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Kostenius C, Lindstrom F, Potts C, Pekkari N. Young peoples' reflections about using a chatbot to promote their mental wellbeing in northern periphery areas - a qualitative study. Int J Circumpolar Health 2024; 83:2369349. [PMID: 38912845 PMCID: PMC11198148 DOI: 10.1080/22423982.2024.2369349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 06/13/2024] [Indexed: 06/25/2024] Open
Abstract
An international research collaboration with researchers from northern Sweden, Finland, Ireland, Northern Ireland, Scotland and developed the ChatPal chatbot to explore the possibility of a multilingual chatbot to promote mental wellbeing in people of all ages. In Sweden the end users were young people. The aim of the current study was to explore and discuss Swedish young peoples' experiences of using a chatbot designed to promote their mental wellbeing. Young people aged 15-19 filled out an open-ended survey giving feedback on the ChatPal chatbot and their suggestions on improvements. A total of 122 survey responses were analysed. The qualitative content analysis of the survey responses resulted in three themes each containing two to three sub-themes. Theme 1, feeling as if someone is there when needed, which highlighted positive aspects regarding availability and accessibility. Theme 2, human-robot interaction has its limitations, which included aspects such as unnatural and impersonal conversations and limited content availability. Theme 3, usability can be improved, given technical errors due to lack of internet connection and difficulty navigating the chatbot were brought up as issues. The findings are discussed, and potential implications are offered for those designing and developing digital mental health technologies for young people.
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Affiliation(s)
| | - Frida Lindstrom
- Health Sciences, Luleå University of Technology, Luleå, Sweden
| | | | - Niklas Pekkari
- Health Sciences, Luleå University of Technology, Luleå, Sweden
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McKenna S, Hutcheon A, Gorban C, Song Y, Scott E, Hickie I. Youth Perspectives on 'Highly Personalised and Measurement-Based Care': Qualitative Co-Design of Education Materials. Health Expect 2024; 27:e14137. [PMID: 38976368 PMCID: PMC11229696 DOI: 10.1111/hex.14137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/15/2024] [Accepted: 06/19/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVES Despite high levels of mental ill-health amongst young people (aged 15-30), this group demonstrates low help-seeking and high drop-out from mental health services (MHS). Whilst shared decision-making can assist people in receiving appropriate and effective health care, young people frequently report that they do not feel involved in treatment decisions. The current study focused on co-design of a clinical education and participant information programme for the Brain and Mind Centre Youth Model of Care. This model, which articulates a youth-focused form of highly personalised and measurement-based care, is designed to promote shared decision-making between young people and clinical service providers. METHODS We conducted workshops with 24 young people (16-31; MAge = 21.5) who had accessed mental health services. Participants were asked what advice they would give to young people entering services, before giving advice on existing materials. Workshops were conducted and transcripts were coded using thematic analysis by two lived experience researchers and a clinical researcher. RESULTS Young people found it empowering to be educated on transdiagnostic models of mental illness, namely clinical staging, which gives them a better understanding of why certain treatments may be inappropriate and ineffective, and thus reduce self-blame. Similarly, young people had limited knowledge of links between mental health and other life domains and found it helpful to be educated on multidisciplinary treatment options. Measurement-based care was seen as an important method of improving shared decision-making between young people and health professionals; however, to facilitate shared decision-making, young people also wanted better information on their rights in care and more support to share their expertise in their own needs, values and treatment preferences. CONCLUSIONS These findings will inform the delivery of the further development and implementation of a youth-specific clinical education and participant information programme for the BMC Youth Model. PATIENT OR PUBLIC CONTRIBUTION Workshops were facilitated by researchers with lived expertise in mental ill-health (A.H. and/or C.G.) and a clinical researcher (who has expertise as an academic and a clinical psychologist). A.H. and C.G. were also involved in conceptualisation, analysis, interpretation, review and editing of this paper.
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Affiliation(s)
- Sarah McKenna
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Alexis Hutcheon
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Carla Gorban
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Yun Song
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Elizabeth Scott
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
| | - Ian Hickie
- The Brain and Mind CentreThe University of SydneyCamperdownNew South WalesAustralia
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3
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Mautner D, Valanju R, Al Hadaya I, Barani M, Cross A, McMahon E, Ren B, Rose D, Sharda A, Sinnett A, Yan F, Wardak S. Experiences from youth advisors in chronic disease prevention research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:56. [PMID: 38849959 PMCID: PMC11157720 DOI: 10.1186/s40900-024-00585-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024]
Abstract
Engaging young people in research is a promising approach to tackling issues like chronic disease prevention. Our involvement as youth advisors provided valuable experiences, including being at the forefront of change and learning to work within a research team. Furthermore, our experience provides greater insight and learnings for future youth engagement in research.
