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Niederberger M, Schifano J, Deckert S, Hirt J, Homberg A, Köberich S, Kuhn R, Rommel A, Sonnberger M. Delphi studies in social and health sciences-Recommendations for an interdisciplinary standardized reporting (DELPHISTAR). Results of a Delphi study. PLoS One 2024; 19:e0304651. [PMID: 39186713 PMCID: PMC11346927 DOI: 10.1371/journal.pone.0304651] [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: 10/18/2023] [Accepted: 05/16/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND While different proposals exist for a guideline on reporting Delphi studies, none of them has yet established itself in the health and social sciences and across the range of Delphi variants. This seems critical because empirical studies demonstrate a diversity of modifications in the conduction of Delphi studies and sometimes even errors in the reporting. The aim of the present study is to close this gap and formulate a general reporting guideline. METHOD In an international Delphi procedure, Delphi experts were surveyed online in three rounds to find consensus on a reporting guideline for Delphi studies in the health and social sciences. The respondents were selected via publications of Delphi studies. The preliminary reporting guideline, containing 65 items on five topics and presented for evaluation, had been developed based on a systematic review of the practice of Delphi studies and a systematic review of existing reporting guidelines for Delphi studies. Starting in the second Delphi round, the experts received feedback in the form of mean values, measures of dispersion, a summary of the open-ended responses and their own response in the previous round. The final draft of the reporting guideline contains the items on which at least 75% of the respondents agreed by assigning scale points 6 and 7 on a 7-point Likert scale. RESULTS 1,072 experts were invited to participate. A total of 91 experts completed the first Delphi round, 69 experts the second round, and 56 experts the third round. Of the 65 items in the first draft of the reporting guideline, consensus was ultimately reached for 38 items addressing the five topics: Title and Abstract (n = 3), Context (n = 7), Method (n = 20), Results (n = 4) and Discussion (n = 4). Items focusing on theoretical research and on dissemination were either rejected or remained subjects of dissent. DISCUSSION We assume a high level of acceptance and interdisciplinary suitability regarding the reporting guideline presented here and referred to as the "Delphi studies in social and health sciences-recommendations for an interdisciplinary standardized reporting" (DELPHISTAR). Use of this reporting guideline can substantially improve the ability to compare and evaluate Delphi studies.
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Affiliation(s)
- Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Julia Schifano
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Stefanie Deckert
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Julian Hirt
- Department of Health, Institute of Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Angelika Homberg
- Department of Medical Education Research, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Stefan Köberich
- Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Rainer Kuhn
- DIALOGIK Non-Profit Institute for Communication and Cooperation Research, Stuttgart, Germany
- Center for Interdisciplinary Risk and Innovation Studies (ZIRIUS), University of Stuttgart, Stuttgart, Germany
| | - Alexander Rommel
- Department 2, Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Marco Sonnberger
- Department of Sociology of Technology, Risk and Environment, University of Stuttgart, Stuttgart, Germany
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Montesanti S, Sehgal A, Zaeem L, McManus C, Squires S, Silverstone P. Assessing primary health care provider and organization readiness to address family violence in Alberta, Canada: development of a Delphi consensus readiness tool. BMC PRIMARY CARE 2024; 25:146. [PMID: 38684969 PMCID: PMC11059610 DOI: 10.1186/s12875-024-02396-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta's PHC settings by exploring readiness factors. METHODS An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators. RESULTS Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta. CONCLUSION The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.
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Affiliation(s)
- Stephanie Montesanti
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
- Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | - Anika Sehgal
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lubna Zaeem
- Islamic Family and Social Services Association, Edmonton, AB, Canada
| | - Carrie McManus
- Sagesse Domestic Violence Prevention Society, Calgary, AB, Canada
| | - Suzanne Squires
- Westgrove Clinic, Westview Primary Care Network, Spruce Grove, AB, Canada
| | - Peter Silverstone
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Massi L, Weatherall L, Nielsen C, Toombs M, Fredericks B, Rae KM. "It's research, our input can grow": identifying health research priorities with Aboriginal and Torres Strait Islander communities-study protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:59. [PMID: 37507759 PMCID: PMC10386625 DOI: 10.1186/s40900-023-00467-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND In Australia, Aboriginal and Torres Strait Islander (Indigenous) families have strong, cohesive, and nurturing cultural practices that contribute to effective family functioning and child rearing. These practices can lead to positive effects on children and communities, and include kinship relations, traditional knowledge systems, collective community focus, respect for Elders contributions, and spirituality. However, poor health and wellbeing outcomes exist across the lifespan for Indigenous Australians. Health programs, services and research that support Indigenous women, babies and their families are a critical investment to improve birthing and health outcomes and impact the life trajectories of Indigenous Australians. AIM The Indigenous Health Research Priorities study aims to identify the research priorities for families during the perinatal and early childhood period through a co-designed and collaborative process. This has been led by communities to determine the priorities identified with and for local Indigenous families in Queensland. This paper aims to report on engagement and involvement with Indigenous communities to identity health research priorities for families and presents preliminary findings of the research process including participants' demographic information and feedback on the yarning sessions, as part of the study protocol. METHODS The study protocol showcases the Participatory Action Research approach, yarning sessions with clients and staff of three community-controlled health services to date, and Delphi workshop methods to prioritise the health issues identified during the yarns with corresponding communities. The study will undertake qualitative data collection and analysis to identify and report on community and health service research priorities for Indigenous families in Queensland. A short survey was conducted to collect participants' demographic information. A feedback form with five open-ended questions was also administered to collect data on participants' views and satisfaction with the research process. PRELIMINARY RESULTS This protocol paper reports on the participant demographic information and feedback on the research process and reactions to participating in the yarning sessions. There have been 12 yarning sessions in Far North Queensland to date. The qualitative analysis of these will be reported on in future, with South East Queensland and further sites to follow. Feedback from 61 community members and health professionals has highlighted they valued sharing stories, being heard, and feeling hopeful. Preliminary findings will be reported. DISCUSSION Identification of health research priorities will allow each organisation and region of Queensland to develop research initiatives and the translational outcomes that are a focus for their community members.
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Affiliation(s)
- Luciana Massi
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, QLD, South Brisbane, Australia
| | - Loretta Weatherall
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, QLD, South Brisbane, Australia
| | - Christine Nielsen
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, QLD, South Brisbane, Australia
| | - Maree Toombs
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
| | - Bronwyn Fredericks
- Office of the Pro-Vice Chancellor Indigenous Engagement, University of Queensland, St Lucia, QLD, Australia
| | - Kym M Rae
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, QLD, South Brisbane, Australia.
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Kabasinguzi I, Ali N, Ochepo P. Mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic in Luton, England. BMC Public Health 2023; 23:592. [PMID: 36991365 PMCID: PMC10054189 DOI: 10.1186/s12889-023-15423-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic intensified the risk factors for poor mental health among care workers in the UK. However, there is inadequate evidence on the mental health impact of COVID-19 on Black, Asian, and minority ethnic (BAME) care workers in particular. This study seeks to explore mental health experiences and coping strategies of BAME care workers who worked in nursing and residential care homes during the COVID-19 pandemic. METHOD This is a qualitative study conducted between February and May, 2021 in Luton, England. A sample of n = 15 care workers from BAME background working in nursing and residential care homes were recruited purposively using the snowball sampling technique. In-depth interviews were conducted around topics such as views on COVID-19, the impact of the COVID-19 pandemic on mental health and coping during the COVID-19 pandemic. Data from the interviews was analysed using the Framework Analysis Approach. RESULTS The COVID-19 pandemic had a negative impact on the participants' mental health as they experienced stress, depression, anxiety, trauma and paranoia. The majority of the participants explained that they managed their mental health by belief in God and religious practices, by keeping themselves busy doing activities they were passionate about, following government guidelines on the prevention of COVID-19, seeing the service users happy and some participants managed through support that was offered by the government. However, some participants did not have any support for their mental health. CONCLUSION Issues such as increased workload associated with COVID-19 restrictions engendered mental health problems among BAME care workers, however, the workload only further increased during the pandemic, but the health and social care sector was already affected by heavy workload due to staff shortages and this needs to be addressed through increasing their wages to encourage more people to work in the health and social care sector. In addition, some BAME care workers never received any support for their mental health during the pandemic. Hence, integrating mental health services such as counselling, supportive psychotherapy and recreational therapies in care homes could help to support the mental health of care workers in the COVID-19 era.
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Affiliation(s)
- Isabella Kabasinguzi
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton, Bedfordshire, LU2 8LE, UK
| | - Nasreen Ali
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton, Bedfordshire, LU2 8LE, UK.
| | - Peter Ochepo
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Luton, Bedfordshire, LU2 8LE, UK
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Armstrong G, Sutherland G, Pross E, Mackinnon A, Reavley N, Jorm A. Effects of an Aboriginal and Torres Strait Islander Mental Health First Aid training programme for non-suicidal self-injury on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions: an uncontrolled trial with precourse and postcourse measurement and 6-month follow-up. BMJ Open 2023; 13:e066043. [PMID: 36631233 PMCID: PMC9835939 DOI: 10.1136/bmjopen-2022-066043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Non-suicidal self-injury (NSSI) is a complex issue affecting Aboriginal and/or Torres Strait Islander Peoples in Australia. We evaluated the effects of an Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) training course on assisting an Aboriginal and/or Torres Strait Islander person engaging in NSSI, including the effects on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions. DESIGN Uncontrolled trial with precourse and postcourse measurement (n=49) and 6-month follow-up (n=17). SETTING Participants attended courses that were run in Queensland and Victorian communities and through one national organisation. PARTICIPANTS Participants were 49 adults who worked directly with Aboriginal and/or Torres Strait Islander Peoples. INTERVENTION The 5-hour 'Talking About Non-Suicidal Self-Injury' course was delivered by accredited AMHFA instructors and teaches people how to support an Aboriginal and/or Torres Strait Islander person who is engaging in NSSI. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome measures were stigmatising attitudes, confidence in ability to assist, and intended and actual actions to assist a person engaging in NSSI. RESULTS Improvements were observed in stigmatising attitudes, with significant changes from precourse in both the 'weak-not-sick' (postcourse p<0.0623; follow-up p=0.0058) and 'dangerous/unpredictable' (postcourse p<0.0001; follow-up p=0.0036) subscales. Participants' confidence in ability to assist increased significantly both postcourse (p<0.0001) and at follow-up (p<0.0001). Despite a high level of endorsement for the nine recommended assisting actions at precourse, significant improvements (p<0.05) were observed in endorsement for six and four of the assisting actions postcourse and at follow-up, respectively. Course content was rated as being somewhat (3.4%), mostly (13.8%) or very (82.7%) culturally appropriate by participants who identified as Aboriginal and/or Torres Strait Islander. CONCLUSIONS The results of this uncontrolled trial were encouraging, suggesting that the Talking About Non-Suicidal Self-Injury course was able to improve participants' attitudes, confidence and intended assisting actions.
