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Ding X, Wuerth K, Sakakibara B, Schmidt J, Parde N, Holsti L, Barbic S. Understanding Mobile Health and Youth Mental Health: Scoping Review. JMIR Mhealth Uhealth 2023; 11:e44951. [PMID: 37220197 PMCID: PMC10278734 DOI: 10.2196/44951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/30/2023] [Accepted: 05/16/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND A total of 75% of people with mental health disorders have an onset of illness between the ages of 12 and 24 years. Many in this age group report substantial obstacles to receiving quality youth-centered mental health care services. With the rapid development of technology and the recent COVID-19 pandemic, mobile health (mHealth) has presented new opportunities for youth mental health research, practice, and policy. OBJECTIVE The research objectives were to (1) synthesize the current evidence supporting mHealth interventions for youths who experience mental health challenges and (2) identify current gaps in the mHealth field related to youth's access to mental health services and health outcomes. METHODS Guided by the methods of Arksey and O'Malley, we conducted a scoping review of peer-reviewed studies that used mHealth tools to improve youth mental health (January 2016-February 2022). We searched MEDLINE, PubMed, PsycINFO, and Embase databases using the following key terms: (1) mHealth; (2) youth and young adults; and (3) mental health. The current gaps were analyzed using content analysis. RESULTS The search produced 4270 records, of which 151 met inclusion criteria. Included articles highlight the comprehensive aspects of youth mHealth intervention resource allocation for targeted conditions, mHealth delivery methods, measurement tools, evaluation of mHealth intervention, and youth engagement. The median age for participants in all studies is 17 (IQR 14-21) years. Only 3 (2%) studies involved participants who reported their sex or gender outside of the binary option. Many studies (68/151, 45%) were published after the onset of the COVID-19 outbreak. Study types and designs varied, with 60 (40%) identified as randomized controlled trials. Notably, 143 out of 151 (95%) studies came from developed countries, suggesting an evidence shortfall on the feasibility of implementing mHealth services in lower-resourced settings. Additionally, the results highlight concerns related to inadequate resources devoted to self-harm and substance uses, weak study design, expert engagement, and the variety of outcome measures selected to capture impact or changes over time. There is also a lack of standardized regulations and guidelines for researching mHealth technologies for youths and the use of non-youth-centered approaches to implementing results. CONCLUSIONS This study may be used to inform future work as well as the development of youth-centered mHealth tools that can be implemented and sustained over time for diverse types of youths. Implementation science research that prioritizes youths' engagement is needed to advance the current understanding of mHealth implementation. Moreover, core outcome sets may support a youth-centered measurement strategy to capture outcomes in a systematic way that prioritizes equity, diversity, inclusion, and robust measurement science. Finally, this study suggests that future practice and policy research are needed to ensure the risk of mHealth is minimized and that this innovative health care service is meeting the emerging needs of youths over time.
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Affiliation(s)
- Xiaoxu Ding
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Faculty of Graduate Studies, Rehabilitation Science, University of British Columbia, Vancouver, BC, Canada
| | - Kelli Wuerth
- Foundry, Providence Health Care, Vancouver, BC, Canada
| | - Brodie Sakakibara
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Faculty of Graduate Studies, Rehabilitation Science, University of British Columbia, Vancouver, BC, Canada
- Faculty of Medicine, Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, BC, Canada
| | - Julia Schmidt
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Faculty of Graduate Studies, Rehabilitation Science, University of British Columbia, Vancouver, BC, Canada
| | - Natalie Parde
- Department of Computer Science, University of Illinois Chicago, Chicago, IL, United States
- Natural Language Processing Laboratory, University of Illinois Chicago, Chicago, IL, United States
| | - Liisa Holsti
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Faculty of Graduate Studies, Rehabilitation Science, University of British Columbia, Vancouver, BC, Canada
| | - Skye Barbic
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Faculty of Graduate Studies, Rehabilitation Science, University of British Columbia, Vancouver, BC, Canada
- Foundry, Providence Health Care, Vancouver, BC, Canada
- Centre for Health Evaluation & Outcome Sciences, Vancouver, BC, Canada
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Hellesen S, Bankston-Lee K, Maytum C, Tong EK. Strategies and lessons learned for smoke and Tobacco-Free policy change on community colleges with community-based support. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2406-2415. [PMID: 33522464 DOI: 10.1080/07448481.2020.1865972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/11/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
Objective: Community colleges face challenges to becoming smoke-free and have higher smoking prevalence rates than four-year colleges. This case study examines how Sacramento Taking Action Against Nicotine Dependence (STAND), a community-based organization's project, achieved tobacco-free policies at California's second largest community college district. Methods: Data sources describing the STAND policymaking activities (2001-2016) include evaluation reports and key informant interviews (n = 9) with community college nursing staff, former STAND staff, and other Sacramento tobacco control partners. Reports and interview transcripts were analyzed using content analysis. Results: Collecting campus data and engaging campus champions were key strategies to demonstrate internal support for stronger policies, as STAND faced resistance from the District leadership. External momentum encouraged the campuses to adopt 100% smoke, tobacco and vape-free policies. Conclusion: Community-based organizations can facilitate long-term support for smoke and tobacco-free campus policymaking efforts at community colleges, as internal and external support is demonstrated for more comprehensive policies.
