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McKenna S, Hutcheon A, Gorban C, Song Y, Scott E, Hickie I. Youth Perspectives on 'Highly Personalised and Measurement-Based Care': Qualitative Co-Design of Education Materials. Health Expect 2024; 27:e14137. [PMID: 38976368 PMCID: PMC11229696 DOI: 10.1111/hex.14137] [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: 11/24/2023] [Revised: 04/15/2024] [Accepted: 06/19/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVES Despite high levels of mental ill-health amongst young people (aged 15-30), this group demonstrates low help-seeking and high drop-out from mental health services (MHS). Whilst shared decision-making can assist people in receiving appropriate and effective health care, young people frequently report that they do not feel involved in treatment decisions. The current study focused on co-design of a clinical education and participant information programme for the Brain and Mind Centre Youth Model of Care. This model, which articulates a youth-focused form of highly personalised and measurement-based care, is designed to promote shared decision-making between young people and clinical service providers. METHODS We conducted workshops with 24 young people (16-31; MAge = 21.5) who had accessed mental health services. Participants were asked what advice they would give to young people entering services, before giving advice on existing materials. Workshops were conducted and transcripts were coded using thematic analysis by two lived experience researchers and a clinical researcher. RESULTS Young people found it empowering to be educated on transdiagnostic models of mental illness, namely clinical staging, which gives them a better understanding of why certain treatments may be inappropriate and ineffective, and thus reduce self-blame. Similarly, young people had limited knowledge of links between mental health and other life domains and found it helpful to be educated on multidisciplinary treatment options. Measurement-based care was seen as an important method of improving shared decision-making between young people and health professionals; however, to facilitate shared decision-making, young people also wanted better information on their rights in care and more support to share their expertise in their own needs, values and treatment preferences. CONCLUSIONS These findings will inform the delivery of the further development and implementation of a youth-specific clinical education and participant information programme for the BMC Youth Model. PATIENT OR PUBLIC CONTRIBUTION Workshops were facilitated by researchers with lived expertise in mental ill-health (A.H. and/or C.G.) and a clinical researcher (who has expertise as an academic and a clinical psychologist). A.H. and C.G. were also involved in conceptualisation, analysis, interpretation, review and editing of this paper.
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Affiliation(s)
- Sarah McKenna
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Alexis Hutcheon
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Carla Gorban
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Yun Song
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Elizabeth Scott
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Ian Hickie
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
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Yang Y(S, Law M, Vaghri Z. New Brunswick's mental health action plan: A quantitative exploration of program efficacy in children and youth using the Canadian Community Health Survey. PLoS One 2024; 19:e0301008. [PMID: 38848408 PMCID: PMC11161078 DOI: 10.1371/journal.pone.0301008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/09/2024] [Indexed: 06/09/2024] Open
Abstract
In 2011, the New Brunswick government released the New Brunswick Mental Health Action Plan 2011-2018 (Action Plan). Following the release of the Action Plan in 2011, two progress reports were released in 2013 and 2015, highlighting the implementation status of the Action Plan. While vague in their language, these reports indicated considerable progress in implementing the Action Plan, as various initiatives were undertaken to raise awareness and provide additional resources to facilitate early prevention and intervention in children and youth. However, whether these initiatives have yielded measurable improvements in population-level mental health outcomes in children and youth remains unclear. The current study explored the impact of the Action Plan by visualizing the trend in psychosocial outcomes and service utilization of vulnerable populations in New Brunswick before and after the implementation of the Action Plan using multiple datasets from the Canadian Community Health Survey. Survey-weighted ordinary least square regression analyses were performed to investigate measurable improvements in available mental health outcomes. The result revealed a declining trend in the mental wellness of vulnerable youth despite them consistently reporting higher frequencies of mental health service use. This study highlights the need for a concerted effort in providing effective mental health services to New Brunswick youth and, more broadly, Canadian youth, as well as ensuring rigorous routine outcome monitoring and evaluation plans are consistently implemented for future mental health strategies at the time of their initiation.
