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Abraham JG, Thomas N, Shenoy DS, Padickaparambil DS. Feasibility and acceptability of an online group dialectical behavioural therapy skills training in a Transdiagnostic group with Anxiety and Depression. Psychiatry Res 2024; 339:116016. [PMID: 38908264 DOI: 10.1016/j.psychres.2024.116016] [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: 12/02/2023] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/24/2024]
Abstract
Transdiagnostic approaches offers a paradigm shift in managing psychiatric disorders. Emotion regulation difficulties are a transdiagnostic prevalent across various mood and personality disorders. Dialectical Behavioural Therapy Skills Training (DBT-ST), initially designed as part of treatment for borderline personality disorder, targets emotion regulation and has shown promise in diverse psychiatric conditions. In lower middle-income countries with resource-constrained settings, online delivery of evidence-based interventions holds potential to bridge treatment gaps. This study assesses the feasibility and acceptability of online group DBT skills training for individuals with depression or anxiety disorders in India. Mental health professionals practising in India referred twenty-four eligible participants currently not engaged in psychotherapy. Of these, 18 initiated the 8-week virtual group DBT-ST program, with 12 completing it (66 % female, 18-35 years of age, 5 on concurrent medication). They provided feedback on therapy content's usefulness. Baseline, post-intervention, and one-month follow-up assessments measured changes in emotion regulation difficulties, depression, and anxiety symptoms. Treatment retained 66.7 % of participants, all participants found the intervention beneficial. Repeated measures ANOVA indicates significant reductions in self-reported difficulties in emotion regulation, depression, and anxiety symptoms post-intervention. These findings highlight the promise of transdiagnostic interventions like DBT-ST that merit further evaluations using RCTs with larger sample sizes.
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Affiliation(s)
- Joshin George Abraham
- Clinical Psychologist/Lecturer Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka, India
| | - Nitha Thomas
- Clinical Psychologist (Previously Assistant Professor, Department of Clinical Psychology, Manipal Academy of Higher Education), Mangalore, Karnataka, India.
| | - Dr Sonia Shenoy
- Associate Professor Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Dr Sebastian Padickaparambil
- Additional Professor Department of Clinical Psychology, Manipal Academy of Higher Education, Manipal, Karnataka, India
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2
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Venkataraman A, Fatma N, Edirippulige S, Ramamohan V. Facilitators and Barriers for Telemedicine Systems in India from Multiple Stakeholder Perspectives and Settings: A Systematic Review. Telemed J E Health 2024; 30:1341-1356. [PMID: 38206654 DOI: 10.1089/tmj.2023.0297] [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] [Indexed: 01/12/2024] Open
Abstract
Background: Telemedicine is viewed as a crucial tool for addressing the challenges of limited medical resources at health care facilities. However, its adoption in health care is not entirely realized due to perceived barriers. This systematic review outlines the critical facilitators and barriers that influence the implementation of telemedicine in the Indian health care system, observed at the infrastructural, sociocultural, regulatory, and financial levels, from the perspectives of health care providers, patients, patient caregivers, society, health organizations, and the government. Methods: This review complies with the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015. A total of 2,706 peer-reviewed studies published from December 2016 to September 2023 in the PubMed, Cochrane, Scopus, Web of Science, CINAHL, MEDLINE, and PsycInfo databases were considered for the title and abstract screening, after which 334 articles were chosen for the full-text review. In the end, 46 studies were selected for data synthesis. Results: Analysis of the literature revealed key barriers such as data privacy and security concerns, doctor and patient resistance to information and communications technology (ICT), infrastructure issues, and ICT training gaps. Facilitators included reduced health care delivery costs, enhanced patient access to health care in remote areas, and shorter patient wait times. The real-world experiences of Indian telemedicine practitioners and pioneers are also explored to complement literature-based perspectives on telemedicine implementation. Both stress the need for reliable internet connectivity, technological adoption, comprehensive ICT training, positive sociocultural attitudes, stringent data privacy measures, and viable business models as crucial for effective telemedicine adoption, with experts emphasizing practical adaptability alongside the literature-recognized facilitators.