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Affiliation(s)
- Dominik Mautner
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Radhika Valanju
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Imeelya Al Hadaya
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Meera Barani
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alexi Cross
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emily McMahon
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bowen Ren
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Dominique Rose
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Aviral Sharda
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alexander Sinnett
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Fulin Yan
- The Health Advisory Panel for Youth at The University of Sydney (HAPYUS), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Sara Wardak
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Level 6, Susan Wakil Building, Sydney, NSW, 2006, Australia.
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4
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Potts C, Lindström F, Bond R, Mulvenna M, Booth F, Ennis E, Parding K, Kostenius C, Broderick T, Boyd K, Vartiainen AK, Nieminen H, Burns C, Bickerdike A, Kuosmanen L, Dhanapala I, Vakaloudis A, Cahill B, MacInnes M, Malcolm M, O'Neill S. A Multilingual Digital Mental Health and Well-Being Chatbot (ChatPal): Pre-Post Multicenter Intervention Study. J Med Internet Res 2023; 25:e43051. [PMID: 37410537 PMCID: PMC10359914 DOI: 10.2196/43051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/30/2022] [Accepted: 01/31/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In recent years, advances in technology have led to an influx of mental health apps, in particular the development of mental health and well-being chatbots, which have already shown promise in terms of their efficacy, availability, and accessibility. The ChatPal chatbot was developed to promote positive mental well-being among citizens living in rural areas. ChatPal is a multilingual chatbot, available in English, Scottish Gaelic, Swedish, and Finnish, containing psychoeducational content and exercises such as mindfulness and breathing, mood logging, gratitude, and thought diaries. OBJECTIVE The primary objective of this study is to evaluate a multilingual mental health and well-being chatbot (ChatPal) to establish if it has an effect on mental well-being. Secondary objectives include investigating the characteristics of individuals that showed improvements in well-being along with those with worsening well-being and applying thematic analysis to user feedback. METHODS A pre-post intervention study was conducted where participants were recruited to use the intervention (ChatPal) for a 12-week period. Recruitment took place across 5 regions: Northern Ireland, Scotland, the Republic of Ireland, Sweden, and Finland. Outcome measures included the Short Warwick-Edinburgh Mental Well-Being Scale, the World Health Organization-Five Well-Being Index, and the Satisfaction with Life Scale, which were evaluated at baseline, midpoint, and end point. Written feedback was collected from participants and subjected to qualitative analysis to identify themes. RESULTS A total of 348 people were recruited to the study (n=254, 73% female; n=94, 27% male) aged between 18 and 73 (mean 30) years. The well-being scores of participants improved from baseline to midpoint and from baseline to end point; however, improvement in scores was not statistically significant on the Short Warwick-Edinburgh Mental Well-Being Scale (P=.42), the World Health Organization-Five Well-Being Index (P=.52), or the Satisfaction With Life Scale (P=.81). Individuals that had improved well-being scores (n=16) interacted more with the chatbot and were significantly younger compared to those whose well-being declined over the study (P=.03). Three themes were identified from user feedback, including "positive experiences," "mixed or neutral experiences," and "negative experiences." Positive experiences included enjoying exercises provided by the chatbot, while most of the mixed, neutral, or negative experiences mentioned liking the chatbot overall, but there were some barriers, such as technical or performance errors, that needed to be overcome. CONCLUSIONS Marginal improvements in mental well-being were seen in those who used ChatPal, albeit nonsignificant. We propose that the chatbot could be used along with other service offerings to complement different digital or face-to-face services, although further research should be carried out to confirm the effectiveness of this approach. Nonetheless, this paper highlights the need for blended service offerings in mental health care.