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Affiliation(s)
- Yuzhi (Stanford) Yang
- Department of Psychology, Faculty of Science, Applied Science, and Engineering, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Moira Law
- Department of Psychology, Faculty of Science, St. Mary’s University, Halifax, Nova Scotia, Canada
| | - Ziba Vaghri
- Global Child Program, Integrated Health Initiative, Faculty of Business, University of New Brunswick, Saint John, New Brunswick, Canada
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Garavito GAA, Moniz T, Mansilla C, Iqbal S, Dobrogowska R, Bennin F, Talwar S, Khalid AF, Vindrola-Padros C. Activities used by evidence networks to promote evidence-informed decision-making in the health sector- a rapid evidence review. BMC Health Serv Res 2024; 24:261. [PMID: 38418985 PMCID: PMC10903073 DOI: 10.1186/s12913-024-10744-3] [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: 10/08/2023] [Accepted: 02/18/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Evidence networks facilitate the exchange of information and foster international relationships among researchers and stakeholders. These networks are instrumental in enabling the integration of scientific evidence into decision-making processes. While there is a global emphasis on evidence-based decision-making at policy and organisational levels, there exists a significant gap in our understanding of the most effective activities to exchange scientific knowledge and use it in practice. The objective of this rapid review was to explore the strategies employed by evidence networks to facilitate the translation of evidence into decision-making processes. This review makes a contribution to global health policymaking by mapping the landscape of knowledge translation in this context and identifying the evidence translation activities that evidence networks have found effective. METHODS The review was guided by standardised techniques for conducting rapid evidence reviews. Document searching was based on a phased approach, commencing with a comprehensive initial search strategy and progressively refining it with each subsequent search iterations. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed. RESULTS The review identified 143 articles, after screening 1135 articles. Out of these, 35 articles were included in the review. The studies encompassed a diverse range of countries, with the majority originating from the United States (n = 14), followed by Canada (n = 5), Sweden (n = 2), and various other single locations (n = 14). These studies presented a varied set of implementation strategies such as research-related activities, the creation of teams/task forces/partnerships, meetings/consultations, mobilising/working with communities, influencing policy, activity evaluation, training, trust-building, and regular meetings, as well as community-academic-policymaker engagement. CONCLUSIONS Evidence networks play a crucial role in developing, sharing, and implementing high-quality research for policy. These networks face challenges like coordinating diverse stakeholders, international collaboration, language barriers, research consistency, knowledge dissemination, capacity building, evaluation, and funding. To enhance their impact, sharing network efforts with wider audiences, including local, national, and international agencies, is essential for evidence-based decision-making to shape evidence-informed policies and programmes effectively.
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Affiliation(s)
- Germán Andrés Alarcón Garavito
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK
| | - Thomas Moniz
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK
| | - Cristián Mansilla
- McMaster Health Forum, McMaster University, Toronto, Ontario, Canada
| | - Syka Iqbal
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK
| | - Rozalia Dobrogowska
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK
| | - Fiona Bennin
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK
| | - Shivangi Talwar
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK
- Division of Psychiatry, University College London, London, UK
| | | | - Cecilia Vindrola-Padros
- Rapid Research Evaluation and Appraisal Lab (RREAL) - Department of Targeted Intervention, University College London, London, UK.