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Affiliation(s)
- Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Georgina Sutherland
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eliza Pross
- Mental Health First Aid Australia, Melbourne, Victoria, Australia
| | - Andrew Mackinnon
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Katz-Wise SL, Gordon AR, Sharp KJ, Johnson NP, Hart LM. Developing Parenting Guidelines to Support Transgender and Gender Diverse Children's Well-being. Pediatrics 2022; 150:189276. [PMID: 36045300 DOI: 10.1542/peds.2021-055347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Parents and caregivers' responses to their child's gender identity or expression play a pivotal role in their mental health. Despite increasing visibility of transgender and gender diverse (TGD) children, few scientific resources exist to advise their parents and caregivers. METHODS We used an online Delphi study to generate expert consensus. Expert adult participants (N = 93; 55% cisgender women, 12% cisgender men, 33% gender minority; 83% White race or ethnicity) rated statements describing parenting strategies compiled from a systematic search of community-generated online literature. Participants represented 3 distinct "panels" of expertise: parents and caregivers of a TGD child, TGD persons, and/or professionals working with TGD populations. Statements rated as essential or important by 80% to 100% of each panel were endorsed as a guideline. Three rounds of surveys were used with iterative feedback to develop consensus. RESULTS Of 813 total statements, only 125 were endorsed by all 3 panels. Key domains of consensus included: supportive strategies for parents (eg, open communication, listening), behaviors to avoid (eg, pressuring a child into a gender transition), strategies for navigating healthcare and school systems, and common responses for parents (eg, confusion). Areas of disagreement, in which professional and TGD panels concurred but the parent panel did not, included whether to allow gender identity experimentation during childhood, the value of providing access to gender diverse media, and how to avoid misgendering a child. CONCLUSIONS These consensus-based guidelines offer a unique and needed resource for parents and caregivers and clinicians and can be used to promote the mental health and well-being of TGD children.
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Affiliation(s)
- Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Allegra R Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Kendall J Sharp
- Department of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Wyber R, Lizama C, Wade V, Pearson G, Carapetis J, Ralph AP, Bowen AC, Peiris D. Improving primary prevention of acute rheumatic fever in Australia: consensus primary care priorities identified through an eDelphi process. BMJ Open 2022; 12:e056239. [PMID: 35273057 PMCID: PMC8915338 DOI: 10.1136/bmjopen-2021-056239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To establish the priorities of primary care providers to improve assessment and treatment of skin sores and sore throats among Aboriginal and Torres Strait Islander people at risk of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). DESIGN Modified eDelphi survey, informed by an expert focus group and literature review. SETTING Primary care services in any one of the five Australian states or territories with a high burden of ARF. PARTICIPANTS People working in any primary care role within the last 5 years in jurisdiction with a high burden of ARF. RESULTS Nine people participated in the scoping expert focus group which informed identification of an access framework for subsequent literature review. Fifteen broad concepts, comprising 29 strategies and 63 different actions, were identified on this review. These concepts were presented to participants in a two-round eDelphi survey. Twenty-six participants from five jurisdictions participated, 16/26 (62%) completed both survey rounds. Seven strategies were endorsed as high priorities. Most were demand-side strategies with a focus on engaging communities and individuals in accessible, comprehensive, culturally appropriate primary healthcare. Eight strategies were not endorsed as high priority, all of which were supply-side approaches. Qualitative responses highlighted the importance of a comprehensive primary healthcare approach as standard of care rather than disease-specific strategies related to management of skin sores and sore throat. CONCLUSION Primary care staff priorities should inform Australia's commitments to reduce the burden of RHD. In particular, strategies to support comprehensive Aboriginal and Torres Strait Islander primary care services rather than an exclusive focus on discrete, disease-specific initiatives are needed.
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Affiliation(s)
- Rosemary Wyber
- Health Systems Science, The George Institute for Global Health, Newtown, New South Wales, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Catalina Lizama
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Vicki Wade
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Glenn Pearson
- Aboriginal Health Institute Leadership Team, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Jonathan Carapetis
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Anna P Ralph
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
- General Medicine and Inectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Asha C Bowen
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - David Peiris
- Health Systems Science, The George Institute for Global Health, Newtown, New South Wales, Australia
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Wu H, Xu L, Zheng Y, Shi L, Zhai L, Xu F. Application of the Delphi Method in the Study of Depressive Disorder. Front Psychiatry 2022; 13:925610. [PMID: 35873226 PMCID: PMC9301200 DOI: 10.3389/fpsyt.2022.925610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Depressive disorder is a common mental disorder that has a high prevalence and low visiting rate, which caused patients years lived with disability. Due to the complexity of the depressive disorder, the Delphi method is a better choice compared with other commonly used methods, which provides a new perspective for the prevention and treatment of depression. This article will summarize the clinical studies of depressive disorders using the Delphi method from four perspectives, and summarize the advantages and disadvantages of the Delphi method in depressive disorders research, arguing that the Delphi method can cross the gap between clinical research and clinical practice, and is a highly practical part of the research process.
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Affiliation(s)
- Hengjin Wu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Linjie Xu
- Graduate School of Beijing University of Traditional Chinese Medicine, Beijing, China.,Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu Zheng
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Shi
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liangfan Zhai
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - FengQuan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Faruk MO, Ching U, Chowdhury KUA. Mental health and well-being of indigenous people during the COVID-19 pandemic in Bangladesh. Heliyon 2021; 7:e07582. [PMID: 34345744 PMCID: PMC8319571 DOI: 10.1016/j.heliyon.2021.e07582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/18/2021] [Accepted: 07/12/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The ongoing pandemic caused by the novel coronavirus and the subsequent containment strategies has taken a heavy toll on the mental health of people irrespective of age, gender, race, ethnicity, and geographical location. Studies have documented the mental health status of non-indigenous Bangladeshi people, but little attention has been paid during the pandemic to the investigation of the mental health status of indigenous people living in remote hilly areas. To address this gap the present study aimed at investigating the prevalence and accompanying risk factors of depression, anxiety, stress, and compromised well-being among indigenous people during the pandemic. METHODS A cross-sectional survey was conducted on 422 indigenous people aged between 16 and 90 using the 21-item Bangla Depression Anxiety Stress Scale (BDASS-21) and the Bangla version of the WHO-5 Well-being Index from January 30 to April 10, 2021. Data were collected by trained research assistants from three remote hilly areas namely Bandarban, Rangamati, and Khagracchari in the Chattogram Hill Tracts (CHT). Chi-squares, logistic regression, and ANOVA were performed to examine the association of variables. RESULTS The prevalence of moderate to extremely severe depression, anxiety, stress, and low well-being among the indigenous population during the pandemic was found to be 49.3%, 47.2%, 36.7%, and 50.9%, respectively. Risk predictors for depression, anxiety, and stress included age, ethnicity, geographical locations, educational attainment, occupation, and marital status. CONCLUSIONS The results suggest that the ongoing pandemic has led to the rise of common mental health problems among indigenous people during the pandemic. The results can contribute to the formation of mental health policy for indigenous people and the development of suitable mental health intervention strategies especially during and after the COVID-19 pandemic.
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Affiliation(s)
- Md. Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Umay Ching
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
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Dale E, Lee KSK, Conigrave KM, Conigrave JH, Ivers R, Clapham K, Kelly PJ. A multi-methods yarn about SMART Recovery: First insights from Australian Aboriginal facilitators and group members. Drug Alcohol Rev 2021; 40:1013-1027. [PMID: 33686719 PMCID: PMC8451896 DOI: 10.1111/dar.13264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION SMART Recovery is a popular mutual support group program. Little is known about its suitability or perceived helpfulness for Indigenous peoples. This study explored the cultural utility of SMART Recovery in an Australian Aboriginal context. METHODS An Indigenous-lensed, multi-methods, exploratory study design was used to develop initial evidence of: (i) attributes of Aboriginal SMART Recovery facilitators and group members; (ii) characteristics of Aboriginal-led SMART Recovery groups; (iii) perceived acceptability and helpfulness of SMART Recovery; and (iv) areas for potential improvement. Data were collected by synthesising Indigenous qualitative methods (research topic and social yarning) with western qualitative and quantitative methods (participant surveys, program adherence rating scale, group observations and field notes). Data were analysed using thematic analysis. RESULTS Participants were a culturally diverse sample of male and female Aboriginal facilitators (n = 10) and group members (n = 11), aged 22-65 years. Aboriginal-led SMART Recovery groups were culturally customised to suit local contexts. Program tools 'goal setting' and 'problem solving' were viewed as the most helpful. Suggested ways SMART Recovery could enhance its cultural utility included: integration of Aboriginal perspectives into facilitator training; creation of Aboriginal-specific program and marketing materials; and greater community engagement and networking. Participants proposed an Aboriginal-specific SMART Recovery program. DISCUSSION AND CONCLUSIONS This study offers insights into Aboriginal peoples' experiences of SMART Recovery. Culturally-informed modifications to the program were identified that could enhance cultural utility. Future research is needed to obtain diverse community perspectives and measure health outcomes associated with group attendance.
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Affiliation(s)
- Elizabeth Dale
- Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, Wollongong, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,La Trobe University, Centre for Alcohol Policy Research, Melbourne, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Drug Health Services, Sydney, Australia
| | - James H Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, Australia
| | - Rowena Ivers
- Australia School of Medicine, The University of Wollongong, Wollongong, Australia.,Illawarra Aboriginal Medical Service, Wollongong, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, Wollongong, Australia.,School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
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11
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Day A, Casey S, Baird M, Geia L, Wanganeen R. Evaluation of the Aboriginal and Torres Strait Islander Mental Health First Aid Program. Aust N Z J Public Health 2021; 45:46-52. [PMID: 33460196 DOI: 10.1111/1753-6405.13064] [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] [Received: 05/01/2020] [Revised: 10/01/2020] [Accepted: 11/01/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study reports findings from an uncontrolled evaluation of a course designed to educate participants in how to recognise and respond to mental health problems until professional help is received. METHODS Utilising a mixed methods design, participants in 21 different courses, delivered across two Australian states, were invited to complete pre-, post-, and follow-up surveys and provide qualitative feedback on their training experiences. RESULTS Participants reported feeling more confident in their capacity to respond appropriately to a person presenting with a mental health need and believed they would be more likely to provide assistance. Satisfaction was attributed to the skills and sensitivities of instructors who had lived experience of mental health concerns in Aboriginal and Torres Strait Islander communities. CONCLUSION This course holds promise in improving mental health literacy in relation to Aboriginal and Torres Strait Islander mental health. Implications for public health: Few courses are available that address issues relating to the social and emotional wellbeing of Aboriginal and Torres Strait Islander People. This study illustrates how community engagement with primary health and specialist mental health services might be strengthened.
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Affiliation(s)
- Andrew Day
- School of Political Sciences, Faculty of Arts, University of Melbourne, Victoria.,Indigenous Education and Research Centre; College of Healthcare Sciences; College of Arts, Society and Education, James Cook University, Queensland
| | - Sharon Casey
- Centre for Investigative Interviewing, Criminology and Criminal Justice, Griffith University, Queensland
| | - Mercy Baird
- School of Political Sciences, Faculty of Arts, University of Melbourne, Victoria.,Indigenous Education and Research Centre; College of Healthcare Sciences; College of Arts, Society and Education, James Cook University, Queensland
| | - Lynore Geia
- School of Political Sciences, Faculty of Arts, University of Melbourne, Victoria.,Indigenous Education and Research Centre; College of Healthcare Sciences; College of Arts, Society and Education, James Cook University, Queensland
| | - Rosemary Wanganeen
- School of Social Sciences, Faculty of Arts, University of Adelaide, South Australia
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12
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Dale E, Conigrave KM, Kelly PJ, Ivers R, Clapham K, Lee KSK. A Delphi yarn: applying Indigenous knowledges to enhance the cultural utility of SMART Recovery Australia. Addict Sci Clin Pract 2021; 16:2. [PMID: 33407873 PMCID: PMC7787604 DOI: 10.1186/s13722-020-00212-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutual support groups are a popular treatment for substance use and other addictive behaviours. However, little is known about the cultural utility of these programmes for Indigenous peoples. METHODS A three-round Delphi study, utilising Indigenous research yarning methods was conducted to: (1) Obtain expert opinion regarding the cultural utility of an Indigenous SMART Recovery handbook; (2) Gain consensus on areas within the SMART Recovery programme that require cultural modification and; (3) Seek advice on how modifications could be implemented in future programme design and delivery. The panellists were 11 culturally, geographically, and professionally diverse Indigenous Australian health and wellbeing experts. A group consensus level of 80% was set prior to each survey round. RESULTS There was 100% participant retention across all three Delphi rounds. The panel reached consensus on five key programme modifications (composition of a separate facilitator and group member handbook; culturally appropriate language, terminology, and literacy level; culturally meaningful programme activities; supplementary storytelling resources; and customisation for diverse community contexts). The panel also developed a series of practical implementation strategies to guide SMART Recovery through a modification process. CONCLUSION The findings highlight the importance of involving Indigenous peoples in the design, delivery and validation of mainstream mutual support programmes. Indigenous-led programme modifications could help improve accessibility and usefulness of mutual support groups for Indigenous peoples worldwide. This study is an example of how Indigenous research methods can be used alongside the Delphi technique. This approach demonstrated a way that Indigenous peoples from culturally and geographically diverse locations can participate in research anonymously, autonomously and without added burden on personal, community or professional obligations.
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Affiliation(s)
- Elizabeth Dale
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.
- School of Psychology, University of Wollongong, Wollongong, NSW, 2500, Australia.
| | - Katherine M Conigrave
- Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, NSW, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- School of Psychology, University of Wollongong, Wollongong, NSW, 2500, Australia
| | - Rowena Ivers
- Gradute School of Medicine, The University of Wollongong, Wollongong, NSW, Australia
- Illawarra Aboriginal Medical Service, Wollongong, NSW, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, Faculty of Business, University of Wollongong, Wollongong, NSW, Australia
| | - K S Kylie Lee
- Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
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13
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Plessas A, Billot MW, Tamatea A, Medvedev ON, McCormack J, Anderson A. Barriers and Facilitators of Access to Psychological Services for Indigenous Populations: A Scoping Review and Thematic Analysis. Front Psychiatry 2021; 12:747054. [PMID: 34712157 PMCID: PMC8545819 DOI: 10.3389/fpsyt.2021.747054] [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: 07/25/2021] [Accepted: 09/13/2021] [Indexed: 11/21/2022] Open
Abstract
Background: The extent to which behavior-analytic interventions are offered to Indigenous populations across CANZUS in accessible and culturally appropriate ways is unknown. We conducted a scoping review with a thematic analysis of the extant literature to find: (1) what are the barriers and facilitators for providing effective and equitable delivery of psychological services (with a behavioral component) to Indigenous populations; and (2) what tools and practices exist for an effective and equitable service delivery. Methods: We systematically reviewed Medline, CINAHL, PubMed, PsycInfo, Web of science, Ovid and INNZ databases between 1990 and 2020. For the scoping review, we adhered to the JBI methodological approach (2015) and the PRISMA strategy for the identification, selection, and appraisal of the reviewed articles. A total of 1265 unique articles met the criteria for the screening by title; 238 by abstract; 57 were included for full text assessment; and 37 were included in the final analysis. Results: Three themes were revealed to account for the barriers and facilitators of culturally friendly practices: (1) connecting practices are about interactions shaping the relationship between service provider and service client; (2) innovative practices test new approaches and innovations that could facilitate access to psychological services and overcome barriers, and (3) reflective practices are about critically examining the processes and actions undertaken toward effective cultural adaptation of services. Conclusions: Our analysis suggests that the level of success in bringing together services and the recipients of treatment (connection), showing flexibility and persistence in finding solutions (innovation) and examining the role of our behaviors in reaching our goals (reflection) is determined by the providers' action in the aforementioned three dimensions of practice.
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Affiliation(s)
- Anna Plessas
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Moana W Billot
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Armon Tamatea
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Oleg N Medvedev
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Jessica McCormack
- National Institute for Health Innovation, Pacific Health, University of Auckland, Auckland, New Zealand
| | - Angelika Anderson
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
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14
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Armstrong G, Sutherland G, Pross E, Mackinnon A, Reavley N, Jorm AF. Talking about suicide: An uncontrolled trial of the effects of an Aboriginal and Torres Strait Islander mental health first aid program on knowledge, attitudes and intended and actual assisting actions. PLoS One 2020; 15:e0244091. [PMID: 33332464 PMCID: PMC7746176 DOI: 10.1371/journal.pone.0244091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/02/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Suicide is a leading cause of death among Aboriginal and Torres Strait Islander people. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is at risk of suicide. We developed culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islander people experiencing suicidal thoughts or behaviour and used this as the basis for a 5-hour suicide gatekeeper training course called Talking About Suicide. This paper describes the outcomes for participants in an uncontrolled trial of this training course. METHODS We undertook an uncontrolled trial of the Talking About Suicide course, delivered by Aboriginal and Torres Strait Islander Mental Health First Aid instructors to 192 adult (i.e. 18 years of age or older) Aboriginal and Torres Strait Islander (n = 110) and non-Indigenous (n = 82) participants. Questionnaires capturing self-report outcomes were self-administered immediately before (n = 192) and after attending the training course (n = 188), and at four-months follow-up (n = 98). Outcome measures were beliefs about suicide, stigmatising attitudes, confidence in ability to assist, and intended and actual actions to assist a suicidal person. RESULTS Despite a high level of suicide literacy among participants at pre-course measurement, improvements at post-course were observed in beliefs about suicide, stigmatising attitudes, confidence in ability to assist and intended assisting actions. While attrition at follow-up decreased statistical power, some improvements in beliefs about suicide, stigmatising attitudes and intended assisting actions remained statistically significant at follow-up. Importantly, actual assisting actions taken showed dramatic improvements between pre-course and follow-up. Participants reported feeling more confident to assist a suicidal person after the course and this was maintained at follow-up. The course was judged to be culturally appropriate by those participants who identified as Aboriginal and/or Torres Strait Islanders. IMPLICATIONS The results of this uncontrolled trial were encouraging, suggesting that the Talking About Suicide course was able to improve participants' knowledge, attitudes, and intended assisting actions as well as actual actions taken.
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Affiliation(s)
- Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Georgina Sutherland
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eliza Pross
- Mental Health First Aid Australia, Parkville, Victoria, Australia
| | - Andrew Mackinnon
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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15
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Niederberger M, Spranger J. Delphi Technique in Health Sciences: A Map. Front Public Health 2020; 8:457. [PMID: 33072683 PMCID: PMC7536299 DOI: 10.3389/fpubh.2020.00457] [Citation(s) in RCA: 356] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/22/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives: In health sciences, the Delphi technique is primarily used by researchers when the available knowledge is incomplete or subject to uncertainty and other methods that provide higher levels of evidence cannot be used. The aim is to collect expert-based judgments and often to use them to identify consensus. In this map, we provide an overview of the fields of application for Delphi techniques in health sciences in this map and discuss the processes used and the quality of the findings. We use systematic reviews of Delphi techniques for the map, summarize their findings and examine them from a methodological perspective. Methods: Twelve systematic reviews of Delphi techniques from different sectors of the health sciences were identified and systematically analyzed. Results: The 12 systematic reviews show, that Delphi studies are typically carried out in two to three rounds with a deliberately selected panel of experts. A large number of modifications to the Delphi technique have now been developed. Significant weaknesses exist in the quality of the reporting. Conclusion: Based on the results, there is a need for clarification with regard to the methodological approaches of Delphi techniques, also with respect to any modification. Criteria for evaluating the quality of their execution and reporting also appear to be necessary. However, it should be noted that we cannot make any statements about the quality of execution of the Delphi studies but rather our results are exclusively based on the reported findings of the systematic reviews.
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Affiliation(s)
- Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, University of Education Schwaebisch Gmuend, Schwäbisch Gmünd, Germany
| | - Julia Spranger
- Department of Research Methods in Health Promotion and Prevention, University of Education Schwaebisch Gmuend, Schwäbisch Gmünd, Germany
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16
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Perkes S, Bonevski B, Mattes J, Hall K, Gould GS. Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: a modified Delphi with an Indigenous panel. BMC Pediatr 2020; 20:368. [PMID: 32758202 PMCID: PMC7409441 DOI: 10.1186/s12887-020-02255-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/23/2020] [Indexed: 01/26/2023] Open
Abstract
Background There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80%) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1), and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
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Affiliation(s)
- Sarah Perkes
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia.
| | - Billie Bonevski
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Joerg Mattes
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Kerry Hall
- First Peoples Health Unit, (FPHU) Griffith University, Southport, Queensland, 4215, Australia
| | - Gillian S Gould
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
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17
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Shoesmith W, Chua SH, Giridharan B, Forman D, Fyfe S. Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study. Int J Ment Health Syst 2020; 14:45. [PMID: 32577126 PMCID: PMC7304147 DOI: 10.1186/s13033-020-00374-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/30/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia. METHODS In the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers. RESULTS The Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute). CONCLUSIONS This study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.Trial registration Registered in the National Medical Research Register, Malaysia, NMRR-13-308-14792.
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Affiliation(s)
- Wendy Shoesmith
- Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia
- Curtin University, Miri, Sarawak Malaysia
| | - Sze Hung Chua
- Hospital Mesra Bukit Padang, Ministry of Health, Kota Kinabalu, Malaysia
| | | | - Dawn Forman
- School of Public Health, Curtin University, Perth, Australia
- University of Derby, Derby, UK
| | - Sue Fyfe
- School of Public Health, Curtin University, Perth, Australia
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18
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Isaak CA, Mota N, Medved M, Katz LY, Elias B, Mignone J, Munro G, Sareen J. Conceptualizations of help-seeking for mental health concerns in First Nations communities in Canada: A comparison of fit with the Andersen Behavioral Model. Transcult Psychiatry 2020; 57:346-362. [PMID: 32116153 DOI: 10.1177/1363461520906978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study explored the fit between on-reserve First Nations community members' conceptualizations of help-seeking for mental health concerns and the Andersen Behavioral Model of Health Services Use. Youth, adults and elders (N = 115) living and or working in eight distinct First Nations communities within a tribal council area in Canada participated in focus groups or individual interviews that were transcribed, coded and then analyzed using a thematic analysis approach informed by grounded theory methodology. Resulting themes were then mapped onto the Andersen Behavioral Model of Health Services Use. Participants' conceptualizations of predisposing characteristics including social structures, health beliefs and mental illness, enabling and impeding resources had a high degree of fit with the model. While perspectives on perceived need for mental health care, and spirituality as a health and lifestyle practice had only moderate fit with the model, these domains could be modified to fit First Nations' interpretations of help-seeking. Participants' perceptions of avoidant strategies and non-use of mental health services, however did not map onto the model. These findings suggest conceptualizations of help-seeking for mental health issues in these First Nations communities are only partially characterized by the Andersen Behavioral Model, suggesting there are a number of considerations to Indigenize the model. Findings also highlight potential explanations for why some members of this population may not access or receive appropriate mental health treatment. Multi-pronged efforts are warranted to link culturally normed pathways of help-seeking with effective mental health supports for First Nations community members in Canada.
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Affiliation(s)
| | | | - Maria Medved
- University of Manitoba, Canada.,The American University of Paris, France
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19
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Mulhall P, Taggart L, Coates V, McAloon T. Using a Delphi survey to gain an international consensus on the challenges of conducting trials with adults with intellectual disabilities. Clin Trials 2019; 17:138-146. [PMID: 31856601 DOI: 10.1177/1740774519887168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND/AIMS People with intellectual disability experience higher rates of multi-morbidity and health inequalities, they are frequently prescribed medications and more likely to have an avoidable or premature death. There is a recognised lack of randomised controlled trials, and subsequently a lack of evidence base, for many of the interventions and treatments provided to people with intellectual disabilities. Very few disability-specific trials are conducted, and people with intellectual, and other cognitive, disabilities are routinely excluded from mainstream trials. There is an urgent need to facilitate more disability-specific trials or to encourage mainstream trialists to include people with disabilities in their studies. Obtaining a thorough understanding of the challenges inherent in these trials, and sharing this knowledge within the research community, may contribute significantly towards addressing this need. The aim of this study was to explore the practical and methodological challenges to conducting trials with adults with intellectual disabilities and to reach a consensus regarding which are the most important challenges for researchers for inclusion in a resource toolkit. METHODS A three-round modified Delphi survey was conducted with a panel of international trials researchers within the intellectual disability field. Items were assessed in terms of the consensus level and stability of responses. RESULTS A total of 64 challenges and barriers were agreed upon, across all aspects of the trial pathway, from planning through to reporting. Some challenges and barriers had been noted in the literature previously, but many previously uncited barriers (both systemic and attitudinal) were identified. CONCLUSION This is the first international survey exploring the experiences of researchers conducting randomised controlled trials with adults with intellectual disabilities. Many of the barriers and challenges reported can be overcome with creativity and some additional resources. Other challenges, including attitudes towards conducting trials with disabled populations, maybe harder to overcome. These findings have implications for conducting trials with other populations with cognitive or communication difficulties. Implications for disability researchers, funding bodies and ethical review panels are discussed.
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Affiliation(s)
- Peter Mulhall
- School of Nursing, Ulster University, Newtownabbey, Northern Ireland
| | - Laurence Taggart
- School of Nursing, Ulster University, Newtownabbey, Northern Ireland
| | - Vivien Coates
- School of Nursing, Ulster University, Newtownabbey, Northern Ireland
| | - Toni McAloon
- School of Nursing, Ulster University, Newtownabbey, Northern Ireland
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20
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Foyston Z, Taylor C, Freestone M. "Who needs secure services for personality disorder?" Results of an expert Delphi study with professional staff. BMC Psychiatry 2019; 19:280. [PMID: 31506071 PMCID: PMC6734324 DOI: 10.1186/s12888-019-2268-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/30/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Personality Disorder (PD) is an enduring, multi-faceted mental disorder, associated with adverse health effects, difficulties with interpersonal relationships and in some cases increased risk to others. A limited number of dedicated forensic mental health services are available for serious offenders with severe personality disorder. The recent Offender Personality Disorder (OPD) strategy aims to ensure that most such offenders are treated in prison rather than secure psychiatric services, except in highly complex cases where this is not possible. While the strategy sets out very broad criteria relating to this, greater clarity is needed to support decisions about appropriate transfer and hence enhance public protection. This study explored which characteristics professional experts associate with appropriate transfer from prison to forensic mental health services for high-risk offenders with PD. METHOD A modified Delphi survey distributed through an online survey system was conducted in two-rounds with a group of professional experts recruited from forensic mental healthcare; criminal justice and specialist commissioning. RESULTS Fifty-one (56%) respondents completed stage one of the Delphi and 34 (61%) of these completed stage two. Consensus was reached for a total of 22 items indicating complexity, including co-morbid mental illness, high level of risk, lack of progress in prison and high motivation for treatment. A preliminary checklist for these factors was developed. Panel members consistently emphasised the importance of the individual's presenting need, the overall clinical picture and formulation in their free text responses. CONCLUSIONS Professionals face a complex picture when making decisions regarding suitability for hospital admission for high-risk male offenders with PD, with varied opinions amongst professional experts as to priorities for intervention and a focus on individual needs through formulation. It was, nevertheless, possible to condense these views into a set of consistent variables that can be used to highlight the need for transfer into hospital-based treatment services.
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Affiliation(s)
- Zoe Foyston
- grid.498924.aManchester University NHS Foundation Trust, Manchester, UK
| | - Celia Taylor
- 0000 0004 0426 7183grid.450709.fEast London NHS Foundation Trust, London, UK
| | - Mark Freestone
- Centre for Psychiatry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
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21
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Filia K, Jackson H, Cotton S, Killackey E. Understanding what it means to be socially included for people with a lived experience of mental illness. Int J Soc Psychiatry 2019; 65:413-424. [PMID: 31159628 DOI: 10.1177/0020764019852657] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Social inclusion is increasingly understood to have positive and beneficial implications for the mental health outcomes of people with severe mental illness. The concept is plagued by definitional inconsistencies and a lack of consensus regarding what it means to be socially included, in particular for groups most vulnerable to social exclusion, such as people with mental illness. The aim of this study was to obtain a consensus regarding the key contributors to social inclusion from the perspective of people with and without a lived experience of mental illness (consumers of mental health services, carers, and general community members). METHODS Delphi methodology was employed to reach consensus agreement. The Delphi questionnaire was based on a previous review of the literature and consisted of 147 items categorized into 13 domains. It was presented to participants over three rounds. Participants (N = 104) were recruited into three groups (32 consumers, 32 carers of people with a mental illness, and 40 members of the general community - neither consumers nor carers). Retention of participants from Round 1 to Round 3 was 79.8%. RESULTS Similarities and differences were observed between the groups. A number of items were very strongly endorsed as key contributors to social inclusion, relating to social participation, social supports, housing, neighbourhood, community involvement, employment and education, health and well-being and service utilization. CONCLUSION Findings supported previous work, indicating the importance of having a strong sense of connection with others as well as the importance of safe and stable housing, support services and personal motivation and hope. We obtained a well-rounded perspective among groups regarding the key contributors to social inclusion, with a particular relevance to people living with mental illness. This perspective has significant clinical and research utility.
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Affiliation(s)
- Kate Filia
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Henry Jackson
- 3 Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Eoin Killackey
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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22
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Jorm AF, Ross AM. Guidelines for the public on how to provide mental health first aid: narrative review. BJPsych Open 2018; 4:427-440. [PMID: 30450221 PMCID: PMC6235998 DOI: 10.1192/bjo.2018.58] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/18/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Expert-consensus guidelines have been developed for how members of the public should assist a person with a mental health problem or in a mental health crisis. AIMS This review aimed to examine the range of guidelines that have been developed and how these have been implemented in practice. METHOD A narrative review was carried out based on a systematic search for literature on the development or implementation of the guidelines. RESULTS The Delphi method has been used to develop a wide range of guidelines for English-speaking countries, Asian countries and a number of other cultural groups. The primary implementation has been through informing the content of training courses. CONCLUSION Further work is needed on guidelines for low- and middle-income countries. DECLARATION OF INTEREST A.F.J. is an unpaid member of the Board of Mental Health First Aid International (trading as Mental Health First Aid Australia), which is a not-for-profit organisation.
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Affiliation(s)
- Anthony F Jorm
- Professorial Fellow, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Anna M Ross
- Research Assistant, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
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Armstrong G, Ironfield N, Kelly CM, Dart K, Arabena K, Bond K, Reavley N, Jorm AF. Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait islanders who are experiencing suicidal thoughts and behaviour. BMC Psychiatry 2018; 18:228. [PMID: 30012118 PMCID: PMC6048843 DOI: 10.1186/s12888-018-1809-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death among Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is suicidal. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islander persons who are experiencing suicidal thoughts or behaviour were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions. METHODS The Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is experiencing suicidal thoughts or displaying suicidal behaviour. A panel was formed, comprising 27 Aboriginal and Torres Strait Islander people who have expertise in Indigenous suicide prevention. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important. RESULTS From a total of 301 statements shown to the expert panel, 172 were endorsed as helping statements to be including in the re-developed guidelines. CONCLUSIONS Aboriginal and Torres Strait Islander suicide prevention experts were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal or Torres Strait Islander person experiencing suicidal thoughts or behaviour. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version, for which the panel had rated 166 helping statements and had endorsed 52. These re-developed guidelines can be used to inform Indigenous suicide gatekeeper training courses.
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Affiliation(s)
- Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition St, Melbourne, VIC 3000 Australia
| | - Natalie Ironfield
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia
| | - Claire M. Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC 3053 Australia
| | - Katrina Dart
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC 3053 Australia
| | - Kerry Arabena
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia
| | - Kathy Bond
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC 3053 Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia
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Turnbull AE, Dinglas VD, Friedman LA, Chessare CM, Sepúlveda KA, Bingham CO, Needham DM. A survey of Delphi panelists after core outcome set development revealed positive feedback and methods to facilitate panel member participation. J Clin Epidemiol 2018; 102:99-106. [PMID: 29966731 DOI: 10.1016/j.jclinepi.2018.06.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/08/2018] [Accepted: 06/14/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The objective of this study was to elicit feedback on consensus methodology used for core outcome set (COS) development. STUDY DESIGN AND SETTING An online survey of international Delphi panelists participating in a recent COS for clinical research studies evaluating acute respiratory failure (ARF) survivors was conducted. Panelists represented 14 countries (56% outside the United States). RESULTS Seventy (92%) panelists completed the survey, including 32 researchers, 19 professional association representatives, 4 research funding representatives, and 15 ARF survivors/caregiver members. Among respondents, 91% reported that the time required to participate was appropriate and 96% were not bothered by reminders for timely response. Attributes of measurement instruments and voting results from previous rounds were evaluated differently across stakeholder groups. When measurement properties were explained in the stem of the survey question, 59 (84%) panelists (including 73% of survivors/families) correctly interpreted information about an instrument's reliability. Without a reminder in the stem, only 20 (29%) panelists (including 38% of researchers) correctly identified properties of a COS. CONCLUSION This international Delphi panel, including >20% patients/caregivers, favorably reported on feasibility of the methodology. Providing all panelists pertinent information/reminders about the project's objective at each voting round is important to informed decision making across all stakeholder groups.
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Affiliation(s)
- Alison E Turnbull
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Victor D Dinglas
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Lisa Aronson Friedman
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Caroline M Chessare
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kristin A Sepúlveda
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Clifton O Bingham
- Divisions of Rheumatology and Allergy and Clinical Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - Dale M Needham
- Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Uribe Guajardo MG, Slewa-Younan S, Kitchener BA, Mannan H, Mohammad Y, Jorm AF. Improving the capacity of community-based workers in Australia to provide initial assistance to Iraqi refugees with mental health problems: an uncontrolled evaluation of a Mental Health Literacy Course. Int J Ment Health Syst 2018; 12:2. [PMID: 29371881 PMCID: PMC5769322 DOI: 10.1186/s13033-018-0180-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/08/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Australia is a multicultural nation with a humanitarian program that welcomes a large number of Iraqi refugees. Despite the high prevalence of trauma related disorders, professional help-seeking in this group is very low. This study sought to evaluate a face-to-face mental health literacy (MHL) Course that teaches community-based workers how to provide initial help to Iraqi refugees with depression and post-traumatic stress disorder (PTSD) related problems. METHODS An uncontrolled pre, post and follow-up design was used to measure improvement in MHL in community-based workers assisting Iraqi refugees. RESULTS Eighty-six participants completed the pre- and post-training questionnaires. Forty-five (52%) completed all 3-time point questionnaires. Fifty-six percent (48/86) of participants were able to correctly recognise 'PTSD' as the problem depicted in a vignette before the training. This increased to 77% (66/86) after training and was maintained at follow-up with 82% (37/45) correctly recognising the problem (p = 0.032). Recognition of depression also increased from 69% (59/86) at pre-training to 83% (71/86) after training and to 82% (37/45) at follow-up. There was a significant increase in perceived helpfulness of professional treatments for depression after training (p < 0.001 at post-training, p = 0.010 at follow-up). Significant changes were reported in confidence of participants when helping an Iraqi refugee with PSTD (p < 0.001 at post-training, p < 0.001 at follow-up) and depression (p < 0.001 at post-training, p = 0.003 at follow-up). A decrease were also found on social distance mean scores associated with PTSD (p = 0.006 at post-training, p < 0.001 at follow-up) and depression (p = 0.007 at follow-up). Changes were not significant following training for offering help and helping behaviours in both PSTD and depression vignettes and, the 'dangerous/unpredictable' subscale in the depression vignette. CONCLUSION This training is a recommendable way to improve and better equip staff on how to respond to mental health crises and offer Mental Health First Aid in a culturally sensitive manner to Iraqi refugees.
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Affiliation(s)
- Maria Gabriela Uribe Guajardo
- Mental Health, Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Shameran Slewa-Younan
- Mental Health, Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Yaser Mohammad
- Bankstown Community Mental Health Services, Sydney, Australia
- Ware St Medical & Dental Centre, Sydney, Australia
| | - Anthony Francis Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Armstrong G, Ironfield N, Kelly CM, Dart K, Arabena K, Bond K, Jorm AF. Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait Islanders who are engaging in non-suicidal self-injury. BMC Psychiatry 2017; 17:300. [PMID: 28830485 PMCID: PMC5568063 DOI: 10.1186/s12888-017-1465-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 08/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is engaging in NSSI. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islanders who are engaging in NSSI were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions. METHODS The Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is engaging in NSSI. The statements were sourced from systematic searches of peer-reviewed literature, grey literature, books, websites and online materials, and existing NSSI courses. A panel was formed, comprising 26 Aboriginal and Torres Strait Islanders with expertise in NSSI. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important. RESULTS From a total of 185 statements shown to the expert panel, 115 were endorsed as helping statements to be included in the re-developed guidelines. CONCLUSIONS A panel of Aboriginal and Torres Strait Islander people with expertise in NSSI were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander engaging in NSSI. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version. The re-developed guidelines will form the basis of an Aboriginal mental health first aid short course on NSSI for Indigenous community members and non-Indigenous frontline workers that will be evaluated in an upcoming trial.
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Affiliation(s)
- Gregory Armstrong
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria 3010 Australia
| | - Natalie Ironfield
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria 3010 Australia
| | - Claire M. Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, Victoria 3053 Australia
| | - Katrina Dart
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, Victoria 3053 Australia
| | - Kerry Arabena
- Indigenous Health Equity Unit, Melbourne School of Population Health, University of Melbourne, 207 Bouverie St, Carlton, Victoria 3010 Australia
| | - Kathy Bond
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, Victoria 3053 Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria 3010 Australia
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Bond KS, Dart KM, Jorm AF, Kelly CM, Kitchener BA, Reavley NJ. Assisting an Australian Aboriginal and Torres Strait Islander person with gambling problems: a Delphi study. BMC Psychol 2017; 5:27. [PMID: 28768547 PMCID: PMC5541654 DOI: 10.1186/s40359-017-0196-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 07/25/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Gambling problems appear to be more prevalent in the Australian Aboriginal and Torres Strait Islander population than in the non-Indigenous population. Although gambling harms can be significant, treatment-seeking rates are low. The Delphi expert consensus method was used to develop a set of guidelines on how a family or community member can assist an Aboriginal or Torres Strait Islander person with gambling problems. METHODS Building on a previous systematic review of websites, books and journal articles a questionnaire was developed that contained items about the knowledge, skills and actions needed for supporting an Aboriginal or Torres Strait Islander person with gambling problems. These items were rated over three rounds by an expert panel comprising professionals who provide treatment to or conduct research with Aboriginal and Torres Strait Islander people with gambling problems. RESULTS A total of 22 experts rated 407 helping statements according to whether they thought the statements should be included in these guidelines. There were 225 helping statements that were endorsed by at least 90% of participants. These endorsed statements were used to develop the guidelines. CONCLUSION Experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support an Aboriginal or Torres Strait Islander person to change.
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Affiliation(s)
- Kathy S Bond
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC 3052 Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie Street, Parkville, VIC 3010 Australia
| | - Katrina M. Dart
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC 3052 Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie Street, Parkville, VIC 3010 Australia
| | - Claire M. Kelly
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC 3052 Australia
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220 Australia
| | - Betty A. Kitchener
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC 3052 Australia
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220 Australia
| | - Nicola J. Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie Street, Parkville, VIC 3010 Australia
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Uribe Guajardo MG, Slewa-Younan S, Santalucia Y, Jorm AF. Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study. Int J Ment Health Syst 2016; 10:54. [PMID: 27594898 PMCID: PMC5009547 DOI: 10.1186/s13033-016-0087-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Refugees are one of the most vulnerable groups in Australian society, presenting high levels of exposure to traumatic events and consequently high levels of severe psychological distress. While there is a need for professional help, only a small percentage will receive appropriate care for their mental health concerns. This study aimed to determine cultural considerations required when providing mental health first aid to Iraqi refugees experiencing mental health problems or crises. METHOD Using a Delphi method, 16 experts were presented with statements about possible culturally-appropriate first aid actions via questionnaires and were encouraged to suggest additional actions not covered by the questionnaire content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥90 % of panellists as 'Essential' or 'Important'. RESULTS From a total of 65 statements, 38 were endorsed (17 for cultural awareness, 12 for cross-cultural communication, 7 for stigma associated with mental health problems, and 2 for barriers to seeking professional help). CONCLUSION Experts were able to reach consensus about how to provide culturally-appropriate first aid for mental health problems to Iraqi refugees, demonstrating the suitability of this methodology in developing cultural considerations guidelines. This specific refugee study provided potentially valuable cultural knowledge required to better equip members of the Australian public on how to respond to and assist Iraqi refugees experiencing mental health problems or crises.
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Affiliation(s)
| | - Shameran Slewa-Younan
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia
| | - Yvonne Santalucia
- Health Promotion Service, Multicultural Health, South Western Sydney Local Health District, Sydney, Australia
| | - Anthony Francis Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Bovopoulos N, Jorm AF, Bond KS, LaMontagne AD, Reavley NJ, Kelly CM, Kitchener BA, Martin A. Providing mental health first aid in the workplace: a Delphi consensus study. BMC Psychol 2016; 4:41. [PMID: 27485609 PMCID: PMC4971664 DOI: 10.1186/s40359-016-0148-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 07/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one's approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. METHODS A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. RESULTS The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. CONCLUSIONS The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures.
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Affiliation(s)
- Nataly Bovopoulos
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC, 3010, Australia. .,Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC, 3010, Australia
| | - Kathy S Bond
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Anthony D LaMontagne
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.,Centre for Health Equity, Melbourne School of Population & Global Health, University of Melbourne, Level 207 Bouverie St, Parkville, VIC, 3010, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC, 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.,School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Betty A Kitchener
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.,School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Angela Martin
- Tasmanian School of Business and Economics, University of Tasmania, Private Bag 84, Hobart, TAS, 7001, Australia
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Abstract
OBJECTIVE The article gives an introductory overview of the use of the Delphi expert consensus method in mental health research. It explains the rationale for using the method, examines the range of uses to which it has been put in mental health research, and describes the stages of carrying out a Delphi study using examples from the literature. METHOD To ascertain the range of uses, a systematic search was carried out in PubMed. The article also examines the implications of 'wisdom of crowds' research for how to conduct Delphi studies. RESULTS The Delphi method is a systematic way of determining expert consensus that is useful for answering questions that are not amenable to experimental and epidemiological methods. The validity of the approach is supported by 'wisdom of crowds' research showing that groups can make good judgements under certain conditions. In mental health research, the Delphi method has been used for making estimations where there is incomplete evidence (e.g. What is the global prevalence of dementia?), making predictions (e.g. What types of interactions with a person who is suicidal will reduce their chance of suicide?), determining collective values (e.g. What areas of research should be given greatest priority?) and defining foundational concepts (e.g. How should we define 'relapse'?). A range of experts have been used in Delphi research, including clinicians, researchers, consumers and caregivers. CONCLUSION The Delphi method has a wide range of potential uses in mental health research.
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Affiliation(s)
- Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
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Experiences of a Mental Health First Aid training program in Sweden: a descriptive qualitative study. Community Ment Health J 2015; 51:497-503. [PMID: 25663123 DOI: 10.1007/s10597-015-9840-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
Abstract
Restricted mental health literacy and stigma are barriers to treatment of mental disorders. A Mental Health First Aid training program was tested for implementation in Sweden among employees in the public sector. The aim of the present qualitative study was to explore participants' experiences of the program in more depth, in conjunction with a randomized controlled study. Twenty four persons participated in a total of six focus groups 6-8 months after program participation. Data were analyzed using content analysis. The analysis resulted in five categories illustrating the participants' experiences of the course: increased awareness, knowledge and understanding; influence on attitude and approach; tool box and confidence; feedback on content and layout; and tangible examples of applied knowledge. The most central finding is the fruitfulness of the program's practical focus and use, the increased confidence and inclination to act following program participation, and the importance of experienced instructors.
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Ahmed R, McCaffery KJ, Aslani P. Development and validation of a question prompt list for parents of children with attention-deficit/hyperactivity disorder: a Delphi study. Health Expect 2015; 19:234-52. [PMID: 25597620 DOI: 10.1111/hex.12341] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2014] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Question prompt lists (QPLs) are structured lists of disease and treatment-specific questions intended to encourage patient question-asking during consultations with clinicians. The aim of this study was to develop a QPL intended for use by parents of children affected by attention-deficit/hyperactivity disorder (ADHD). METHODS The QPL content (111 questions) was derived through thematic analysis of existing ADHD- and QPL-related resources. A modified Delphi method, involving a three-round web-based survey, was used to reach consensus about the QPL content. Thirty-six experts were recruited into either a professional [paediatricians, child and adolescent psychiatrists, psychologists, researchers (n =28)] or non-professional panel [parents of children diagnosed with ADHD, ADHD consumer advocates (n = 8)]. Panel members were asked to rate the importance of the QPL content using a five-point scale ranging from 'Essential' to 'Should not be included'. RESULTS A total of 122 questions, including 11 new questions suggested by panellists, were rated by both panels. Of these, 88 (72%) were accepted for inclusion in the QPL. Of the accepted questions, 39 were re-rated during two follow-up survey rounds and 29 (74%) were subsequently accepted for inclusion. The questions covered key topics including diagnosis, understanding ADHD, treatment, health-care team, monitoring ADHD, managing ADHD, future expectations and support and information. CONCLUSIONS To our knowledge, this is the first ADHD-specific QPL to be developed and the first use of the Delphi method to validate the content of any QPL. It is anticipated that the QPL will assist parents in obtaining relevant, reliable information and empowering their treatment decisions by enhancing the potential for shared decision making with clinicians.
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Affiliation(s)
- Rana Ahmed
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | | | - Parisa Aslani
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia
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Hart LM, Damiano SR, Chittleborough P, Paxton SJ, Jorm AF. Parenting to prevent body dissatisfaction and unhealthy eating patterns in preschool children: a Delphi consensus study. Body Image 2014; 11:418-25. [PMID: 25084034 DOI: 10.1016/j.bodyim.2014.06.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/17/2014] [Accepted: 06/28/2014] [Indexed: 10/24/2022]
Abstract
Interventions to prevent body dissatisfaction and unhealthy eating patterns are needed in early childhood. Identifying effective parenting strategies would be useful for parents and prevention researchers. To develop expert consensus, an online Delphi study was conducted with experts (N=28, Mage=44.34) who rated statements describing potential parenting strategies gleaned from a systematic literature search. If 90-100% rated a statement as either Essential or Important, it was endorsed as a guideline. From a total of 335 statements 153 were endorsed. Despite some areas of disagreement, including whether parents should weigh their child or discourage weighing, experts were able to reach consensus on a wide range of issues, such as how to discuss healthy eating with children. The developed guidelines provide a novel and required resource for parents, and a framework for researchers developing interventions to prevent the onset of body dissatisfaction and unhealthy eating patterns in early childhood.
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Affiliation(s)
- Laura M Hart
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Stephanie R Damiano
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Philip Chittleborough
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Susan J Paxton
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Hadlaczky G, Hökby S, Mkrtchian A, Carli V, Wasserman D. Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis. Int Rev Psychiatry 2014; 26:467-75. [PMID: 25137113 DOI: 10.3109/09540261.2014.924910] [Citation(s) in RCA: 203] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants' knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass's Δ = 0.56 (95% CI = 0.38 - 0.74; p < 0.001), 0.28 (95% CI = 0.22 - 0.35; p < 0.001) and 0.25 (95% CI = 0.12 - 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or 'publication quality' (journal impact factor). The results demonstrate that MHFA increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.
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Affiliation(s)
- Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet , Stockholm , Sweden
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Day A, Francisco A. Social and emotional wellbeing in Indigenous Australians: identifying promising interventions. Aust N Z J Public Health 2014; 37:350-5. [PMID: 23895478 DOI: 10.1111/1753-6405.12083] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To review the empirical evidence that exists to support the delivery of the range of psycho-social interventions that have been implemented to improve social and emotional wellbeing (SEWB) in Aboriginal and Torres Strait Islander individuals and communities. METHODS A systematic review of the available literature, with relevant evaluations classified using the Maryland Scientific Methods Scale. RESULTS Despite a substantial literature on topics relevant to SEWB being identified, only a small number of program evaluations have been published that meet the criteria for inclusion in a systematic review, making it impossible to articulate what might be considered evidence-based practice in this area. Examples of those programs with the strongest empirical support are outlined. CONCLUSIONS The results are discussed in terms of the need to develop key indicators of improvement in SEWB, such that more robust evidence about program outcomes can be gathered. The diversity of the identified programs further suggests the need to develop a broader and over-arching framework from which to approach low levels of SEWB, drawing on the concepts of 'grief and loss' and 'healing' and how high levels of social disadvantage have an impact on service utilisation and outcomes. IMPLICATIONS From a public health perspective, the pressing need to implement programs that have positive impacts on low levels of social and emotional well-being in Aboriginal and Torres Strait Islander communities in Australia seems clear.
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Affiliation(s)
- Andrew Day
- School of Psychology, Deakin University, Victoria School of Psychology, Deakin University, Victoria, Australia.
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Chalmers KJ, Bond KS, Jorm AF, Kelly CM, Kitchener BA, Williams-Tchen A. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines. Int J Ment Health Syst 2014; 8:6. [PMID: 24467923 PMCID: PMC3922159 DOI: 10.1186/1752-4458-8-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 12/10/2013] [Indexed: 11/26/2022] Open
Abstract
Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a mental health crisis.
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Affiliation(s)
| | | | | | - Claire M Kelly
- Mental Health First Aid Australia, Parkville, Victoria, Australia.
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Rogerson B, Copeland J, Buttner P, Bohanna I, Cadet-James Y, Sarnyai Z, Clough AR. An exploratory study of cannabis withdrawal among Indigenous Australian prison inmates: study protocol. BMJ Open 2013; 3:bmjopen-2013-002951. [PMID: 23793690 PMCID: PMC3657653 DOI: 10.1136/bmjopen-2013-002951] [Citation(s) in RCA: 5] [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] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Cannabis use and dependence is a serious health and criminal justice issue among incarcerated populations internationally. Upon abrupt, enforced cessation of cannabis, prisoners may suffer irritability and anger that can lead to threatening behaviour, intimidation, violence, sleep disturbances and self-harm. Cannabis withdrawal syndrome, proposed for inclusion in the Diagnostic and Statistical Manual of Mental Disorders in 2013, has not been examined in Indigenous populations. Owing to the exceptionally high rates of cannabis use in the community, high proportions of Australian Indigenous prisoners may suffer from withdrawal upon entry to custody. METHODS AND ANALYSIS 60 male and 60 female Indigenous prisoners (18-40 years) at a high risk of cannabis dependence will be recruited upon entry to custody. A pictorial representation of the standard Cannabis Withdrawal Scale will be tested for reliability and validity. Cortisol markers will be measured in saliva, as the indicators of onset and severity of cannabis withdrawal and psychological distress. The characteristics will be described as percentages and mean or median values with 95% CI. Receiver operator curve analysis will determine an ideal cut-off of the Cannabis Withdrawal Scale and generalised estimating equations modelling will test changes over time. The acceptability and efficacy of proposed resources will be assessed qualitatively using thematic analysis. OUTCOMES A valid and reliable measure of cannabis withdrawal for use with Indigenous populations, the onset and time course of withdrawal symptoms in this population and the development of culturally acceptable resources and interventions to identify and manage cannabis withdrawal. ETHICS AND DISSEMINATION The project has been approved by the James Cook University Human Research Ethics Committee (approval number H4651).The results will be reported via peer reviewed publications, conference, seminar presentations and on-line media for national and international dissemination.
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Affiliation(s)
- Bernadette Rogerson
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns and Townsville, Queensland, Australia
| | - Jan Copeland
- National Cannabis Prevention & Information Centre, UNSW Medicine, Sydney, New South Wales, Australia
| | - Petra Buttner
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns and Townsville, Queensland, Australia
| | - India Bohanna
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns and Townsville, Queensland, Australia
| | - Yvonne Cadet-James
- School of Indigenous Australian Studies, James Cook University, Townsville, Queensland, Australia
| | - Zoltan Sarnyai
- School of Veterinary and Biomedical Sciences, James Cook University, Townsville, Queensland, Australia
| | - Alan R Clough
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns and Townsville, Queensland, Australia
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Morawska A, Fletcher R, Pope S, Heathwood E, Anderson E, McAuliffe C. Evaluation of mental health first aid training in a diverse community setting. Int J Ment Health Nurs 2013; 22:85-92. [PMID: 22783922 DOI: 10.1111/j.1447-0349.2012.00844.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mental health first aid (MHFA) training has been disseminated in the community and has yielded positive outcomes in terms of increasing help-seeking behaviour and mental health literacy. However, there has been limited research investigating the effectiveness of this programme in multicultural communities. Given the increasing levels of multiculturalism in many countries, as well as the large number of barriers presented to these groups when trying to seek help for mental illnesses, the present study aimed to investigate the effectiveness of MHFA in these settings. A total of 458 participants, who were recruited from multicultural organizations, participated in a series of MHFA training courses. Participants completed questionnaires pre and post the training course, and 6-month follow-up interviews were conducted with a subsample of participants. Findings suggested that MHFA training increased participant recognition of mental illnesses, concordance with primary care physicians about treatments, confidence in providing first aid, actual help provided to others, and a reduction in stigmatizing attitudes. A 6-month follow up also yielded positive long-term effects of MHFA. The results have implications for further dissemination and the use of MHFA in diverse communities. In addition, the results highlight the need for mental health training in health-care service providers.
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Affiliation(s)
- Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Australia.
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Demarchi C, Bohanna I, Baune BT, Clough AR. Detecting psychotic symptoms in Indigenous populations: a review of available assessment tools. Schizophr Res 2012; 139:136-43. [PMID: 22682369 DOI: 10.1016/j.schres.2012.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Revised: 04/28/2012] [Accepted: 05/15/2012] [Indexed: 11/20/2022]
Abstract
As efforts to shorten the duration of untreated psychosis increase, there is a need for short screening instruments to identify those at-risk. It is feared that remote Indigenous populations, manifesting many of the risk factors associated with schizophrenia and often lacking access to adequate mental health services, may be overlooked as the general population effort shifts towards early detection. This article aimed to review studies investigating psychotic symptoms in Indigenous communities in Australia, New Zealand, Canada and United States of America and aimed to evaluate the usefulness of the instruments. Eleven relevant studies were identified using seven unique instruments. The available instruments assessed psychotic symptoms to varying degrees, although no screener for early detection was found thus supporting concerns that these disadvantaged populations do not have access to suitable support enabling early detection of psychosis. We recommend that a rapid screening tool for detecting at-risk individuals be developed and validated for community use in Indigenous populations living in remote areas.
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Affiliation(s)
- Célia Demarchi
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia
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Durey A, Thompson SC. Reducing the health disparities of Indigenous Australians: time to change focus. BMC Health Serv Res 2012; 12:151. [PMID: 22682494 PMCID: PMC3431273 DOI: 10.1186/1472-6963-12-151] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 06/10/2012] [Indexed: 11/12/2022] Open
Abstract
Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist attitudes and beliefs into their lived experience, lowering expectations and their sense of self-worth. Conclusions Current health policies and practices favour standardised care where the voice of those who are marginalised is often absent. Examining the effectiveness of such models in reducing health disparities requires health providers to critically reflect on whether policies and practices promote or compromise Indigenous health and wellbeing - an important step in changing the discourse that places Indigenous people at the centre of the problem.
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Affiliation(s)
- Angela Durey
- Curtin Health Innovation Research Unit, Curtin University, Perth, 6845, Western Australia.
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Hinton R, Nagel T. Evaluation of a Culturally Adapted Training in Indigenous Mental Health and Wellbeing for the Alcohol and Other Drug Workforce. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/380581] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Indigenous Australians have high rates of mental illness comorbid with substance misuse. The complex needs of this client group create challenges for the alcohol and other drug (AOD) workforce. This paper describes the outcomes of an Indigenous-specific “Yarning about Mental Health” training for the AOD workforce to strengthen knowledge and skills in mental health approaches and in their engagement with Indigenous clients. The training provides culturally adapted strategies and tools for understanding mental health, promoting wellbeing, and delivering brief interventions in the substance misuse setting. A nonexperimental evaluation which incorporated pre-post questionnaires was conducted with workshop participants attending one of four trainings. The training was perceived to be highly appropriate and helpful in participants’ work with Indigenous AOD clients. There was significant improvement in confidence and knowledge related to Indigenous mental health and wellbeing and qualitative data supported these positive outcomes. This study supports the need to blend Indigenous concepts of health and wellbeing with non-Indigenous ways of understanding and treating illness in order to develop services which are appropriate to Indigenous peoples. It also suggests research is required to understand whether self-reported increases in knowledge and confidence can translate into behavioural changes in participants' teaching and practice of culturally competent care and to improved client outcomes.