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Affiliation(s)
- Aparna Venkataraman
- Department of Mechanical Engineering, Faculty of Medicine, UQ-IITD Academy of Research, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
| | - Najiya Fatma
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
| | - Sisira Edirippulige
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Varun Ramamohan
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
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3
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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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Fernandes D, D’Souza E, Sambari S, Pacheco M, D’Souza J, Velleman R, Bhatia U, Nadkarni A. Experiences of a mobile phone delivered brief intervention for hazardous drinking: A qualitative study nested in the AMBIT trial from Goa, India. Glob Ment Health (Camb) 2023; 10:e58. [PMID: 37854400 PMCID: PMC10579675 DOI: 10.1017/gmh.2023.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 10/20/2023] Open
Abstract
Background This study explores the experiences of participants receiving a mobile-based brief intervention (BI) for hazardous drinking in India, to determine characteristics that influenced engagement and examine perceived reasons for change in alcohol consumption. Methods Semi-structured interviews were conducted with 10 adult hazardous drinkers who received a mobile-based BI in the intervention arm of a pilot randomised control trial. Data were coded through an iterative process and analysed using thematic analysis. Findings Study participants reported a positive experience, with factors such as customised intervention delivery and personal motivation facilitating their engagement. Participants reported a reduction in quantity and frequency of alcohol use. This was credited to the intervention, particularly, its provision of health-related information, goal-setting content and strategies to manage drinking. Apart from alcohol reduction, participants reported improvements in diet, lifestyle, wellbeing, and familial relations. Implication By providing a context to explain the impact of the intervention, the learnings from this study can be used to strengthen the implementation of mobile-based interventions. This study outlines the scope for further research in digital health, such as Internet-based health interventions, and incorporating digital interventions within the ambit of existing health care programmes.
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Affiliation(s)
| | - Ethel D’Souza
- Addictions and Related Research Group, Sangath, Porvorim, India
| | - Seema Sambari
- Addictions and Related Research Group, Sangath, Porvorim, India
| | | | | | - Richard Velleman
- Addictions and Related Research Group, Sangath, Porvorim, India
- Department of Psychology, University of Bath, Bath, UK
| | - Urvita Bhatia
- Addictions and Related Research Group, Sangath, Porvorim, India
| | - Abhijit Nadkarni
- Addictions and Related Research Group, Sangath, Porvorim, India
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Ghosh A, Krishnan NC, Kathirvel S, Pillai RR, Basu D, George BB, P V A, Sharma K, Kumar A. Digital screening and brief intervention for alcohol misuse in college students: A pilot, mixed-methods, cluster randomized controlled trial from a low-resourced setting. Asia Pac Psychiatry 2023; 15:e12527. [PMID: 36974919 DOI: 10.1111/appy.12527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/28/2023] [Accepted: 03/11/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION We examined the feasibility and acceptability of digital screening and brief intervention (d-SBI) for alcohol misuse in college students; the effectiveness of d-SBI was our secondary outcome. We also explored the barriers and facilitators of d-SBI. METHODS The study design is a mixed-methods, pilot, and cluster randomized trial. Five colleges from a northern city in India were randomly allocated to d-SBI and control groups. One hundred and ninety-one students were screened, and 25 (male = 23 and female = 2) participants (age 19.62 ± 2.58 years) fulfilled eligibility. All participants completed follow-up assessments at 3 months. In-depth interviews were done with 11 participants. Alcohol Use Disorder Identification Test (AUDIT) based screening brief intervention was provided on a web portal- or mobile application in the d-SBI group. The control group received digital screening and brief education. Direct questions and usage statistics assessed the measurement acceptability of the intervention. We compared the change in AUDIT scores in the intervention groups over 3 months post-intervention. Thematic analyses of transcripts of interviews were done by inductive coding. RESULTS Most participants reported that d-SBI was user-friendly (80%), advice was appropriate (80%), and perceived it to be useful (72%). Ninety-six percent of users, who logged in, completed screening. There was a significant decrease in AUDIT scores both in d-SBI (p < .001) and control groups (p < .001). Time and group significantly affected the mean AUDIT score, but time × group interaction was non-significant. Thematic analysis revealed six overarching themes. CONCLUSIONS Digital SBI for alcohol misuse is acceptable, feasible, and possibly effective among college students from low-resource settings.