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van der Heijden-Hobus IMW, Rosema BS, Vorstman JAS, Kas MJH, Franke SK, Boonstra N, Sommer IEC. Personal preferences for treatment and care during and after a First Episode Psychosis: A qualitative study. Early Interv Psychiatry 2023. [PMID: 38030570 DOI: 10.1111/eip.13477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/31/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
AIM A first episode of psychosis (FEP) is a stressful, often life-changing experience. Scarce information is available about personal preferences regarding their care needs during and after a FEP. Whereas a more thorough understanding of these preferences is essential to aid shared decision-making during treatment and improve treatment satisfaction. METHODS Face-to-face interviews with participants in remission of a FEP were set up, addressing personal preferences and needs for care during and after a FEP. The interviews were conducted by a female and a male researcher, the latter being an expert with lived experience. RESULTS Twenty individuals in remission of a FEP were interviewed, of which 16 had been hospitalized. The distinguished themes based on personal preferences were tranquillity, peace and quietness, information, being understood, support from significant others, and practical guidance in rebuilding one's life. Our findings revealed that the need for information and the need to be heard were often not sufficiently met. For 16/20 participants, the tranquillity of inpatient treatment of the FEP was predominantly perceived as a welcome safe haven. The presence and support of family and close friends were mentioned as an important factor in the process of achieving remission. CONCLUSIONS The current exploratory study showed that patients were able to indicate their personal needs. Important findings are the need for information and the need to be heard. Interestingly, hospitalization was mostly seen as an opportunity to achieve tranquillity. More lived experience expertise is needed to elucidate the needs of individuals in the early phase of a FEP to aid people who are recovering from their first psychosis in rebuilding their lives again.
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Affiliation(s)
- Inge M W van der Heijden-Hobus
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Janssen-Cilag B.V., Breda, The Netherlands
| | - Bram-Sieben Rosema
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jacob A S Vorstman
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- SickKids Research Institute & Genetics & Genome Biology Program, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Martien J H Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - Sigrid K Franke
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Boonstra
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- NHL/Stenden, University of Applied Sciences, Leeuwarden, The Netherlands
- KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands
| | - Iris E C Sommer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Sheikhan NY, Kuluski K, McKee S, Hiebert M, Hawke LD. Exploring the impact of engagement in mental health and substance use research: A scoping review and thematic analysis. Health Expect 2023; 26:1806-1819. [PMID: 37282732 PMCID: PMC10485342 DOI: 10.1111/hex.13779] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/03/2023] [Accepted: 05/14/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND There is growing evidence demonstrating the impact of engaging people with lived experience (PWLE) in health research. However, it remains unclear what evidence is available regarding the impact of engagement specific to mental health and substance use research. METHODS A scoping review of three databases and thematic analysis were conducted. Sixty-one articles that described the impact of engagement in mental health and substance use research on either individual experiences or the research process were included. RESULTS Key topics include (a) the impact of engagement on individual experiences; (b) the impact of engagement on the research process; and (c) facilitators and barriers to impactful engagement. Studies largely focused on the perceived positive impact of engagement on PWLE (e.g., personal and professional growth, empowering and rewarding experience, feeling heard and valued), researchers (e.g., rewarding experience, deeper understanding of research topic, changes to practice), and study participants (e.g., added value, fostered a safe space). Engagement activities were perceived to improve facets of the research process, such as improvements to research quality (e.g., rigour, trustworthiness, relevance to the community), research components (e.g., recruitment), and the research environment (e.g., shifted power dynamics). Facilitators and barriers were mapped onto the lived experience, researcher, team, and institutional levels. Commonly used terminologies for engagement and PWLE were discussed. CONCLUSION Engaging PWLE-from consultation to co-creation throughout the research cycle-is perceived as having a positive impact on both the research process and individual experiences. Future research is needed to bring consistency to engagement, leverage the facilitators to engagement, and address the barriers, and in turn generate research findings that have value not only to the scientific community, but also to the people impacted by the science. PATIENT OR PUBLIC CONTRIBUTION PWLE were engaged throughout the scoping review process, including the screening phase, analysis phase, and write-up phase.
