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Santa K, Dixon C, Ganga RN, Trainor G, Smith G, Furfie V, Brown H. Facilitating Access to Mental Health Services: A Stakeholder-Driven Improvement of the Children and Young People (CYP) as One Referral Platform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:784. [PMID: 38929030 PMCID: PMC11203779 DOI: 10.3390/ijerph21060784] [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: 03/05/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
(1) Background: Pre-pandemic, child and adolescent mental health service (CAMHS) referrals were paper based in Liverpool and Sefton (England, United Kingdom), causing delays in waiting times. The "CYP as One" online mental health referral platform was co-created to overcome these challenges. (2) Methods: This study aims to improve "CYP as One" accessibility and usability and, subsequently, support CAMHS to improve waiting times. The current study utilised the Living Lab approach. We conducted content analysis on completed online referrals extracted from the "CYP as One" platform. These findings were supplemented by seven online focus groups, with 16-19-year-old young people, parents of children under 16, and health service providers. Thematic analysis was conducted on all data. (3) Results: The thematic analysis returned seven themes, namely (i) "CYP as One" vs. Traditional Referrals, (ii) Gender and Language Dynamics, (iii) Digital Empathy in Action, (iv) the Influence of the Provider Perspective, (v) Age and Social Sensitivity, (vi) Enhancing Access to Information, and (vii) Boosting Admin and Clinical Efficiency. (4) Conclusions: Digital content that seeks to replace in-person referrals can provide adequate support to children and young people who have faced difficulties accessing mental health services.
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Affiliation(s)
- Kristof Santa
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Chloe Dixon
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Rafaela Neiva Ganga
- Liverpool Business School, Faculty of Business and Law, Liverpool John Moores University, Liverpool L1 2TZ, UK
| | - Gemma Trainor
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Grahame Smith
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | | | - Holly Brown
- Alder Hey Children’s Hospital, Liverpool L14 5AB, UK
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Lim B, Newnham EA, Lobo R. An Exploration of Satisfaction with Mental Health Counseling Services in Western Australia Among Sexuality and Gender Diverse Youth. JOURNAL OF HOMOSEXUALITY 2024:1-26. [PMID: 38833639 DOI: 10.1080/00918369.2024.2360611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Clinically significant psychological distress affects approximately 29.3% of Australian adolescents and 80.6% of sexuality and/or gender diverse youth (SGD-Y). Often, SGD-Y experience inadequate access and lower satisfaction with mental health services, stemming from age- and sexuality and/or gender diversity-status. Accordingly, exploration of factors affecting SGD-Y's access to, and satisfaction with, mental health services is critical. Using a social constructionist lens, we explored factors supporting SGD-Y's satisfaction with mental health services, and how these needs are or could be met. Seven LGBTQA+ youth aged 15 to 21 who received counseling in Western Australia in the last year, recruited via a university student participant pool and community organizations, participated in semi-structured interviews via video-conference, phone call, or SMS. Reflexive thematic analysis was inductively applied to participants' verbatim accounts. Satisfaction was tied to participants' sense of control over their healthcare-system experiences, shaped by four themes: person-centered support during the service-access process, resources to guide the search for services, confidence in therapists, and healthcare-system organization. Practices and policies supporting SGD-Y's self-determination during their service access may allow for empowering and personally meaningful therapeutic experiences. Developers of policies and initiatives may need to adopt a systems approach to foster SGD-Y's self-determination as they access services.
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Affiliation(s)
- Bruce Lim
- School of Population Health, Curtin University, Bentley, Western Australia
| | - Elizabeth A Newnham
- School of Population Health, Curtin University, Bentley, Western Australia
- Curtin EnAble Institute, Curtin University, Bentley, Western Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, Western Australia
- Curtin EnAble Institute, Curtin University, Bentley, Western Australia
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Berardi C, Antonini M, Jordan Z, Wechtler H, Paolucci F, Hinwood M. Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework. BMC Health Serv Res 2024; 24:243. [PMID: 38408938 PMCID: PMC10898174 DOI: 10.1186/s12913-023-10536-1] [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: 02/04/2023] [Accepted: 12/28/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. METHODS We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. RESULTS Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients' intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. CONCLUSION It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. PROTOCOL REGISTRATION The protocol is registered on PROSPERO, CRD42021276838.
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Affiliation(s)
- Chiara Berardi
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia.
| | - Marcello Antonini
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK
| | - Zephanie Jordan
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Heidi Wechtler
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Francesco Paolucci
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Madeleine Hinwood
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Namata C, Hatzidimitriadou E. Strategies for improving access to primary care services for homeless immigrants in England: a Delphi study. Prim Health Care Res Dev 2023; 24:e70. [PMID: 38093561 PMCID: PMC10790723 DOI: 10.1017/s1463423623000646] [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: 06/27/2023] [Revised: 09/22/2023] [Accepted: 11/05/2023] [Indexed: 12/18/2023] Open
Abstract
AIM The aim of the study was to identify the most prioritized strategies in improving access to primary care services (PCS) for homeless immigrants. BACKGROUND The issue of improving access to PCS for homeless immigrants is a complex and multifaceted one, and yet there is limited research on the strategies aimed at improving these services. Hence, the need for more studies that directly engage homeless immigrants and service providers in understanding their barriers to accessing PCS and their preferences for improving access to these services. METHODS The study used a two round Delphi method to elicit the views of stakeholders. The Delphi process utilized a web-based questionnaire. The stakeholders included healthcare providers and voluntary sector providers. The first round had a total of 58 items belonging to 14 categories. The second round comprised a total of 25 items belonging to 12 categories which were preselected based on participants' ranking of their importance in the first round. Participants were required to rank the relative importance of all the items on a 5-point Likert scale. Data were analysed using the STATA-15 software package. FINDINGS A total of 12 stakeholders participated in both rounds of the Delphi survey. The top three strategies encompassed fighting against discrimination and prejudice, improving and promoting mental health services, and empowering homeless immigrants. These evidence-based strategies hold the potential to support the implementation of healthcare interventions aimed at improving access to PCS and healthcare outcomes for homeless immigrants. However, it is crucial to conduct further research that includes homeless immigrants in the Delphi study to gain insights into the strategies that are most important to them in enhancing access to PCS, as they are the primary target users. Such research will contribute to the development of comprehensive and effective interventions tailored to the specific needs of homeless.
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Affiliation(s)
- Carol Namata
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, England
| | - Eleni Hatzidimitriadou
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, England
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Ali AZ, Wright B, Curran JA, Newton AS. Review: Patient engagement in child, adolescent, and youth mental health care research - a scoping review. Child Adolesc Ment Health 2023; 28:524-535. [PMID: 36494910 DOI: 10.1111/camh.12615] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Youth and children's lived experiences are rarely considered in studies seeking to improve or evaluate their mental health care. We conducted a scoping review to identify approaches to child, adolescent, and youth engagement in mental health studies as well as study-reported barriers, constraints, and facilitators to engagement. METHOD We systematically searched six electronic databases for literature. We included studies of mental health care service design, development, or evaluation that involved engagement of children, adolescents, and/or youth with mental disorders or who intentionally self-harm. Studies could be of any design as long as patient engagement was used at any point during its design and/or conduct. Engagement could include co-designing health services/interventions and/or participating as a co-researcher. We assessed the reporting of patient engagement using the Guidance for Reporting Involvement of Patients and the Public 2 Long-Form (GRIPP2-LF) checklist and used the Experience Based Co-design (EBCD) framework to guide data extraction and analysis. RESULTS Sixteen articles were included in the review. Most studies used engagement to develop or adapt a mental health service (75%) and utilized a participatory or co-design approach (69%). Participants were namely adolescents and youth (aged 10-24 years) with some studies including young adults (up to 29 years old). Most studies followed less than 50% of the EBCD framework, and the commonly reported study barriers were related to aspects addressed in EBCD: time restrictions, recruitment, and generalizability. Frequently reported study facilitators included study methodology, youth engagement, and having a diverse participant sample. CONCLUSIONS Findings from this review suggest that the EBCD framework is not commonly used to guide patient engagement in studies of mental health care services. Future initiatives should consider following the framework to ensure meaningful evaluation and improvements to youth and children's mental health care services.