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Affiliation(s)
- Abhishek Ghosh
- Drug De-Addiction & Treatment Centre, Department of Psychiatry, PGIMER, Chandigarh, India
| | - Narayanan C Krishnan
- Department of Data Science, Indian Institute of Technology (IIT), Palakkad, India
| | - Soundappan Kathirvel
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Renjith R Pillai
- Drug De-Addiction & Treatment Centre, Department of Psychiatry, PGIMER, Chandigarh, India
| | - Debasish Basu
- Drug De-Addiction & Treatment Centre, Department of Psychiatry, PGIMER, Chandigarh, India
| | - Blessy B George
- Drug De-Addiction & Treatment Centre, Department of Psychiatry, PGIMER, Chandigarh, India
| | - Aswathy P V
- Drug De-Addiction & Treatment Centre, Department of Psychiatry, PGIMER, Chandigarh, India
| | - Kshitiz Sharma
- Drug De-Addiction & Treatment Centre, Department of Psychiatry, PGIMER, Chandigarh, India
| | - Anil Kumar
- Department of Computer Science, Indian Institute of Technology (IIT), Ropar, India
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Quirk HD, Nagar R, Anderson PL. A qualitative exploration of college students' experiences using mobile apps to improve self-care during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37053590 DOI: 10.1080/07448481.2023.2198033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/09/2023] [Accepted: 03/19/2023] [Indexed: 06/19/2023]
Abstract
Objective: This project examines students' experiences using a mental health mobile application (app) as part of a class assignment developed to support student well-being. Participants: Data was collected from 265 undergraduate students enrolled in a psychology course during the COVID-19 pandemic. Methods: Students developed a self-care goal and used an app to support progress toward it. Thematic analysis was applied to students' written reflections about their experiences using the app and practicing self-care. Results: Students reported using an app for self-care was 1) more helpful than expected for improving focus, productivity, motivation, sleep, and mental health symptoms; 2) challenging due to loss of interest, slow improvement, difficulty integrating into routine, or negative feelings triggered; and 3) influenced by the pandemic and transition to remote learning. Conclusions: A classroom assignment designed to promote self-care using a mental health app shows promise. Future research is needed to better understand engagement and impact.
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Affiliation(s)
| | - Ria Nagar
- Psychology, Georgia State University, Atlanta, Georgia, USA
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Liu XQ, Guo YX, Xu Y. Risk factors and digital interventions for anxiety disorders in college students: Stakeholder perspectives. World J Clin Cases 2023; 11:1442-1457. [PMID: 36926387 PMCID: PMC10011984 DOI: 10.12998/wjcc.v11.i7.1442] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/06/2023] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
The worldwide prevalence of anxiety disorders among college students is high, which negatively affects countries, schools, families, and individual students to varying degrees. This paper reviews the relevant literature regarding risk factors and digital interventions for anxiety disorders among college students from the perspectives of different stakeholders. Risk factors at the national and societal levels include class differences and the coronavirus disease 2019 pandemic. College-level risk factors include the indoor environment design of the college environment, peer relationships, student satisfaction with college culture, and school functional levels. Family-level risk factors include parenting style, family relationship, and parental level of education. Individual-level risk factors include biological factors, lifestyle, and personality. Among the intervention options for college students' anxiety disorders, in addition to traditional cognitive behavioral therapy, mindfulness-based interventions, psychological counseling, and group counseling, digital mental health interventions are increasingly popular due to their low cost, positive effect, and convenient diagnostics and treatment. To better apply digital intervention to the prevention and treatment of college students' anxiety, this paper suggests that the different stakeholders form a synergy among themselves. The nation and society should provide necessary policy guarantees, financial support, and moral and ethical supervision for the prevention and treatment of college students' anxiety disorders. Colleges should actively participate in the screening and intervention of college students' anxiety disorders. Families should increase their awareness of college students' anxiety disorders and take the initiative to study and understand various digital intervention methods. College students with anxiety disorders should actively seek psychological assistance and actively accept and participate in digital intervention projects and services. We believe that in the future, the application of methods such as big data and artificial intelligence to improve digital interventions and provide individualized treatment plans will become the primary means of preventing and treating anxiety disorders among college students.