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Affiliation(s)
- Natasha Y. Sheikhan
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
| | - Kerry Kuluski
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
- Institute for Better Health, Trillium Health Partners
| | - Shelby McKee
- Centre for Addiction and Mental HealthTorontoOntarioCanada
| | | | - Lisa D. Hawke
- Centre for Addiction and Mental HealthTorontoOntarioCanada
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Papastavrou Brooks C, Kafle E, Butt N, Chawner D, Day A, Elsby-Pearson C, Elson E, Hammond J, Herbert P, Jenkins CL, Johnson Z, Keith-Roach SH, Papasileka E, Reeves S, Stewart N, Gilbert N, Startup H. Co-producing principles to guide health research: an illustrative case study from an eating disorder research clinic. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:84. [PMID: 37730642 PMCID: PMC10510247 DOI: 10.1186/s40900-023-00460-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/26/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND There is significant value in co-produced health research, however power-imbalances within research teams can pose a barrier to people with lived experience of an illness determining the direction of research in that area. This is especially true in eating disorder research, where the inclusion of co-production approaches lags other research areas. Appealing to principles or values can serve to ground collaborative working. Despite this, there has not been any prior attempt to co-produce principles to guide the work of a research group and serve as a basis for developing future projects. METHODS The aim of this piece of work was to co-produce a set of principles to guide the conduct of research within our lived experience led research clinic, and to offer an illustrative case for the value of this as a novel co-production methodology. A lived experience panel were recruited to our eating disorder research group. Through an iterative series of workshops with the members of our research clinic (composed of a lived experience panel, clinicians, and researchers) we developed a set of principles which we agreed were important in ensuring both the direction of our research, and the way in which we wanted to work together. RESULTS Six key principles were developed using this process. They were that research should aim to be: 1) real world-offering a clear and concrete benefit to people with eating disorders, 2) tailored-suitable for marginalised groups and people with atypical diagnoses, 3) hopeful-ensuring that hope for recovery was centred in treatment, 4) experiential-privileging the 'voice' of people with eating disorders, 5) broad-encompassing non-standard therapeutic treatments and 6) democratic-co-produced by people with lived experience of eating disorders. CONCLUSIONS We reflect on some of the positives as well as limitations of the process, highlighting the importance of adequate funding for longer-term co-production approaches to be taken, and issues around ensuring representation of minority groups. We hope that other health research groups will see the value in co-producing principles to guide research in their own fields, and will adapt, develop, and refine this novel methodology.
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Affiliation(s)
- Cat Papastavrou Brooks
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK.
| | - Eshika Kafle
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Natali Butt
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Dave Chawner
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
- Comedy for Coping, Aesthetics Research Centre, University of Kent, Room 2.16, Jarman Building, Canterbury, Kent, CT2 7UG, UK
| | - Anna Day
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Chloë Elsby-Pearson
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Emily Elson
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - John Hammond
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Penny Herbert
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Catherine L Jenkins
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Zach Johnson
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Sarah Helen Keith-Roach
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Eirini Papasileka
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
- Department of Psychology, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Stella Reeves
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
- School of Human and Behavioural Sciences, Bangor University, Bangor, LL57 2DG, UK
| | - Natasha Stewart
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
| | - Nicola Gilbert
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
- Maudsley Learning, ORTUS Conferencing and Events Venue, 82-96 Grove Lane, London, SE5 8SN, UK
| | - Helen Startup
- SPIRED Clinic, Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Nevill Avenue, Hove, BN3 7HZ, UK
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Meeting in the middle: experiences of citizenship in community-engaged psychosis research. JOURNAL OF PUBLIC MENTAL HEALTH 2023. [DOI: 10.1108/jpmh-10-2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Purpose
Previous research has highlighted the importance of engaging people with lived experience (PWLE) in the knowledge creation process. However, diverse approaches to engagement exist. In addition, tensions remain in community-engaged research (CER), including how to address structural inequalities in research settings. This study aims to consider how CER interacts with citizenship within and beyond the research context.
