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Khan BN, Chu C, Brual J, Dang-Nguyen M, Oladimeji A, Kthupi A, Bolea-Alamañac B, Tadrous M, O'Riordan A, Rubenstein D, Carlin K, Longum P, Gibson D, Abejirinde IOO. An Observational Study of a Digital Substance Use and Recovery Program. Psychiatr Serv 2024:appips20230427. [PMID: 38982834 DOI: 10.1176/appi.ps.20230427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
OBJECTIVE Digital substance use treatment programs present an opportunity to provide nonresidential care for people with problematic substance use. In June 2021, the provincial government in Ontario provided free access to Breaking Free Online (BFO), a digital behavioral change program for people with substance use disorders. METHODS An observational study was conducted with retrospective data to characterize clients' use and engagement patterns in BFO and examine changes in self-reported outcomes. RESULTS In total, 6,370 individuals registered for BFO between June 2021 and October 2022, of whom 3,650 completed the intake assessment. Most of these clients were self-referred (64%), with 37% having been referred by health service providers. More than one-half of the clients (52%) resided in Ontario West or East regions. Support for addressing problematic alcohol use was the most requested program (40%). By October 2022, about 44% of the clients had completed between one and four of 12 program strategies. Analysis revealed significant changes in pre-post scores across four validated scales (p<0.001), indicating a decrease in anxiety and depression, an increase in quality of life, an improvement in recovery progression, and a decrease in severity of symptoms associated with substance use disorders. CONCLUSIONS BFO clients with higher completion rates had the most improvement across the scales used; however, clients with lower and medium completion rates also had improvements. Because of the shame and stigma associated with substance use, digital supports with low barriers to entry can help support the autonomy, privacy, and preferences of individuals seeking help for problematic substance use.
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Affiliation(s)
- Bilal Noreen Khan
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Cherry Chu
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Janette Brual
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Marlena Dang-Nguyen
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Adetola Oladimeji
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Altea Kthupi
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Blanca Bolea-Alamañac
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Mina Tadrous
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Anne O'Riordan
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Donna Rubenstein
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Kathleen Carlin
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Philip Longum
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Daryn Gibson
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
| | - Ibukun-Oluwa Omolade Abejirinde
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto (Khan, Chu, Brual, Dang-Nguyen, Oladimeji, Bolea-Alamañac, Tadrous, O'Riordan, Rubenstein, Carlin, Longum, Gibson, Abejirinde); Dalla Lana School of Public Health, University of Toronto, Toronto (Khan, Kthupi, Abejirinde); Women's College Research Institute, Toronto (Kthupi); Department of Psychiatry, University of Toronto, Toronto (Bolea-Alamañac); Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto (Tadrous); Patient Advisors Network, Toronto (O'Riordan, Rubenstein, Carlin)
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Murphy JK, Saker S, Ananyo Chakraborty P, Chan YM(M, Michalak EE, Irrarazaval M, Withers M, Ng CH, Khan A, Greenshaw A, O’Neil J, Nguyen VC, Minas H, Ravindran A, Paric A, Chen J, Wang X, Hwang TY, Ibrahim N, Hatcher S, Evans V, Lam RW. Advancing equitable access to digital mental health in the Asia-Pacific region in the context of the COVID-19 pandemic and beyond: A modified Delphi consensus study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002661. [PMID: 38857265 PMCID: PMC11164385 DOI: 10.1371/journal.pgph.0002661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/01/2024] [Indexed: 06/12/2024]
Abstract
The COVID-19 pandemic had an unprecedented impact on global mental health and well-being, including across the Asia-Pacific. Efforts to mitigate virus spread led to far-reaching disruption in the delivery of health and social services. In response, there was a rapid shift to the use of digital mental health (DMH) approaches. Though these technologies helped to improve access to care for many, there was also substantial risk of access barriers leading to increased inequities in access to mental health care, particularly among at-risk and equity-deserving populations. The objective of this study was to conduct a needs assessment and identify priorities related to equitable DMH access among at-risk and equity-deserving populations in the Asia Pacific region during the first year of the COVID-19 pandemic. The study consisted of a modified Delphi consensus methodology including two rounds of online surveys and online consultations with stakeholders from across the region. Study participants included policy makers, clinicians and service providers, and people with lived experience of mental health conditions. Results demonstrate that vulnerabilities to negative mental health impacts and access barriers were compounded during the pandemic. Access barriers included a lack of linguistically and culturally appropriate DMH options, low mental health literacy and poor access to technological infrastructure and devices, low levels of awareness and trust of DMH options, and lack of policies and guidelines to support effective and equitable delivery of DMH. Recommendations to improve equitable access include ensuring that diverse people with lived experience are engaged in research, co-design and policy development, the development and implementation of evidence-based and equity-informed guidelines and frameworks, clear communication about DMH evidence and availability, and the integration of DMH into broader health systems. Study results can inform the development and implementation of equitable DMH as its use becomes more widespread across health systems.
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Affiliation(s)
- Jill K. Murphy
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shirley Saker
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Erin E. Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Mellissa Withers
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, United States of America
| | - Chee H. Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Amna Khan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - John O’Neil
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, Hanoi, Vietnam
| | - Harry Minas
- Centre for Mental Health, University of Melbourne, Melbourne, Australia
| | - Arun Ravindran
- Centre for Addiction and Mental Health/ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Angela Paric
- Centre for Addiction and Mental Health/ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jun Chen
- Shanghai Mental Health Centre, Shanghai, China
| | - Xing Wang
- Shanghai Mental Health Centre, Shanghai, China
| | - Tae-Yeon Hwang
- Korea Foundation for Suicide Prevention, Seoul, South Korea
| | - Nurashikin Ibrahim
- Mental Health, Injury and Violence Prevention and Substance Abuse Sector Section, Ministry of Health, Kuala Lumpur, Malaysia
| | - Simon Hatcher
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Vanessa Evans
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymond W. Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Hicks LJ, Toombs E, Lund J, Kowatch KR, Hopkins C, Mushquash CJ. Expanding our understanding of digital mental health interventions for Indigenous youth: An updated systematic review. J Telemed Telecare 2024:1357633X241239715. [PMID: 38584397 DOI: 10.1177/1357633x241239715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Past research has examined available literature on electronic mental health interventions for Indigenous youth with mental health concerns. However, as there have recently been increases in both the number of studies examining electronic mental health interventions and the need for such interventions (i.e. during periods of pandemic isolation), the present systematic review aims to provide an updated summary of the available peer-reviewed and grey literature on electronic mental health interventions applicable to Indigenous youth. The purpose of this review is to better understand the processes used for electronic mental health intervention development. Among the 48 studies discussed, smoking cessation and suicide were the most commonly targeted mental health concerns in interventions. Text message and smartphone application (app) interventions were the most frequently used delivery methods. Qualitative, quantitative, and/or mixed outcomes were presented in several studies, while other studies outlined intervention development processes or study protocols, indicating high activity in future electronic mental health intervention research. Among the findings, common facilitators included the use of community-based participatory research approaches, representation of culture, and various methods of motivating participant engagement. Meanwhile, common barriers included the lack of necessary resources and limits on the amount of support that online interventions can provide. Considerations regarding the standards and criteria for the development of future electronic mental health interventions for Indigenous youth are offered and future research directions are discussed.
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Affiliation(s)
- Lydia J Hicks
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Kristy R Kowatch
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Carol Hopkins
- Thunderbird Partnership Foundation, Bothwell, ON, Canada
| | - Christopher J Mushquash
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
- Thunder Bay Regional Health Sciences Centre, ON, Canada
- Thunder Bay Regional Health Research Institute, ON, Canada
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Bhattacharjee A, Chen P, Mandal A, Hsu A, O'Leary K, Mariakakis A, Williams JJ. