attract and engage young people and to ensure relevance and appeal.
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Affiliation(s)
- Sandra Garrido
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Milperra, NSW, Australia.,Translational Health Institute, Western Sydney University, Campbelltown, NSW, Australia.,School of Social Sciences & Psychology, Western Sydney University, Milperra, NSW, Australia
| | - Chris Millington
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Milperra, NSW, Australia
| | - Daniel Cheers
- MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Milperra, NSW, Australia.,NSW Health, Sydney, NSW, Australia
| | | | - Emery Schubert
- School of Arts & Humanities, University of New South Wales, Kensington, NSW, Australia
| | - Tanya Meade
- School of Social Sciences & Psychology, Western Sydney University, Milperra, NSW, Australia
| | - Quang Vinh Nguyen
- School of Computing & Engineering, Western Sydney University, Parramatta, NSW, Australia
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Lamb T, Pachana NA, Dissanayaka N. Update of Recent Literature on Remotely Delivered Psychotherapy Interventions for Anxiety and Depression. Telemed J E Health 2018; 25:671-677. [PMID: 30300082 DOI: 10.1089/tmj.2018.0079] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introduction: Anxiety and depression are harmful to individuals suffering from these disorders, their caregivers, and the economy. Remote delivery of psychotherapy has been established as a viable alternative to traditional in-person psychotherapy for treating anxiety and depression. However, literature comparing and evaluating the variety of remote delivery modalities of psychotherapy has not yet been integrated. This review examines the efficacy, practicality, and limitations of telephone, video, and online-administered psychotherapy for the treatment of anxiety and depression. Methods: A comprehensive literature search conducted using PubMed and PsycINFO included systematic reviews, randomized controlled trials, and cost-analysis studies focused on a remote delivery method of psychotherapy for anxiety and depression. Results: Overall, interventions delivered through telephone, video, and online modalities demonstrated good efficacy in treating anxiety and depression in general, and when presenting comorbid with other disorders. The literature also suggested that telehealth psychotherapy is accessible, convenient, and cost-effective. However, there is less evidence for video-delivered psychotherapy for anxiety and depression compared with telephone-administered and online-administered modalities. Despite this, overall, the efficacy and practical benefits of remote psychotherapy interventions in treating anxiety and depression across a diverse range of patient groups suggested that it is an appropriate alternative for those who cannot access in-person psychotherapy. Conclusions: Further research evaluating the efficacy and practical benefits of video-delivered psychotherapy for anxiety and depression is much needed for patients with limited access to in-person psychological care.
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Affiliation(s)
- Timothy Lamb
- 1School of Psychology, The University of Queensland, Brisbane, Australia
| | - Nancy A Pachana
- 1School of Psychology, The University of Queensland, Brisbane, Australia
| | - Nadeeka Dissanayaka
- 1School of Psychology, The University of Queensland, Brisbane, Australia.,2UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,3Department of Neurology, Royal Brisbane and Woman's Hospital, Brisbane, Australia
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Kahler CW, Surace A, Gordon REF, Cioe PA, Spillane NS, Parks A, Bock BC, Brown RA. Positive psychotherapy for smoking cessation enhanced with text messaging: Protocol for a randomized controlled trial. Contemp Clin Trials 2018; 71:146-153. [PMID: 29936125 PMCID: PMC6484849 DOI: 10.1016/j.cct.2018.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/13/2018] [Accepted: 06/20/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite reductions in cigarette smoking in the U.S., improvements in the efficacy of smoking cessation treatments are needed, as rates of sustained abstinence remain disappointingly low. Both low positive affect and high negative affect contribute to smoking relapse and constitute viable targets for smoking cessation interventions. Although some clinical trials have evaluated interventions to address depression as a smoking relapse risk factor, very few have focused on positive affect. Recently, we developed and conducted a preliminary clinical trial of a smoking cessation treatment that targets positive affect and cognitions by incorporating interventions rooted in positive psychology. The current randomized controlled trial will expand upon this preliminary trial to test whether this positive psychology-informed approach results in higher smoking cessation rates compared to a time-matched standard smoking cessation treatment control. METHODS Three hundred and forty adult daily smokers will be randomly assigned to either positive psychotherapy for smoking cessation or standard behavioral smoking cessation counseling. Participants will meet weekly with a study counselor for 6 weeks and will receive transdermal nicotine patch and text messaging smoking cessation support. Additionally, text messaging in the positive psychotherapy condition will encourage engagement in positive psychology-specific strategies for boosting mood and staying smoke free. Smoking cessation outcomes will be measured at 12, 26, and 52 weeks following target quit date. CONCLUSION Results from this study will provide evidence on whether incorporating positive psychology interventions into smoking cessation treatment can improve smoking cessation outcomes relative to standard behavioral counseling with nicotine patch and text messaging.