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Affiliation(s)
- Sarah Hellesen
- Public Health Sciences, University of California, Davis, USA
| | - Kimberly Bankston-Lee
- Breathe California Sacramento Region, Sacramento, USA
- The SOL Project, Sacramento, USA
| | - Carol Maytum
- Breathe California Sacramento Region, Sacramento, USA
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Chalela P, McAlister AL, Despres C, Muñoz E, Sukumaran P, Akopian D, Kaghyan S, Trujillo J, Ramirez AG. Direct Outreach in Bars and Clubs to Enroll Cigarette Smokers in Mobile Cessation Services: Exploratory Study. JMIR Form Res 2022; 6:e28059. [PMID: 35653173 PMCID: PMC9204570 DOI: 10.2196/28059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/30/2021] [Accepted: 01/29/2022] [Indexed: 11/24/2022] Open
Abstract
Background Cigarette smoking and alcohol use are well known to be concomitant behaviors, but there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars and clubs. Adapting recruitment strategies to expand the reach of cessation programs to where tobacco users are located may help decrease the health-equity gap in tobacco control by improving reach and enrollment of underserved smokers residing in low-income and rural areas who are not reached by traditional cessation services. Objective The purpose of this exploratory study was to assess the feasibility of direct outreach in bars, clubs, and restaurants to recruit smokers to Quitxt, our mobile smoking cessation service. Quitxt is delivered through SMS text messaging or Facebook Messenger. Methods We collaborated with an advertising agency to conduct in-person recruitment of young adult smokers aged 18-29 years, focusing on urban and rural Spanish-speaking Latino participants, as well as English-speaking rural White and African American participants. Street team members were recruited and trained in a 4-hour session, including a brief introduction to the public health impacts of cigarette smoking and the aims of the project. The street teams made direct, face-to-face contact with smokers in and near smoking areas at 25 bars, clubs, and other venues frequented by young smokers in urban San Antonio and nearby rural areas. Results The 3923 interactions by the street teams produced 335 (8.5%) program enrollments. Most participants were English speakers with a mean age of 29.2 (SD 10.6) years and smoked a mean of 8.5 (SD 6.2) cigarettes per day. Among users who responded to questions on gender and ethnicity, 66% (70/106) were women and 56% (60/107) were Hispanic/Latino. Among users ready to make a quit attempt, 22% (17/77) reported 1 tobacco-free day and 16% (10/62) reported maintaining cessation to achieve 1 week without smoking. The response rate to later follow-up questions was low. Conclusions Direct outreach in bars and clubs is a useful method for connecting young adult cigarette smokers with mobile cessation services. However, further research is needed to learn more about how mobile services can influence long-term smoking cessation among those recruited through direct outreach, as well as to test the use of incentives in obtaining more useful response rates.
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Affiliation(s)
- Patricia Chalela
- Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Alfred L McAlister
- School of Public Health, Austin Regional Campus, University of Texas Health Science Center at Houston, Austin, TX, United States
| | - Cliff Despres
- Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Edgar Muñoz
- Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Pramod Sukumaran
- Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - David Akopian
- College of Engineering, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Sahak Kaghyan
- College of Engineering, The University of Texas at San Antonio, San Antonio, TX, United States
| | | | - Amelie G Ramirez
- Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
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Developing a framework for youth empowerment to prevent smoking behavior in a rural setting: study protocol for a participatory action research. HEALTH EDUCATION 2020. [DOI: 10.1108/he-06-2020-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThere is limited research examining community-based youth empowerment that addresses smoking prevention in the rural Indonesian context. This paper describes participatory action research (PAR) applied to develop a framework for empowering youth aged 17–25 years toward smoking prevention. This research conducted in the Indonesian rural community setting was divided into four stages: diagnosing, planning action, taking action and evaluating action.Design/methodology/approachPAR was chosen as the approach to developing a framework for youth empowerment in smoking prevention programs. In this study, the PAR cycle started with a prestep stage through interviews with village heads, community leaders, youth organization organizers, observations of target resources and observations of participation in youth activities as well as forming teamwork with target participants. The diagnosis stage consists of three activities, that is, focus group discussions with youth groups of male and female, youth assessment of empowerment domains through the Participatory Rural Appraisal (PRA) with the Empowerment Assessment Rating Scale (EARS) and measuring individual and group involvement levels related to the smoking behavior prevention program by questionnaire. The EARS assessment results were presented in the action planning stage, followed by a discussion on youth empowerment plans and strategies. In the action stage, activities and programs are planned according to the planning discussion, that is: training in healthy life skills (outbound and training) and initiating youth health programs without smoking called “Remaja Berdaya Sehat Tanpa Rokok” (Empowered Youth Healthy Without Smoking) or the JayaStar Program. After these community participation activities, the evaluating action stage will assess the empowerment domain in the youth groups, conduct focus group discussions with parents, evaluate the impact of empowerment on individual and group changes with a questionnaire and facilitate self-reflection by the youth community called Madiska.FindingsThis protocol describes a doctoral research project on developing a youth empowerment framework in smoking prevention programs through PAR. The intended study will provide valuable information on the planning, implementation and evaluation of youth empowerment in the prevention of smoking behavior.Originality/valueThis research project is expected to contribute to the literature relating to PAR for rural settings and the use of empowerment strategies to prevent youth smoking behavior. The results can be replicated in the same settings, but the process of empowerment must still be adapted to the characteristics and local wisdom of the community.
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Coppo A, Gattino S, Faggiano F, Gilardi L, Capra P, Tortone C, Fedi A, De Piccoli N. Psychosocial empowerment-based interventions for smoking reduction: concepts, measures and outcomes. A systematic review. Glob Health Promot 2020; 27:88-96. [PMID: 32583747 DOI: 10.1177/1757975920929400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although empowerment is a widely used concept in health-related areas, its definition remains unclear. While there is evidence for the effectiveness of empowerment interventions in improving some psychosocial factors linked to health (e.g. patient self-care strategy, coping skills, access and effective use of health services) and some health outcomes like mental health and HIV/AIDS-related behaviour, other data appear to contradict this. Moreover, concepts, measures, and outcomes related to empowerment are operationalized in different ways. Using the case of tobacco control programmes, we wanted to explore: (a) how research on smoking reduction/prevention has conceptualized empowerment; (b) which measures and instruments have been used to assess behaviour outcomes and the empowerment process. We hypothesized that the transformative potential that characterizes empowerment is marginally considered.A total of 18 studies reporting on the effect of prevention interventions on smoking and/or empowerment outcomes were reviewed. Two kinds of study were distinguished: (a) studies reporting behaviour outcomes without data about the impact on empowerment; (b) studies analysing the empowerment process. Among this latter type, some studies did not provide information about the specific behaviour (smoking), while others examined the impact of intervention on both smoking and empowerment. In about half of all studies, empowerment strategies were found to be effective in improving smoking outcomes, while no differences were found between intervention and control groups in the remaining studies. The present review suggests that pragmatic definitions of empowerment need to be developed in order to promote its transferability and evaluation.
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Affiliation(s)
- Alessandro Coppo
- Department of Translational Medicine, Avogadro University, Novara, Italy
| | | | - Fabrizio Faggiano
- Department of Translational Medicine, Avogadro University, Novara, Italy
| | - Luisella Gilardi
- Dors - Piedmont Regional Health Promotion Documentation Centre - Asl TO3, Torino, Italy
| | - Paola Capra
- Dors - Piedmont Regional Health Promotion Documentation Centre - Asl TO3, Torino, Italy
| | - Claudio Tortone
- Dors - Piedmont Regional Health Promotion Documentation Centre - Asl TO3, Torino, Italy
| | - Angela Fedi
- Department of Psychology, University of Turin, Italy
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