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Affiliation(s)
- Courtney Potts
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Frida Lindström
- Department of Social Sciences,Technology and Arts, Luleå University of Technology, Luleå, Sweden
| | - Raymond Bond
- School of Computing, Ulster University, Belfast, United Kingdom
| | | | - Frederick Booth
- Department of Accounting, Finance & Economics, Ulster University, Belfast, United Kingdom
| | - Edel Ennis
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Karolina Parding
- Department of Social Sciences,Technology and Arts, Luleå University of Technology, Luleå, Sweden
| | - Catrine Kostenius
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Thomas Broderick
- Department of Sport, Leisure & Childhood Studies, Munster Technological University, Cork, Ireland
| | - Kyle Boyd
- School of Art, Ulster University, Belfast, United Kingdom
| | - Anna-Kaisa Vartiainen
- Department of Social and Health Management, University of Eastern Finland, Kuopio, Finland
| | - Heidi Nieminen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Con Burns
- Department of Sport, Leisure & Childhood Studies, Munster Technological University, Cork, Ireland
| | - Andrea Bickerdike
- Department of Sport, Leisure & Childhood Studies, Munster Technological University, Cork, Ireland
| | - Lauri Kuosmanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Indika Dhanapala
- Nimbus Research Centre, Munster Technological University, Cork, Ireland
| | - Alex Vakaloudis
- Nimbus Research Centre, Munster Technological University, Cork, Ireland
| | - Brian Cahill
- Nimbus Research Centre, Munster Technological University, Cork, Ireland
| | - Marion MacInnes
- Research & Innovation, National Health Service Western Isles, Scotland, United Kingdom
| | - Martin Malcolm
- Public Health Intelligence and Information Services, National Health Service Western Isles, Scotland, United Kingdom
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Coleraine, United Kingdom
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Wells K, Thames AD, Young AS, Zhang L, Heilemann MV, Romero DF, Oliva A, Jones F, Tang L, Brymer M, Elliott T, Arevian A. Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation. JMIR Form Res 2022; 6:e42031. [PMID: 36346902 DOI: 10.2196/42031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic increased disparities for communities burdened by structural barriers such as reduced affordable housing, with mental health consequences. Limited data are available on digital resources for public mental health prevention during the COVID-19 pandemic. OBJECTIVE The study aim was to evaluate engagement in and impact of free digital resources on the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website during COVID-19 in California. METHODS A pilot evaluation of T4W/Juntos was performed, with partner agencies inviting providers, clients, and partners to visit the website and complete surveys at baseline (September 20, 2021, to April 4, 2022) and at 4-6-week follow-up (October 22, 2021, to May 17, 2022). Website use was assessed by three engagement items (ease of use, satisfaction, relevance), comfort in use, and use of six resource categories. Primary outcomes at follow-up were depression and anxiety (scores≥3 on Patient Health Questionnaire-2 item [PHQ2] and Generalized Anxiety Disorder-2 item [GAD2] scales). Secondary outcomes were post-pre differences in PHQ2 and GAD2 scores, and use of behavioral health hotlines and services the month before follow-up. RESULTS Of 366 eligible participants, 315 (86.1%) completed baseline and 193 (61.3%) completed follow-up surveys. Of baseline participants, 72.6% identified as female, and 21.3% identified as lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+). In terms of ethnicity, 44.0% identified as Hispanic, 17.8% as African American, 26.9% as non-Hispanic white, and 11.4% as other ethnicity. Overall, 32.7% had moderate anxiety or depression (GAD2/PHQ2≥3) at baseline. Predictors of baseline website engagement included being Hispanic versus other race/ethnicity (β=.27, 95% CI .10-.44; P=.002) and number of COVID-19-related behavior changes (β=.09, 95% CI .05-.13; P<.001). Predictors of comfort using the website were preferring English for website use (odds ratio [OR] 5.57, 95% CI 2.22-13.96; P<.001) and COVID-19-related behavior changes (OR 1.37, 95% CI 1.12-1.66; P=.002); receiving overnight behavioral health treatment in the prior 6 months (OR 0.15, 95% CI 0.03-0.69, P=.015) was associated with less comfort in website use. The main predictor of depression at follow-up (PHQ2≥3) was baseline depression (OR 6.24, 95% CI 2.77-14.09; P<.001). Engagement in T4W/Juntos was associated with lower likelihood of depression (OR 0.54, 95% CI 0.34-0.86; P=.01). Website use the month before follow-up was associated with a post-pre reduction in PHQ2 score (β=-.62, 95% CI -1.04 to -0.20; P=.004). The main predictor of GAD2≥3 at follow-up was baseline GAD2≥3 (OR 13.65, 95% CI 6.06-30.72; P<.001). Greater baseline website engagement predicted reduced hotline use (OR 0.36, 95% CI 0.18-0.71; P=.004). CONCLUSIONS Ethnicity/language and COVID-19-related behavior changes were associated with website engagement; engagement and use predicted reduced follow-up depression and behavioral hotline use. Findings are based on participants recommended by community agencies with moderate follow-up rates; however, significance was similar when weighting for nonresponse. This study may inform research and policy on digital mental health prevention resources.