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Affiliation(s)
- Rachael Hinton
- Wellbeing and Chronic Disease Division, Menzies School of Health Research, P.O. Box 41096, Casuarina, NT 0811, Australia
| | - Tricia Nagel
- Wellbeing and Chronic Disease Division, Menzies School of Health Research, P.O. Box 41096, Casuarina, NT 0811, Australia
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Jorm AF, Kitchener BA. Noting a landmark achievement: Mental Health First Aid training reaches 1% of Australian adults. Aust N Z J Psychiatry 2011; 45:808-13. [PMID: 21827342 DOI: 10.3109/00048674.2011.594785] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Anthony F. Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Betty A. Kitchener
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
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Colucci E, Kelly CM, Minas H, Jorm AF, Suzuki Y. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in Japan. Int J Ment Health Syst 2011; 5:12. [PMID: 21592409 PMCID: PMC3108941 DOI: 10.1186/1752-4458-5-12] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 05/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to develop guidelines for how a member of the Japanese public should provide mental health first aid to a person who is suicidal. METHODS The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 32 Japanese mental health professionals to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. RESULTS The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 38 new items were written based on suggestions from panel members and, of these 176 items, 56 met the consensus criterion. These statements were used to develop the guidelines appended to this article. CONCLUSIONS There are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training.
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Affiliation(s)
- Erminia Colucci
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Harry Minas
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anthony F Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, NCNP, Kodaira, Tokyo, Japan
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Kelly CM, Mithen JM, Fischer JA, Kitchener BA, Jorm AF, Lowe A, Scanlan C. Youth mental health first aid: a description of the program and an initial evaluation. Int J Ment Health Syst 2011; 5:4. [PMID: 21272345 PMCID: PMC3041764 DOI: 10.1186/1752-4458-5-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 01/27/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions. METHODS The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries. RESULTS The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were maintained at follow-up. Over the first 3 years of this program, a total of 318 instructors were trained to deliver the course and these instructors have delivered courses to 10,686 people across all states and territories in Australia. The program has also spread to Canada, Singapore and England, and will spread to Hong Kong, Sweden and China in the near future. CONCLUSIONS Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally. TRIAL REGISTRATION ACTRN12609000033246.
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Affiliation(s)
- Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
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Ryan SM, Jorm AF, Kelly CM, Hart LM, Morgan AJ, Lubman DI. Parenting strategies for reducing adolescent alcohol use: a Delphi consensus study. BMC Public Health 2011; 11:13. [PMID: 21210993 PMCID: PMC3022696 DOI: 10.1186/1471-2458-11-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 01/06/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND International concern regarding the increase in preventable harms attributed to adolescent alcohol consumption has led to growing political and medical consensus that adolescents should avoid drinking for as long as possible. For this recommendation to be adopted, parents and guardians of adolescents require information about strategies that they can employ to prevent or reduce their adolescent's alcohol use that are supported by evidence. METHODS The Delphi method was used to obtain expert consensus on parenting strategies effective in preventing and reducing adolescent alcohol consumption. A literature search identified 457 recommendations for parents to reduce their adolescent child's alcohol use. These recommendations were presented to a panel of 38 Australian experts who were asked to rate their importance over three survey rounds. RESULTS There were 289 parenting strategies that were endorsed as important or essential in reducing adolescent alcohol use by ≥90% of the panel. These strategies were categorised into 11 sub-headings: things parents should know about adolescent alcohol use, delaying adolescent's introduction to alcohol, modelling responsible drinking and attitudes towards alcohol, talking to adolescents about alcohol, establishing family rules, monitoring adolescents when unsupervised, preparing adolescents for peer pressure, unsupervised adolescent drinking, what to do when an adolescent has been drinking without parental permission, hosting adolescent parties, and establishing and maintaining a good parent-child relationship. The endorsed strategies were written into a document suitable for parents. CONCLUSIONS A comprehensive set of parenting strategies for preventing or reducing adolescent alcohol consumption were identified. These strategies can be promoted to parents to help them implement national recommendations for use of alcohol by young people.
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Affiliation(s)
- Siobhan M Ryan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Laura M Hart
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Amy J Morgan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
- Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Victoria, Australia
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Minas H, Jorm AF. Where there is no evidence: use of expert consensus methods to fill the evidence gap in low-income countries and cultural minorities. Int J Ment Health Syst 2010; 4:33. [PMID: 21176157 PMCID: PMC3016371 DOI: 10.1186/1752-4458-4-33] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 12/21/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In both developing countries and in relation to cultural minorities there have been calls to scale up mental health services and for evidence-informed policy and practice. EVIDENCE BASED MEDICINE The evidence based medicine movement has had a major influence in improving practice. However, implementation of this approach has some major difficulties. One that has been neglected is the situation where there is no relevant evidence. This situation is more likely to occur for healthcare decisions in developing countries or for cultural minorities within developed countries, because resources do not exist for expensive research studies. CONSENSUS METHODS Consensus methods, such as the Delphi process, can be useful in providing an evidence base in situations where there is insufficient evidence. They provide a way of systematically tapping the expertise of people working in the area and give evidence that is readily applicable for a particular country and culture. Although consensus methods are often thought of as low in the hierarchy of evidence, consensus is central to the scientific process. We present four examples where the Delphi method was used to assess expert consensus in situations where no other evidence existed: estimating the prevalence of dementia in developing countries, developing mental health first aid guidelines in Asian countries, mental health first aid guidelines for Australian Aboriginal people, and modification of the concept of 'recovery' for Australian immigrant communities. CONCLUSION Consensus methods can provide a basis for decision-making and considered action when there is no evidence or when there are doubts about the applicability of evidence that has been generated from other populations or health system settings.
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Affiliation(s)
- Harry Minas
- Centre for International Mental Health, Melbourne School of Population Health, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia
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Colucci E, Kelly CM, Minas H, Jorm AF, Nadera D. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines. Int J Ment Health Syst 2010; 4:32. [PMID: 21167076 PMCID: PMC3017011 DOI: 10.1186/1752-4458-4-32] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 12/20/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND This study aimed to develop guidelines for how a member of the Filipino public should provide mental health first aid to a person who is suicidal. METHODS The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 34 Filipino mental health clinicians to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. RESULTS The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 48 new items were written based on suggestions from panel members and, of these 186 items, 102 met the consensus criterion. These statements were used to develop the guidelines appended to this paper. The guidelines are currently being translated into local languages. CONCLUSIONS There are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings.
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Affiliation(s)
- Erminia Colucci
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Harry Minas
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anthony F Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Dinah Nadera
- Faculty of Management and Development Studies, UP Open University, Los Banos, Laguna, Philippines
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Hart LM, Bourchier SJ, Jorm AF, Kanowski LG, Kingston AH, Stanley D, Lubman DI. Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study. BMC Psychiatry 2010; 10:78. [PMID: 20932326 PMCID: PMC2964528 DOI: 10.1186/1471-244x-10-78] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 10/08/2010] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Problems with substance use are common in some Aboriginal communities. Although problems with substance use are associated with significant mortality and morbidity, many people who experience them do not seek help. Training in mental health first aid has been shown to be effective in increasing knowledge of symptoms and behaviours associated with seeking help. The current study aimed to develop culturally appropriate guidelines for providing mental health first aid to an Aboriginal or Torres Strait Islander person who is experiencing problem drinking or problem drug use (e.g. abuse or dependence). METHODS Twenty-eight Aboriginal health experts participated in two independent Delphi studies (n = 22 problem drinking study, n = 21 problem drug use; 15 participated in both). Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the content. Statements were accepted for inclusion in the guidelines if they were endorsed by ≥ 90% of panellists as either 'Essential' or 'Important'. At the end of the two Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. RESULTS From a total of 735 statements presented over two studies, 429 were endorsed (223 problem drinking, 206 problem drug use). Statements were grouped into sections based on common themes (n = 7 problem drinking, n = 8 problem drug use), then written into guideline documents. Participants evaluated the Delphi method employed, and the guidelines developed, as useful and appropriate for Aboriginal and Torres Strait Islander people. CONCLUSIONS Aboriginal health experts were able to reach consensus about culturally appropriate first aid for problems with substance use. Many first aid actions endorsed in the current studies were not endorsed in previous international Delphi studies, conducted on problem drinking and problem drug use in non-Indigenous people, highlighting the need for culturally specific first aid strategies to be employed when assisting Aboriginal or Torres Strait Islander people.
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Affiliation(s)
- Laura M Hart
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Sarah J Bourchier
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Leonard G Kanowski
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Anna H Kingston
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Donna Stanley
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia,Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Fitzroy, Victoria, Australia
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Abstract
Indigenous peoples often have the worst health status in comparison to non-indigenous people in their own nations; urgent action to address the health inequities for indigenous people is required. The role of rehabilitation in addressing health and disability inequities is particularly important due to the health need of indigenous peoples; the unequal distribution of health determinants; and disparities in access to, quality of care through and outcomes following rehabilitation. This article will present a perspective for Māori, the indigenous peoples of New Zealand, on a framework for improving rehabilitation services for Māori and ultimately their health and wellbeing.
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Affiliation(s)
- Matire Harwood
- Te Kupenga Hauora Maori, Faculty of Medicine and Health Sciences, University of Auckland and Medical Research Institute of new Zealand, Auckland, New Zealand.
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