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Kostenius C, Lindstrom F, Potts C, Pekkari N. Young peoples' reflections about using a chatbot to promote their mental wellbeing in northern periphery areas - a qualitative study. Int J Circumpolar Health 2024; 83:2369349. [PMID: 38912845 PMCID: PMC11198148 DOI: 10.1080/22423982.2024.2369349] [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: 11/28/2023] [Accepted: 06/13/2024] [Indexed: 06/25/2024] Open
Abstract
An international research collaboration with researchers from northern Sweden, Finland, Ireland, Northern Ireland, Scotland and developed the ChatPal chatbot to explore the possibility of a multilingual chatbot to promote mental wellbeing in people of all ages. In Sweden the end users were young people. The aim of the current study was to explore and discuss Swedish young peoples' experiences of using a chatbot designed to promote their mental wellbeing. Young people aged 15-19 filled out an open-ended survey giving feedback on the ChatPal chatbot and their suggestions on improvements. A total of 122 survey responses were analysed. The qualitative content analysis of the survey responses resulted in three themes each containing two to three sub-themes. Theme 1, feeling as if someone is there when needed, which highlighted positive aspects regarding availability and accessibility. Theme 2, human-robot interaction has its limitations, which included aspects such as unnatural and impersonal conversations and limited content availability. Theme 3, usability can be improved, given technical errors due to lack of internet connection and difficulty navigating the chatbot were brought up as issues. The findings are discussed, and potential implications are offered for those designing and developing digital mental health technologies for young people.
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Affiliation(s)
| | - Frida Lindstrom
- Health Sciences, Luleå University of Technology, Luleå, Sweden
| | | | - Niklas Pekkari
- Health Sciences, Luleå University of Technology, Luleå, Sweden
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Potts C, Lindström F, Bond R, Mulvenna M, Booth F, Ennis E, Parding K, Kostenius C, Broderick T, Boyd K, Vartiainen AK, Nieminen H, Burns C, Bickerdike A, Kuosmanen L, Dhanapala I, Vakaloudis A, Cahill B, MacInnes M, Malcolm M, O'Neill S. A Multilingual Digital Mental Health and Well-Being Chatbot (ChatPal): Pre-Post Multicenter Intervention Study. J Med Internet Res 2023; 25:e43051. [PMID: 37410537 PMCID: PMC10359914 DOI: 10.2196/43051] [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: 09/28/2022] [Revised: 11/30/2022] [Accepted: 01/31/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In recent years, advances in technology have led to an influx of mental health apps, in particular the development of mental health and well-being chatbots, which have already shown promise in terms of their efficacy, availability, and accessibility. The ChatPal chatbot was developed to promote positive mental well-being among citizens living in rural areas. ChatPal is a multilingual chatbot, available in English, Scottish Gaelic, Swedish, and Finnish, containing psychoeducational content and exercises such as mindfulness and breathing, mood logging, gratitude, and thought diaries. OBJECTIVE The primary objective of this study is to evaluate a multilingual mental health and well-being chatbot (ChatPal) to establish if it has an effect on mental well-being. Secondary objectives include investigating the characteristics of individuals that showed improvements in well-being along with those with worsening well-being and applying thematic analysis to user feedback. METHODS A pre-post intervention study was conducted where participants were recruited to use the intervention (ChatPal) for a 12-week period. Recruitment took place across 5 regions: Northern Ireland, Scotland, the Republic of Ireland, Sweden, and Finland. Outcome measures included the Short Warwick-Edinburgh Mental Well-Being Scale, the World Health Organization-Five Well-Being Index, and the Satisfaction with Life Scale, which were evaluated at baseline, midpoint, and end point. Written feedback was collected from participants and subjected to qualitative analysis to identify themes. RESULTS A total of 348 people were recruited to the study (n=254, 73% female; n=94, 27% male) aged between 18 and 73 (mean 30) years. The well-being scores of participants improved from baseline to midpoint and from baseline to end point; however, improvement in scores was not statistically significant on the Short Warwick-Edinburgh Mental Well-Being Scale (P=.42), the World Health Organization-Five Well-Being Index (P=.52), or the Satisfaction With Life Scale (P=.81). Individuals that had improved well-being scores (n=16) interacted more with the chatbot and were significantly younger compared to those whose well-being declined over the study (P=.03). Three themes were identified from user feedback, including "positive experiences," "mixed or neutral experiences," and "negative experiences." Positive experiences included enjoying exercises provided by the chatbot, while most of the mixed, neutral, or negative experiences mentioned liking the chatbot overall, but there were some barriers, such as technical or performance errors, that needed to be overcome. CONCLUSIONS Marginal improvements in mental well-being were seen in those who used ChatPal, albeit nonsignificant. We propose that the chatbot could be used along with other service offerings to complement different digital or face-to-face services, although further research should be carried out to confirm the effectiveness of this approach. Nonetheless, this paper highlights the need for blended service offerings in mental health care.