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Affiliation(s)
- Kenneth Wells
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - April Denise Thames
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexander S Young
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lily Zhang
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - MarySue V Heilemann
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Daniela Flores Romero
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adrian Oliva
- Healthy African American Families II, Los Angeles, CA, United States
| | - Felica Jones
- Healthy African American Families II, Los Angeles, CA, United States
| | - Lingqi Tang
- Research Center for Health Services and Society, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Melissa Brymer
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Thomas Elliott
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Armen Arevian
- Chorus Innovations, Inc, Long Beach, CA, United States
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Balcombe L, De Leo D. Linking music streaming platform advertisements with a digital mental health assessment and interventions. Front Digit Health 2022; 4:964251. [PMID: 36419871 PMCID: PMC9677233 DOI: 10.3389/fdgth.2022.964251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
Accessibility issues and low rates of help-seeking hinder engagement with mental health resources and treatment. Pragmatic, (cost-)effective solutions are required to increase engagement with efficacious digital mental health interventions (DMHIs) including for hard-to-reach individuals. As an example, music-based interventions have been positively used in health care to reduce stress, anxiety and depression through music medicine, music therapy and recreational use. Although, enhanced mental health awareness from music listening has yet to be converted into engagement with a DMH assessment (DMHA) and DMHIs. Therefore, a new study is proposed to place linked advertisements on Spotify, the most used music streaming platform. MindSpot's vetted DMHA is suitable to use as an example for linking unto because it measures depression, anxiety, general mental well-being problems and psychological distress in Australian adults and provides access to DMHIs. The primary aim is to provide a convenient, robust and scalable consumer pathway to reduce engagement barriers and maximize facilitation to a vetted DMHA and DMHIs. The proposed study is important because it addresses notorious help-seeking difficulties in the adult population (e.g., young people and men). It also expands outreach to the underserved and the unserved and streamlines the integration of digital solutions with mental health services.
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Bell IH, Thompson A, Valentine L, Adams S, Alvarez-Jimenez M, Nicholas J. Ownership, Use of, and Interest in Digital Mental Health Technologies Among Clinicians and Young People Across a Spectrum of Clinical Care Needs: Cross-sectional Survey. JMIR Ment Health 2022; 9:e30716. [PMID: 35544295 PMCID: PMC9133993 DOI: 10.2196/30716] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/14/2021] [Accepted: 12/22/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is currently an increased interest in and acceptance of technology-enabled mental health care. To adequately harness this opportunity, it is critical that the design and development of digital mental health technologies be informed by the needs and preferences of end users. Despite young people and clinicians being the predominant users of such technologies, few studies have examined their perspectives on different digital mental health technologies. OBJECTIVE This study aims to understand the technologies that young people have access to and use in their everyday lives and what applications of these technologies they are interested in to support their mental health. The study also explores the technologies that youth mental health clinicians currently use within their practice and what applications of these technologies they are interested in to support their clients' mental health. METHODS Youth mental health service users (aged 12-25 years) from both primary and specialist services, young people from the general population (aged 16-25 years), and youth mental health clinicians completed a web-based survey exploring technology ownership, use of, and interest levels in using different digital interventions to support their mental health or that of their clients. RESULTS A total of 588 young people and 73 youth mental health clinicians completed the survey. Smartphone ownership or private access among young people within mental health services and the general population was universal (611/617, 99%), with high levels of access to computers and social media. Youth technology use was frequent, with 63.3% (387/611) using smartphones several times an hour. Clinicians reported using smartphones (61/76, 80%) and video chat (69/76, 91%) commonly in clinical practice and found them to be helpful. Approximately 50% (296/609) of the young people used mental health apps, which was significantly less than the clinicians (χ23=28.8, n=670; P<.001). Similarly, clinicians were significantly more interested in using technology for mental health support than young people (H3=55.90; P<.001), with 100% (73/73) of clinicians being at least slightly interested in technology to support mental health compared with 88% (520/591) of young people. Follow-up tests revealed no difference in interest between young people from the general population, primary mental health services, and specialist mental health services (all P>.23). Young people were most interested in web-based self-help, mobile self-help, and blended therapy. CONCLUSIONS Technology access is pervasive among young people within and outside of youth mental health services; clinicians are already using technology to support clinical care, and there is widespread interest in digital mental health technologies among these groups of end users. These findings provide important insights into the perspectives of young people and clinicians regarding the value of digital mental health interventions in supporting youth mental health.