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Affiliation(s)
- Christopher W Kahler
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States.
| | - Anthony Surace
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Rebecca E F Gordon
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Patricia A Cioe
- Center for Alcohol and Addiction Studies and the Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Nichea S Spillane
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
| | | | - Beth C Bock
- Alpert Medical School of Brown University and The Miriam Hospital, Providence, RI, United States
| | - Richard A Brown
- School of Nursing, University of Texas, Austin, TX, United States
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46
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Veinot TC, Mitchell H, Ancker JS. Good intentions are not enough: how informatics interventions can worsen inequality. J Am Med Inform Assoc 2018; 25:1080-1088. [PMID: 29788380 PMCID: PMC7646885 DOI: 10.1093/jamia/ocy052] [Citation(s) in RCA: 279] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 04/12/2018] [Accepted: 05/03/2018] [Indexed: 01/09/2023] Open
Abstract
Health informatics interventions are designed to help people avoid, recover from, or cope with disease and disability, or to improve the quality and safety of healthcare. Unfortunately, they pose a risk of producing intervention-generated inequalities (IGI) by disproportionately benefiting more advantaged people. In this perspective paper, we discuss characteristics of health-related interventions known to produce IGI, explain why health informatics interventions are particularly vulnerable to this phenomenon, and describe safeguards that can be implemented to improve health equity. We provide examples in which health informatics interventions produced inequality because they were more accessible to, heavily used by, adhered to, or effective for those from socioeconomically advantaged groups. We provide a brief outline of precautions that intervention developers and implementers can take to guard against creating or worsening inequality through health informatics. We conclude by discussing evaluation approaches that will ensure that IGIs are recognized and studied.
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Affiliation(s)
- Tiffany C Veinot
- School of Information and Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Hannah Mitchell
- Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York, New York, USA
| | - Jessica S Ancker
- Department of Healthcare Policy & Research, Division of Health Informatics, Weill Cornell Medical College, New York, New York, USA
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47
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Rice S, Gleeson J, Davey C, Hetrick S, Parker A, Lederman R, Wadley G, Murray G, Herrman H, Chambers R, Russon P, Miles C, D'Alfonso S, Thurley M, Chinnery G, Gilbertson T, Eleftheriadis D, Barlow E, Cagliarini D, Toh JW, McAlpine S, Koval P, Bendall S, Jansen JE, Hamilton M, McGorry P, Alvarez-Jimenez M. Moderated online social therapy for depression relapse prevention in young people: pilot study of a 'next generation' online intervention. Early Interv Psychiatry 2018; 12:613-625. [PMID: 27311581 DOI: 10.1111/eip.12354] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/28/2016] [Accepted: 04/20/2016] [Indexed: 01/18/2023]
Abstract
AIM Implementation of targeted e-mental health interventions offers a promising solution to reducing the burden of disease associated with youth depression. A single-group pilot study was conducted to evaluate the acceptability, feasibility, usability and safety of a novel, moderated online social therapy intervention (entitled Rebound) for depression relapse prevention in young people. METHODS Participants were 42 young people (15-25 years) (50% men; mean age = 18.5 years) in partial or full remission. Participants had access to the Rebound platform for at least 12 weeks, including the social networking, peer and clinical moderator and therapy components. RESULTS Follow-up data were available for 39 (92.9%) participants. There was high system usage, with 3034 user logins (mean = 72.2 per user) and 2146 posts (mean = 51.1). Almost 70% of users had ≥10 logins over the 12 weeks, with 78.5% logging in over at least 2 months of the pilot. A total of 32 (84%) participants rated the intervention as helpful. There was significant improvement between the number of participants in full remission at baseline (n = 5; none of whom relapsed) relative to n = 19 at 12-week follow-up (P < 0.001). Six (14.3%) participants relapsed to full threshold symptoms at 12 weeks. There was a significant improvement to interviewer-rated depression scores (Montgomery-Asberg Depression Rating Scale (MADRS); P = 0.014, d = 0.45) and a trend for improved strength use (P = 0.088, d = 0.29). The single-group design and 12-week treatment phase preclude a full understanding of the clinical benefits of the Rebound intervention. CONCLUSIONS The Rebound intervention was shown to be acceptable, feasible, highly usable and safe in young people with major depression.