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Affiliation(s)
- Amber Z Ali
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Bruce Wright
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Janet A Curran
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Amanda S Newton
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Hasnain A, Hajek J, Borschmann R. Impact of Cultural and Linguistic Maintenance on Mental Health Outcomes in Migrant Adolescents: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e40143. [PMID: 37338960 DOI: 10.2196/40143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND There is no consensus on how the disruption or maintenance of heritage culture and language affect mental health outcomes in adolescents with a migrant (also known as "immigrant" or "international migrant") background. Even though previous literature reviews have investigated the association between acculturation and mental health in migrants, none have explicitly focused on adolescents. OBJECTIVE The aim of the scoping review described in this protocol is to understand (1) the focus, scope, and nature of quantitative empirical research investigating heritage cultural maintenance, including linguistic maintenance, and mental health outcomes in adolescents with a migrant background worldwide and (2) the potential effects of cultural and linguistic maintenance or disruption on migrant adolescent mental health outcomes. METHODS A total of 11 key electronic health, medical, social science, and language databases (APA PsycArticles Full Text; Embase Classic+Embase; Ovid MEDLINE All and Epub Ahead of Print, In-Process, In-Data-Review and Other Non-Indexed Citations and Daily; Ovid MEDLINE All; APA PsycInfo; University of Melbourne full-text journals; Science Citation Index Expanded; Social Sciences Citation Index; Arts & Humanities Citation Index; Scopus; Linguistics and Language Behavior Abstracts) were searched. Databases were searched without time restrictions from the beginning of their coverage. Publication date, location, and quantitative study design (except for literature reviews) were not restricted; however, the search was only conducted in English. Data from included studies will be extracted using a template with predefined data items, and results will be summarized in a structured, narrative summary. RESULTS A search was conducted on April 20, 2021, returning 2569 results. We are currently at the final stages of screening titles and abstracts of our search results, which will be followed by a full-text review and the data extraction of included studies. We expect to submit the full review for publication by the end of 2023. CONCLUSIONS The scoping review aims to provide a better understanding of existing research on the association between cultural (including linguistic) maintenance and mental health in migrant adolescents. It will help identify gaps in the existing literature and develop hypotheses that could inform future research, eventually facilitating the development of targeted prevention initiatives and improving migrant adolescents' well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40143.
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Affiliation(s)
- Anila Hasnain
- Research Unit for Multilingualism and Cross-Cultural Communication, School of Languages and Linguistics, University of Melbourne, Melbourne, Australia
| | - John Hajek
- Research Unit for Multilingualism and Cross-Cultural Communication, School of Languages and Linguistics, University of Melbourne, Melbourne, Australia
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- School of Population Health, Curtin University, Perth, Australia
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Kegel F, Greve M, Schnell K, Stein M, Kolbe LM. Co-Creative Vermittlungsplattformen für die Psychische Gesundheitsversorgung. HMD PRAXIS DER WIRTSCHAFTSINFORMATIK 2022. [PMCID: PMC9632594 DOI: 10.1365/s40702-022-00925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ZusammenfassungIm deutschen Gesundheitswesen nimmt die Versorgung psychischer Störungen eine immer wichtigere Rolle ein. Nicht erst seit dem Beginn der Corona-Pandemie steigt die Zahl der Menschen mit psychischen Erkrankungen deutlich an. Damit gehen sowohl wirtschaftliche als auch persönliche Herausforderungen einher.Dieser Artikel leistet einen Beitrag zur digitalen Transformation im Gesundheitswesen, indem eine konzeptionelle Analyse der Vermittlungsproblematik in der psychischen Gesundheitsversorgung vorgenommen wird. Die Studie zeigt, dass digitale Plattformen die Möglichkeit bieten, den bisherigen undurchsichtigen Angebotsmarkt zu strukturieren, Betroffenen sowie deren Angehörigen passende online und offline Versorgungs- und Unterstützungsangebote niederschwellig zugänglich zu machen und die Patient*innenreise sinnvoll zu erweitern. Die Ergebnisse verdeutlichen die Notwendigkeit der Berücksichtigung der Eigenschaften Regionalität, Inklusion und Kollaboration der Plattform sowie die der Umsetzung mit Hilfe co-creativer Methodiken. Zusammenfassend stellt die Studie eine umfassende und kontextualisierte Konzeption einer Vermittlungsplattform dar, und liefert damit sowohl für den wissenschaftlichen Diskurs im Bereich Gesundheits-IT als auch für Stakeholder aus der Praxis relevante Anhaltspunkte für die Gestaltung und Konzeption zukünftiger Plattformen.
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Hsieh HL, Lai JM, Chuang BK, Tsai CH. Determinants of Telehealth Continuance Intention: A Multi-Perspective Framework. Healthcare (Basel) 2022; 10:healthcare10102038. [PMID: 36292485 PMCID: PMC9601836 DOI: 10.3390/healthcare10102038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 11/04/2022] Open
Abstract
Owing to the COVID-19 pandemic, many countries’ physicians in the world have used telehealth to visit patients via telehealth. The study aimed to integrate the theory of planned behavior (TPB), the technology acceptance model (TAM), and self-determination theory (SDT) to explore the adoption behavior of a telehealth system. A convenient sample of residents was drawn from the population of Nantou County in Taiwan and analyzed via structural equation modeling. The findings revealed that attitude, perceived behavioral control, perceived usefulness, and perceived autonomy support jointly have significantly positive effects on continuance intention. Results also confirmed that perceived autonomy support, perceived ease of use, and perceived usefulness jointly have significantly positive effects on attitude. Furthermore, this study also showed that a crucial mediators’ role is played by perceived ease of use, perceived usefulness, and attitude. The conclusions and practical implications of the research will hopefully provide health organizations and institutions with some innovative insights and foresights, which in turn will promote better practices and services of telehealth technology.
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Affiliation(s)
| | - Jhih-Ming Lai
- Department of Information Technology and Management, Tzu Chi University of Science and Technology, Hualien 973302, Taiwan
| | | | - Chung-Hung Tsai
- Department of Information Technology and Management, Tzu Chi University of Science and Technology, Hualien 973302, Taiwan
- Correspondence:
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Chelberg GR, Butten K, Mahoney R. Culturally Safe eHealth Interventions With Aboriginal and Torres Strait Islander People: Protocol for a Best Practice Framework. JMIR Res Protoc 2022; 11:e34904. [PMID: 35687420 PMCID: PMC9233256 DOI: 10.2196/34904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/26/2022] [Accepted: 05/20/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There is growing global evidence on the adoption and effectiveness of eHealth (including mobile health and telehealth) by First Nation peoples including Aboriginal and Torres Strait Islander people. Although there are frameworks to guide eHealth development, implementation, and evaluation, it is unknown whether they adequately encapsulate the health, cultural, and community-related priorities of Aboriginal and Torres Strait Islander people. OBJECTIVE The aim of this research program is to prepare a best practice framework that will guide the co-design, implementation, and evaluation of culturally safe eHealth interventions within existing models of health care for Aboriginal and Torres Strait Islander people. The framework will be a synthesis of evidence that represents best practices in eHealth, as determined by Aboriginal and Torres Strait Islander people. METHODS Research activities to develop the best practice framework will occur in stepped but overlapping qualitative research phases with governance from an existing multiagency research collaboration (the Collaboration). The research protocol has been informed by key research frameworks such as the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and Developers of Health Research Reporting Guidelines. The seven phases of research will include the following: systematic literature review, scoping review, theme development, theme consultation, Delphi processes for expert reviews, and dissemination. RESULTS Members of the Collaboration conceived this research program in August 2020, and a draft was produced in June 2021 with subsequent funding obtained in July 2021. The Collaboration approved the protocol in December 2021. Results for several research phases of the best practice framework development are expected by January 2023, commencing with the systematic literature review and the scoping review. CONCLUSIONS The research program outlined in this protocol is a timely response to the growing number of eHealth interventions with Aboriginal and Torres Strait Islander people. A best practice framework is needed to guide the rigorous development and evaluation of eHealth innovations to promote genuine co-design and ensure cultural safety and clinical effectiveness for Aboriginal and Torres Strait Islander people. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/34904.
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Affiliation(s)
- Georgina R Chelberg
- Australian E-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Australia.,Centre for Online Health, The University of Queensland, Woolloongabba, Australia
| | - Kaley Butten
- Australian E-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Australia
| | - Ray Mahoney
- Australian E-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Australia.,School of Public Health, The University of Queensland, Herston, Australia
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Cluley V, Ziemann A, Feeley C, Olander EK, Shamah S, Stavropoulou C. Mapping the role of patient and public involvement during the different stages of healthcare innovation: A scoping review. Health Expect 2022; 25:840-855. [PMID: 35174585 DOI: 10.1111/hex.13437] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patient and public involvement (PPI) has become increasingly important in the development, delivery and improvement of healthcare. PPI is used in healthcare innovation; yet, how it is used has been under-reported. The aim of this scoping review is to identify and map the current available empirical evidence on the role of PPI during different stages of healthcare innovation. METHODS The scoping review was conducted in accordance with PRISMAScR and included any study published in a peer-reviewed journal between 2004 and 2021 that reported on PPI in healthcare innovation within any healthcare setting or context in any country. The following databases were searched: Medline, EMBASE, CINAHL, PsycInfo, HMIC and Google Scholar. We included any study type, including quantitative, qualitative and mixed-method studies. We excluded theoretical frameworks, conceptual, scientific or grey literature as well as discussion and opinion papers. RESULTS Of the 87 included studies, 81 (93%) focused on or were conducted by authors in developed countries. A wide range of conditions were considered, with more studies focusing on mental health (n = 18, 21%) and cancer care (n = 8, 9%). The vast majority of the studies focused on process and service innovations (n = 62, 71%). Seven studies focused on technological and clinical innovations (8%), while 12 looked at both technological and service innovations (14%). Only five studies examined systems innovation (5%) and one study looked across all types of innovations (1%). PPI is more common in the earlier stages of innovation, particularly problem identification and invention, in comparison to adoption and diffusion. CONCLUSION Healthcare innovation tends to be a lengthy process. Yet, our study highlights that PPI is more common across earlier stages of innovation and focuses mostly on service innovation. Stronger PPI in later stages could support the adoption and diffusion of innovation. PATIENT OR PUBLIC CONTRIBUTION One of the coauthors of the paper (S. S.) is a service user with extensive experience in PPI research. S. S. supported the analysis and writing up of the paper.
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Affiliation(s)
- Victoria Cluley
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Alexandra Ziemann
- Centre for Healthcare Innovation Research, City, University of London, London, UK
| | - Claire Feeley
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Shani Shamah
- Service-User, Research (Public Patient Involvement) Consultant, Independent, London, UK
| | - Charitini Stavropoulou
- Centre for Healthcare Innovation Research, City, University of London, London, UK.,School of Health Sciences, City, University of London, London, UK
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Wiebe DE, Remers S, Nippak P, Meyer J. Evaluation of an Online System for Routine Outcome Monitoring: Cross-sectional Survey Study. JMIR Ment Health 2021; 8:e29243. [PMID: 34855615 PMCID: PMC8686458 DOI: 10.2196/29243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/13/2021] [Accepted: 08/27/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The use of routine outcome monitoring (ROM) in the treatment of mental health has emerged as a method of improving psychotherapy treatment outcomes. Despite this, very few clinicians regularly use ROM in clinical practice. Online ROM has been suggested as a solution to increase adoption. OBJECTIVE The aim of this study is to identify the influence of moving ROM online on client completion rates of self-reported outcome measures and to identify implementation and utilization barriers to online ROM by assessing clinicians' views on their experience using the online system over previous paper-based methods. METHODS Client completion rates of self-reported outcome measures were compared pre- and postimplementation of an online system of ROM. In addition, a survey questionnaire was administered to 324 mental health service providers regarding their perception of the benefits with an online system of ROM. RESULTS Client completion rates of self-reported measures increased from 15.62% (427/2734) to 53.98% (1267/2347) after they were moved online. Furthermore, 57% (56/98) of service providers found the new system less time-consuming than the previous paper-based ROM, and 64% (63/98) found that it helped monitor clients. However, the perceived value of the system remains in doubt as only 23% (23/98) found it helped them identify clients at risk for treatment failure, and only 18% (18/98) found it strengthened the therapeutic alliance. CONCLUSIONS Although the current study suggests mixed results regarding service providers' views on their experience using an online system for ROM, it has identified barriers and challenges that are actionable for improvement.