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Affiliation(s)
- Imogen H Bell
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Andrew Thompson
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Lee Valentine
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | | | - Mario Alvarez-Jimenez
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Jennifer Nicholas
- Orygen, Parkville, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
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8
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Dohnt HC, Dowling MJ, Davenport TA, Lee G, Cross SP, Scott EM, Song YJC, Hamilton B, Hockey SJ, Rohleder C, LaMonica HM, Hickie IB. Supporting Clinicians to Use Technology to Deliver Highly Personalized and Measurement-Based Mental Health Care to Young People: Protocol for an Evaluation Study. JMIR Res Protoc 2021; 10:e24697. [PMID: 34125074 PMCID: PMC8240796 DOI: 10.2196/24697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/22/2020] [Accepted: 01/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Australia's mental health care system has long been fragmented and under-resourced, with services falling well short of demand. In response, the World Economic Forum has recently called for the rapid deployment of smarter, digitally enhanced health services to facilitate effective care coordination and address issues of demand. The University of Sydney's Brain and Mind Centre (BMC) has developed an innovative digital health solution that incorporates 2 components: a highly personalized and measurement-based (data-driven) model of youth mental health care and a health information technology (HIT) registered on the Australian Register of Therapeutic Goods. Importantly, research into implementation of such solutions considers education and training of clinicians to be essential to adoption and optimization of use in standard clinical practice. The BMC's Youth Mental Health and Technology Program has subsequently developed a comprehensive education and training program to accompany implementation of the digital health solution. OBJECTIVE This paper describes the protocol for an evaluation study to assess the effectiveness of the education and training program on the adoption and optimization of use of the digital health solution in service delivery. It also describes the proposed tools to assess the impact of training on knowledge and skills of mental health clinicians. METHODS The evaluation study will use the Kirkpatrick Evaluation Model as a framework with 4 levels of analysis: Reaction (to education and training), Learning (knowledge acquired), Behavior (practice change), and Results (client outcomes). Quantitative and qualitative data will be collected using a variety of tools, including evaluation forms, pre- and postknowledge questionnaires, skill development and behavior change scales, as well as a real-time clinical practice audit. RESULTS This project is funded by philanthropic funding from Future Generation Global. Ethics approval has been granted via Sydney Local Health District's Human Research Ethics Committee. At the time of this publication, clinicians and their services were being recruited to this study. The first results are expected to be submitted for publication in 2021. CONCLUSIONS The education and training program teaches clinicians the necessary knowledge and skills to assess, monitor, and manage complex needs; mood and psychotic syndromes; and trajectories of youth mental ill-health using a HIT that facilitates a highly personalized and measurement-based model of care. The digital health solution may therefore guide clinicians to help young people recover low functioning associated with subthreshold diagnostic presentations and prevent progression to more serious mental ill-health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/24697.
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Affiliation(s)
| | | | | | - Grace Lee
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Shane P Cross
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | | | - Yun Ju C Song
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Blake Hamilton
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Samuel J Hockey
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Cathrin Rohleder
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
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9
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Iorfino F, Piper SE, Prodan A, LaMonica HM, Davenport TA, Lee GY, Capon W, Scott EM, Occhipinti JA, Hickie IB. Using Digital Technologies to Facilitate Care Coordination Between Youth Mental Health Services: A Guide for Implementation. FRONTIERS IN HEALTH SERVICES 2021; 1:745456. [PMID: 36926493 PMCID: PMC10012639 DOI: 10.3389/frhs.2021.745456] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022]
Abstract
Enhanced care coordination is essential to improving access to and navigation between youth mental health services. By facilitating better communication and coordination within and between youth mental health services, the goal is to guide young people quickly to the level of care they need and reduce instances of those receiving inappropriate care (too much or too little), or no care at all. Yet, it is often unclear how this goal can be achieved in a scalable way in local regions. We recommend using technology-enabled care coordination to facilitate streamlined transitions for young people across primary, secondary, more specialised or hospital-based care. First, we describe how technology-enabled care coordination could be achieved through two fundamental shifts in current service provisions; a model of care which puts the person at the centre of their care; and a technology infrastructure that facilitates this model. Second, we detail how dynamic simulation modelling can be used to rapidly test the operational features of implementation and the likely impacts of technology-enabled care coordination in a local service environment. Combined with traditional implementation research, dynamic simulation modelling can facilitate the transformation of real-world services. This work demonstrates the benefits of creating a smart health service infrastructure with embedded dynamic simulation modelling to improve operational efficiency and clinical outcomes through participatory and data driven health service planning.
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Affiliation(s)
- Frank Iorfino
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Sarah E Piper
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Ante Prodan
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia.,School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, NSW, Australia
| | - Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | | | - Grace Yeeun Lee
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - William Capon
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Elizabeth M Scott
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Jo-An Occhipinti
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
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