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Affiliation(s)
- Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia.,Orygen Youth Health, Melbourne, Australia
| | - John Gleeson
- School of Psychology, Australian Catholic University, Brisbane, Australia
| | - Christopher Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia.,Orygen Youth Health, Melbourne, Australia
| | - Sarah Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Alexandra Parker
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Reeva Lederman
- Department of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
| | - Greg Wadley
- Department of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
| | - Greg Murray
- Department of Psychological Science, Swinburne University of Technology, Melbourne, Australia
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Richard Chambers
- Campus Community Division, Monash University, Melbourne, Victoria, Australia
| | - Penni Russon
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Christopher Miles
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Simon D'Alfonso
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | | | - Gina Chinnery
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Tamsyn Gilbertson
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Dina Eleftheriadis
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Emma Barlow
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Daniella Cagliarini
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | | | | | - Peter Koval
- School of Psychology, Australian Catholic University, Brisbane, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | | | - Matthew Hamilton
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre of Youth Mental Health, Melbourne, Australia
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48
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Choubisa R, Singh K. Development and validation of a web-delivered positive psychological intervention in an Indian Milieu: Lessons from a limited pilot randomized controlled trial. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1488512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Rajneesh Choubisa
- Department of Humanities and Social Sciences, Birla Institute of Technology & Science (BITS), Pilani, Pilani 333031, Rajasthan, India
| | - Kamlesh Singh
- Department of Humanities & Social Sciences, Indian Institute of Technology (IIT)-Delhi, Hauz Khas, New Delhi 110016, India
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49
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Lam JA, Kahler CW. A randomized crossover trial to test the effects of positive psychology intervention delivered by text messaging. THE JOURNAL OF POSITIVE PSYCHOLOGY 2018. [DOI: 10.1080/17439760.2017.1315649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Jeffrey A. Lam
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Christopher W. Kahler
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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50
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Sherman KA, Przezdziecki A, Alcorso J, Kilby CJ, Elder E, Boyages J, Koelmeyer L, Mackie H. Reducing Body Image-Related Distress in Women With Breast Cancer Using a Structured Online Writing Exercise: Results From the My Changed Body Randomized Controlled Trial. J Clin Oncol 2018; 36:1930-1940. [PMID: 29688834 DOI: 10.1200/jco.2017.76.3318] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose Breast cancer treatment adverse effects result in one in three survivors experiencing body image-related distress (BID) that negatively impacts on a woman's ability to recover after cancer and into survivorship. My Changed Body (MyCB) is a Web-based psychological intervention to alleviate BID and improve body appreciation in survivors of breast cancer (BCSs) through a single-session, self-compassion focused writing activity. This randomized controlled trial evaluated the impact of MyCB on BID and body appreciation in BCSs. The moderating effect of lymphedema status (affected or unaffected) and appearance investment (self-importance placed on personal appearance) and the mediating effect of self-compassion were evaluated. Patients and Methods Women (disease-free stage I to III BCSs who had experienced at least one negative event related to bodily changes after breast cancer) were randomly assigned to MyCB (n = 149) or an expressive writing control arm (n = 155). Primary outcomes were reduction in BID and improvement in body appreciation 1 week after intervention. Secondary outcomes included psychological distress (depression and anxiety) and self-compassion. Follow-up assessments occurred 1 week, 1 month, and 3 months after writing. Results Compliance with the MyCB intervention was 88%, and attrition was 9.2%. Intent-to-treat linear mixed models indicated that participants who received MyCB reported significantly less BID ( P = .035) and greater body appreciation ( P = .004) and self-compassion ( P < .001) than expressive writing participants. Intervention effects on BID were moderated by lymphedema status ( P = .007) and appearance investment ( P = .042). Self-compassion mediated effects on both primary outcomes. Therapeutic effects were maintained at 1 month (BID and body appreciation) and 3 months (body appreciation) after intervention. Significant reductions in psychological distress (1-month depression, P = .001; 1-week and 1-month anxiety, P = .007) were evident for MyCB participants with lymphedema. Conclusion This study supports the efficacy of MyCB for reducing BID and enhancing body appreciation among BCSs.
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Affiliation(s)
- Kerry A Sherman
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - Astrid Przezdziecki
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - Jessica Alcorso
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - Christopher Jon Kilby
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - Elisabeth Elder
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - John Boyages
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - Louise Koelmeyer
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
| | - Helen Mackie
- Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia
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