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Affiliation(s)
- Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yu-Xin Guo
- School of Education, Tianjin University, Tianjin 300350, China
| | - Yi Xu
- School of Education, Tianjin University, Tianjin 300350, China
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Girase B, Parikh R, Vashisht S, Mullick A, Ambhore V, Maknikar S. India's policy and programmatic response to mental health of young people: A narrative review. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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MacEntee K, Lee EOJ, Oudshoorn A, Abramovich A, Kiptui R, Ayuku D, Van Berkum A, Saarela O, Tang TS, Apondi E, Wachira J, MacDonald SA, Braitstein P. Using scenario videos with Theatre Testing method to adapt a peer navigation model to improve street-connected youth's access to HIV care in Kenya and Canada. Front Public Health 2022; 10:975117. [PMID: 36408034 PMCID: PMC9669244 DOI: 10.3389/fpubh.2022.975117] [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: 06/21/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Theatre testing (TT) method demonstrates whole or portions of an evidence-based intervention to stakeholders to elicit feedback on context-specific adaptations and future implementation. The Peer Navigator Project (PNP) studied the adaptation and implementation of Peer Navigators in five urban sites to increase street-connected youth (SCY) access to HIV prevention, testing, and treatment in Canada and Kenya. TT was used with SCY, healthcare providers, and community stakeholders to collect feedback on the optimal characteristics of the PNs (e.g., social identities) and their professional activities and responsibilities in each site. Sites scripted unique scenarios of PNs supporting SCY and interacting with social service providers. Local actors were employed, and the scenarios were filmed and edited into videos alongside audience discussion questions. Videos were screened to separate audiences of SCY (n = 40), healthcare providers (n = 12), and community stakeholders (n = 59). Facilitated discussion about the scenarios were recorded as data, and transcripts were analyzed thematically by the research team. The scenario videos are presented as a unique adaptation to the TT method. The adaptations were time-consuming and limited the ability to present responsive changes while presenting the method to different audiences. They were also effective at maintaining presentation fidelity and eliciting diverse and meaningful responses from different stakeholder groups. One site successfully adapted the method for use in a physically distanced manner that complied with COVID-19 public health regulations. TT using video scenarios is an engaging approach that garners rich responses from diverse stakeholder groups about the adaptation of evidence-based interventions preparing for implementation in international settings.
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Affiliation(s)
- Katie MacEntee
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada,*Correspondence: Katie MacEntee
| | - Edward Ou Jin Lee
- École de Travail Social, Université de Montréal, Montréal, QC, Canada
| | - Abe Oudshoorn
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Alex Abramovich
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Reuben Kiptui
- Academic Model Providing Access to Healthcare in Eldoret, Eldoret, Kenya
| | - David Ayuku
- Academic Model Providing Access to Healthcare in Eldoret, Eldoret, Kenya,Department of Mental Health and Behavioral Sciences, School of Medicine, Moi University, Eldoret, Kenya
| | - Amy Van Berkum
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Olli Saarela
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Thai-Son Tang
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Edith Apondi
- Academic Model Providing Access to Healthcare in Eldoret, Eldoret, Kenya,Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Juddy Wachira
- Academic Model Providing Access to Healthcare in Eldoret, Eldoret, Kenya,Department of Mental Health and Behavioral Sciences, School of Medicine, Moi University, Eldoret, Kenya
| | - Sue-Ann MacDonald
- École de Travail Social, Université de Montréal, Montréal, QC, Canada
| | - Paula Braitstein
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Epidemiology and Biostatistics, School of Public Health, Moi University, Eldoret, Kenya
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Willis HA, Gonzalez JC, Call CC, Quezada D, Galán CA. Culturally Responsive Telepsychology & mHealth Interventions for Racial-Ethnic Minoritized Youth: Research Gaps and Future Directions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:1053-1069. [PMID: 36227174 PMCID: PMC9627988 DOI: 10.1080/15374416.2022.2124516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Telepsychology and mHealth (TPmH) services for youth and their families have become increasingly prevalent in recent years. However, significant limitations in theory, research, and policy introduce questions about the effectiveness of such interventions, particularly for racial-ethnic minoritized youth and their families, who already contend with inequities in mental health treatment access and outcomes. Although TPmH have the potential to reduce barriers to mental health services in ways that may benefit racial-ethnic minoritized youth and their families, the mental health field must first grapple with limitations in culturally responsive TPmH work to avoid perpetuating existing mental health inequities. As such, this article begins by briefly reviewing extant literature on (1) TPmH for youth, (2) culturally adapted or culturally responsive evidence-based interventions for racial-ethnic minoritized youth and families, and (3) the intersection of TPmH and culturally responsive interventions. Informed by the gaps identified by this review, we provide recommendations for future directions in culturally responsive TPmH for racial-ethnic minoritized youth and families. These recommendations have been organized into four overarching categories: (1) conceptual and theoretical recommendations, (2) research priorities, (3) practice and policy recommendations, and (4) engagement and access recommendations. These recommendations offer novel ideas for researchers, clinicians, funding agencies, policy-makers, and other key stakeholders and are intended to facilitate equity in TPmH for racial-ethnic minoritized youth and their families.