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Affiliation(s)
- Deanna E Wiebe
- Department of Health Services Management, Ryerson University, Toronto, ON, Canada
| | | | - Pria Nippak
- Department of Health Services Management, Ryerson University, Toronto, ON, Canada
| | - Julien Meyer
- Department of Health Services Management, Ryerson University, Toronto, ON, Canada
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12
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Bunyi J, Ringland KE, Schueller SM. Accessibility and Digital Mental Health: Considerations for More Accessible and Equitable Mental Health Apps. Front Digit Health 2021; 3:742196. [PMID: 34713206 PMCID: PMC8521906 DOI: 10.3389/fdgth.2021.742196] [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: 07/15/2021] [Accepted: 09/02/2021] [Indexed: 01/18/2023] Open
Abstract
Digital mental health is often touted as a solution to issues of access to mental health care. However, there has been little research done to understand the accessibility of digital mental health, especially for those with disabilities. In this piece, we define accessibility as it relates to mental health apps, describe the current state of accessibility in the digital world broadly and in mental health apps more specifically, outline why accessibility matters in mental health apps, and identify future steps to better incorporate accessibility into research and development of mental health apps.
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Affiliation(s)
- John Bunyi
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Kathryn E Ringland
- Computational Media Department, University of California, Santa Cruz, Santa Cruz, CA, United States
| | - Stephen M Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States.,Department of Informatics, University of California, Irvine, Irvine, CA, United States
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LaMonica HM, Roberts AE, Lee GY, Davenport TA, Hickie IB. Privacy Practices of Health Information Technologies: Privacy Policy Risk Assessment Study and Proposed Guidelines. J Med Internet Res 2021; 23:e26317. [PMID: 34528895 PMCID: PMC8485195 DOI: 10.2196/26317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/15/2021] [Accepted: 05/04/2021] [Indexed: 01/09/2023] Open
Abstract
Background Along with the proliferation of health information technologies (HITs), there is a growing need to understand the potential privacy risks associated with using such tools. Although privacy policies are designed to inform consumers, such policies have consistently been found to be confusing and lack transparency. Objective This study aims to present consumer preferences for accessing privacy information; develop and apply a privacy policy risk assessment tool to assess whether existing HITs meet the recommended privacy policy standards; and propose guidelines to assist health professionals and service providers with understanding the privacy risks associated with HITs, so that they can confidently promote their safe use as a part of care. Methods In phase 1, participatory design workshops were conducted with young people who were attending a participating headspace center, their supportive others, and health professionals and service providers from the centers. The findings were knowledge translated to determine participant preferences for the presentation and availability of privacy information and the functionality required to support its delivery. Phase 2 included the development of the 23-item privacy policy risk assessment tool, which incorporated material from international privacy literature and standards. This tool was then used to assess the privacy policies of 34 apps and e-tools. In phase 3, privacy guidelines, which were derived from learnings from a collaborative consultation process with key stakeholders, were developed to assist health professionals and service providers with understanding the privacy risks associated with incorporating HITs as a part of clinical care. Results When considering the use of HITs, the participatory design workshop participants indicated that they wanted privacy information to be easily accessible, transparent, and user-friendly to enable them to clearly understand what personal and health information will be collected and how these data will be shared and stored. The privacy policy review revealed consistently poor readability and transparency, which limited the utility of these documents as a source of information. Therefore, to enable informed consent, the privacy guidelines provided ensure that health professionals and consumers are fully aware of the potential for privacy risks in using HITs to support health and well-being. Conclusions A lack of transparency in privacy policies has the potential to undermine consumers’ ability to trust that the necessary measures are in place to secure and protect the privacy of their personal and health information, thus precluding their willingness to engage with HITs. The application of the privacy guidelines will improve the confidence of health professionals and service providers in the privacy of consumer data, thus enabling them to recommend HITs to provide or support care.
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Affiliation(s)
- Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Anna E Roberts
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Grace Yeeun Lee
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | | | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia
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