Design/methodology/approach
This study discusses the authors’ experiences as a majority-PWLE of psychosis research team in Canada, including successes and challenges the authors experienced building their team and navigating research institutions. This study also reflects on the authors’ pathways through citizenship, prior to and during the research process. This study discusses divergent models of CER and their applicability to the cyclical process of citizenship and community participation.
Findings
Relationships between academic and peer researchers developed organically over time. However, this study was limited by structural barriers such as pay inequality and access to funding. The authors recognize that there are barriers to full citizenship and acknowledge their resources and privilege of being well supported within their communities. Team members built on a foundation of citizenship to access participation in research. This led to opportunities to engage in community spaces, and for PWLE to participate in research as partners and leaders. This study also found that citizenship is a way of giving back, by building a sense of social responsibility.
Originality/value
Academic and peer researchers can reflect on the authors’ experiences to build more inclusive research teams and communities by using a citizenship approach to research participation.
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Watson D, Mhlaba M, Molelekeng G, Chauke TA, Simao SC, Jenner S, Ware LJ, Barker M. How do we best engage young people in decision-making about their health? A scoping review of deliberative priority setting methods. Int J Equity Health 2023; 22:17. [PMID: 36698119 PMCID: PMC9876416 DOI: 10.1186/s12939-022-01794-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/18/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION International organisations have called to increase young people's involvement in healthcare and health policy development. We currently lack effective methods for facilitating meaningful engagement by young people in health-related decision-making. The purpose of this scoping review is to identify deliberative priority setting methods and explore the effectiveness of these in engaging young people in healthcare and health policy decision-making. METHODS Seven databases were searched systematically, using MeSH and free text terms, for articles published in English before July 2021 that described the use of deliberative priority setting methods for health decision-making with young people. All titles, abstracts and full-text papers were screened by a team of six independent reviewers between them. Data extraction followed the Centre for Reviews and Dissemination guidelines. The results are presented as a narrative synthesis, structured around four components for evaluating deliberative processes: 1) representation and inclusion of diverse participants, 2) the way the process is run including levels and timing of participant engagement, 3) the quality of the information provided to participants and 4) resulting outcomes and decisions. FINDINGS The search yielded 9 reviews and 21 studies. The more engaging deliberative priority setting tools involved young people-led committees, mixed methods for identifying and prioritising issues and digital data collection and communication tools. Long-term and frequent contact with young people to build trust underpinned the success of some of the tools, as did offering incentives for taking part and skills development using creative methods. The review also suggests that successful priority setting processes with young people involve consideration of power dynamics, since young people's decisions are likely to be made together with family members, health professionals and academics. DISCUSSION Young people's engagement in decision-making about their health is best achieved through investing time in building strong relationships and ensuring young people are appropriately rewarded for their time and contribution. If young people are to be instrumental in improving their health and architects of their own futures, decision-making processes need to respect young people's autonomy and agency. Our review suggests that methods of power-sharing with young people do exist but that they have yet to be adopted by organisations and global institutions setting global health policy.
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Affiliation(s)
- Daniella Watson
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Global Health and Social Medicine, King's College London, London, UK.