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Affiliation(s)
| | - Juan Carlos Gonzalez
- Department of Counseling, Clinical, & School Psychology, University of California
| | | | - David Quezada
- Department of Psychology, University of Southern California
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Emran A, Smith JA, Iqbal N. Psychotherapists’ experience of the transition to telepsychotherapy amidst COVID-19 in India. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2093164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ashti Emran
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
| | - Jonathan A. Smith
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Naved Iqbal
- Department of Psychology, Jamia Millia Islamia, New Delhi, India
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Koly KN, Saba J, Muzaffar R, Modasser RB, M TH, Colon-Cabrera D, Warren N. Exploring the potential of delivering mental health care services using digital technologies in Bangladesh: A qualitative analysis. Internet Interv 2022; 29:100544. [PMID: 35615404 PMCID: PMC9125629 DOI: 10.1016/j.invent.2022.100544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/20/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bangladesh is a lower-middle-income country affected by a severe lack of mental health service availability due to a scarcity of mental health experts, limited mental health literacy, and community stigma. In other low and middle-income countries, the online provision of mental health care services has addressed issues affecting service availability, accessibility, mass awareness of services, and stigma. OBJECTIVE The current study sought to understand stakeholders' perceptions of the potential of digital media-based mental health care delivery in strengthening Bangladesh's mental health system. METHOD Online in-depth interviews were conducted with seven psychiatrists and eleven people with lived experiences of mental health issues. In addition, two online focus groups were conducted with ten psychologists and nine mental health entrepreneurs. A thematic analysis of the audio transcriptions was used to identify themes. RESULT Stakeholders perceived that the benefits of digital media-based mental health services included the potential of increasing the awareness, availability, and accessibility of mental health services. Participants recommended: the rehabilitation of existing pathways; the use of social media to raise awareness; and the implementation of strategies that integrate different digital-based services to strengthen the mental health system and foster positive mental health-seeking behaviors. CONCLUSION Growing mental health awareness, combined with the appropriate use of digital media as a platform for distributing information and offering mental services, can help to promote mental health care. To strengthen mental health services in Bangladesh, tailored services, increased network coverage, and training are required on digital mental health.
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Key Words
- Bangladesh
- CMD, Common Mental Health Disorders
- COREQ, Consolidated Reporting Criteria for Qualitative Studies
- COVID-19, Coronavirus Disease 2019
- DALYs, Disability-Adjusted Life-Years
- Digital technology
- E-mental health
- FGD, Focus Group Discussions
- HIC, High Income Country
- Health system
- IDI, In-Depth Interviews
- IRB, Institutional Review Board
- Internet
- KII, Key Informant Interviews
- LMIC, Low and Middle-Income Country
- MH, Mental Health
- Mental health
- PWLE, People with Lived Experiences of Mental Health Issues
- UHC, Universal Health Coverage
- WHO, World Health Organization
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Affiliation(s)
- Kamrun Nahar Koly
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh,Corresponding author at: Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh.