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Affiliation(s)
- Courtney Potts
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Frida Lindström
- Department of Social Sciences,Technology and Arts, Luleå University of Technology, Luleå, Sweden
| | - Raymond Bond
- School of Computing, Ulster University, Belfast, United Kingdom
| | | | - Frederick Booth
- Department of Accounting, Finance & Economics, Ulster University, Belfast, United Kingdom
| | - Edel Ennis
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Karolina Parding
- Department of Social Sciences,Technology and Arts, Luleå University of Technology, Luleå, Sweden
| | - Catrine Kostenius
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Thomas Broderick
- Department of Sport, Leisure & Childhood Studies, Munster Technological University, Cork, Ireland
| | - Kyle Boyd
- School of Art, Ulster University, Belfast, United Kingdom
| | - Anna-Kaisa Vartiainen
- Department of Social and Health Management, University of Eastern Finland, Kuopio, Finland
| | - Heidi Nieminen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Con Burns
- Department of Sport, Leisure & Childhood Studies, Munster Technological University, Cork, Ireland
| | - Andrea Bickerdike
- Department of Sport, Leisure & Childhood Studies, Munster Technological University, Cork, Ireland
| | - Lauri Kuosmanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Indika Dhanapala
- Nimbus Research Centre, Munster Technological University, Cork, Ireland
| | - Alex Vakaloudis
- Nimbus Research Centre, Munster Technological University, Cork, Ireland
| | - Brian Cahill
- Nimbus Research Centre, Munster Technological University, Cork, Ireland
| | - Marion MacInnes
- Research & Innovation, National Health Service Western Isles, Scotland, United Kingdom
| | - Martin Malcolm
- Public Health Intelligence and Information Services, National Health Service Western Isles, Scotland, United Kingdom
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, United Kingdom
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Koschmann E, Jacob R, Robinson K, Foster Friedman M, Foster A, Rodriguez-Quintana N, Vichich J, Smith M, Rajaram H. Mental health needs in a large urban school district: Findings from a web-based survey. Health Serv Res 2022; 57:830-841. [PMID: 35243624 PMCID: PMC9264464 DOI: 10.1111/1475-6773.13924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore the mental health needs of students, and the professional development and support needs of teachers and school health professionals, as a way to foster community engagement and help set priorities for a comprehensive school mental health system in the Detroit Public Schools Community District (DPSCD). SETTING The study team surveyed all DPSCD staff in June 2019 and all students in grades 8-12 between October and December 2019. STUDY DESIGN A descriptive study based on anonymous, web-based surveys focused on student trauma exposure and mental health symptoms, student mental health resource utilization, staff burnout, and professional development needs. DATA COLLECTION All students (grades 8-12) and district staff were eligible to participate; the student survey was made available in six languages. Parents/guardians could opt children out; schools could exclude children unable to complete the survey independently. Student surveys were administered in school; staff surveys were sent via email. PRINCIPAL FINDINGS Thirty-four percent of DPSCD students reported moderate/severe depression symptoms; 22% had seriously considered suicide in the past year. Rates exceed national averages; 37% of students with severe depression and 34% of those with suicidal ideation had not accessed mental health supports. Staff indicated high levels of burnout and substantial interest in learning about self-care strategies or coping with vicarious trauma. Over 75% of teachers and school mental health professionals expressed interest in learning about best practices for supporting students impacted by trauma or mental illness. CONCLUSIONS A large number of DPSCD students are experiencing symptoms of depression and anxiety, and many students who need care are not accessing it. Addressing the mental health needs of students is a high priority for staff, but they need more training and support, as well as support for their own vicarious trauma and high levels of burnout.
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Affiliation(s)
- Elizabeth Koschmann
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Robin Jacob
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Katja Robinson
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Megan Foster Friedman
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Anna Foster
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Natalie Rodriguez-Quintana
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jennifer Vichich
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Maureen Smith
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Hersheena Rajaram
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
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