| | - Mimi Mhlaba
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Gontse Molelekeng
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Thulani Andrew Chauke
- Department of Adult, College of Education, Community and Continuing Education, University of South Africa, Pretoria, South Africa
| | - Sara Correia Simao
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah Jenner
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Lisa J Ware
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Barker
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- School of Health Sciences, Faculty of Life and Environmental Sciences, University of Southampton, Southampton, UK
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
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Henderson J, Hawke LD, Iyer SN, Hayes E, Darnay K, Mathias S, Thabane L. Youth Perspectives on Integrated Youth Services: A Discrete Choice Conjoint Experiment. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:524-533. [PMID: 34874207 PMCID: PMC9234900 DOI: 10.1177/07067437211044717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Integrated youth services (IYS) are an emerging model of care offering a broad range of mental health and social services for youth in one location. This study aimed to determine the IYS service characteristics most important to youth, as well as to determine whether different classes of youth have different service preferences, and if so, what defines these classes. METHODS Ontario youth aged 14-29 years with mental health challenges were recruited to participate in a discrete choice experiment (DCE) survey. The DCE contained 12 attributes, each represented by 4 levels representing core characteristics of IYS models. To supplement the DCE questions, demographic information was collected and a mental health screener was administered. Preferences were examined, latent class analyses were conducted, and latent classes were compared. RESULTS As a whole, participants endorsed the IYS model of service delivery. Among 274 youth, there were three latent classes: 1) the Focused Service (37.6%) latent class prioritized efficient delivery of mental health services. 2) The Holistic Services (30.3%) latent class prioritized a diverse array of mental health and social services delivered in a timely fashion. 3) The Responsive Services (32.1%) latent class prioritized services that matched the individual needs of the youth being served. Differences between classes were observed based on sociodemographic and clinical variables. CONCLUSIONS IYS is an acceptable model of care, in that it prioritizes components that reflect youth preferences. The differences in preference profiles of different groups of youth point to the need for flexible models of service delivery. Service design initiatives should take these preferences into account, designing services that meet the needs and preferences of a broad range of youth. Working locally to co-design services with the youth in the target population who wish to be engaged will help meet the needs of youth.
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Affiliation(s)
- Joanna Henderson
- 26632Centre for Addiction and Mental Health.,7978University of Toronto Department of Psychiatry
| | - Lisa D Hawke
- 26632Centre for Addiction and Mental Health.,7978University of Toronto Department of Psychiatry
| | | | - Em Hayes
- 26632Centre for Addiction and Mental Health
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Simmons MB, Brushe M, Elmes A, Polari A, Nelson B, Montague A. Shared Decision Making With Young People at Ultra High Risk of Psychotic Disorder. Front Psychiatry 2021; 12:683775. [PMID: 34603094 PMCID: PMC8481955 DOI: 10.3389/fpsyt.2021.683775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/31/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: While the majority of young people who meet the criteria for being considered at increased risk of psychosis do not go on to develop a psychotic disorder, young people are currently being identified and treated in early intervention services. Ethical concerns have been raised concerning the decision about whether or not to provide treatment, and if so, what type of treatment. This study sought to support young people themselves to make these decisions with support from their clinician through a shared decision-making approach, facilitated by an online decision aid. Methods: This project used the International Patient Decision Aid Standards (IPDAS) to guide the development and piloting of an online decision aid across two phases: (1) qualitative, semi-structured focus groups with young people who were past clients and clinicians from an early psychosis service; and (2) pilot testing of the decision aid with clinicians and young people who were current clients to finalize the development. Results: Issues discussed by clinicians in the focus group were grouped into three main areas: (1) engagement phase; (2) assessment and priorities for treatment; and (3) initial and ongoing decision making. Clients focused on the context in which the decisions were made, including as they experienced initial feelings of resistance, and then acceptance of efforts made to describe and treat their mental health challenges. Clients highlighted the need for collaboration between themselves and their clinician, and the need to be equipped with the knowledge and tools to take care of themselves. These focus group data were used to refine the online decision aid. Pilot testing revealed that while it was overall useful and relevant, important limitations were noted by both clients and clinicians. Discussion: The use of a decision aid to facilitate shared decision making (SDM) in this area is feasible and has utility for both clients and clinicians. Use of such a tool can help to address the need to uphold the rights of young people as decision makers about their own care. Future efforts should embed decision aids within complex SDM interventions, and research to understand issues relating to implementation of these interventions.
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Affiliation(s)
- Magenta Bender Simmons
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Mary Brushe
- Telethon Kids Institute, University of Western Australia, Adelaide, SA, Australia.,School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Aurora Elmes
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alice Montague
- North East London Foundation NHS Trust, London, United Kingdom.,Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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