| | - Jobaida Saba
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh
| | - Rasma Muzaffar
- Department of Public Health, North South University, Bashundhara, Dhaka 1229, Bangladesh
| | - Rifath Binta Modasser
- School of Public Health, Independent University Bangladesh (IUB), Bashundhara, Dhaka 1229, Bangladesh
| | - Tasdik Hasan M
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom,Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia,Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh
| | - David Colon-Cabrera
- Department of Sociology and Anthropology, School of Social Sciences, Monash University, Australia
| | - Narelle Warren
- Department of Sociology and Anthropology, School of Social Sciences, Monash University, Australia
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Spanhel K, Balci S, Feldhahn F, Bengel J, Baumeister H, Sander LB. Cultural adaptation of internet- and mobile-based interventions for mental disorders: a systematic review. NPJ Digit Med 2021; 4:128. [PMID: 34433875 PMCID: PMC8387403 DOI: 10.1038/s41746-021-00498-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 08/03/2021] [Indexed: 02/07/2023] Open
Abstract
Providing accessible and effective healthcare solutions for people living in low- and middle-income countries, migrants, and indigenous people is central to reduce the global mental health treatment gap. Internet- and mobile-based interventions (IMI) are considered scalable psychological interventions to reduce the burden of mental disorders and are culturally adapted for implementation in these target groups. In October 2020, the databases PsycInfo, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were systematically searched for studies that culturally adapted IMI for mental disorders. Among 9438 screened records, we identified 55 eligible articles. We extracted 17 content, methodological, and procedural components of culturally adapting IMI, aiming to consider specific situations and perspectives of the target populations. Adherence and effectiveness of the adapted IMI seemed similar to the original IMI; yet, no included study conducted a direct comparison. The presented taxonomy of cultural adaptation of IMI for mental disorders provides a basis for future studies investigating the relevance and necessity of their cultural adaptation.PROSPERO registration number: CRD42019142320.
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Affiliation(s)
- Kerstin Spanhel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany.
| | - Sumeyye Balci
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Felicitas Feldhahn
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Juergen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lasse B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
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Systematic review and narrative synthesis of suicide prevention in high-schools and universities: a research agenda for evidence-based practice. BMC Public Health 2021; 21:1116. [PMID: 34112141 PMCID: PMC8194002 DOI: 10.1186/s12889-021-11124-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 05/24/2021] [Indexed: 11/20/2022] Open
Abstract
Background Youth suicide prevention in high-schools and universities is a public health priority. Our aim was to propose a research agenda to advance evidence-based suicide prevention in high-schools and universities by synthesizing and critically reviewing the research focus and methodologies used in existing intervention studies. Methods Fourteen databases were systematically searched to identify studies which evaluate suicide prevention interventions delivered on high-school or university campuses, with before and after measures. Data from included studies (n = 43) were extracted to identify what, where, how and for whom interventions have been tested. Narrative synthesis was used to critically evaluate research focus and methodology. Study quality was assessed. Results Research has focused primarily on selective interventions, with less attention on indicated and universal interventions. Most evidence comes from North America and high-income countries. The target of interventions has been: non-fatal suicidal behaviour; confidence and ability of staff/students to intervene in a suicidal crisis; suicide-related knowledge and attitudes; and suicide-related stigma. No studies included suicide deaths as an outcome, evaluated eco-systemic interventions, explored how context influences implementation, used multisite study designs, or focused explicitly on LGBTQ+ youth. Two studies evaluated digital interventions. Quality of the majority of studies was compromised by lack of methodological rigour, small samples, and moderate/high risk of bias. Interventions often assume the existence of an external well-functioning referral pathway, which may not be true in low-resource settings. Conclusion To advance evidence-based suicide prevention in educational settings we need to: conduct more high-quality clinical and pragmatic trials; promote research in low- and middle-income countries; test targeted interventions for vulnerable populations (like LGBTQ+ youth), evaluate interventions where death by suicide is the primary outcome; include translational studies and use implementation science to promote intervention uptake; evaluate the potential use of digital and eco-systemic interventions; and conduct multisite studies in diverse cultural settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11124-w.
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Lehtimaki S, Martic J, Wahl B, Foster KT, Schwalbe N. Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview. JMIR Ment Health 2021; 8:e25847. [PMID: 33913817 PMCID: PMC8120421 DOI: 10.2196/25847] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/15/2021] [Accepted: 03/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low- and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues. OBJECTIVE This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low- and middle-income countries). METHODS We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews. RESULTS In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings. CONCLUSIONS Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low- and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.
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Affiliation(s)
| | - Jana Martic
- Spark Street Advisors, New York, NY, United States
| | - Brian Wahl
- Spark Street Advisors, New York, NY, United States.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katherine T Foster
- Department of Psychology, University of Washington, Seattle, WA, United States.,Department of Global Health, University of Washington, Seattle, WA, United States
| | - Nina Schwalbe
- Spark Street Advisors, New York, NY, United States.,Heilbrunn Department of Population and Family Health, Columbia Mailman School of Public Health, New York, NY, United States.,United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia
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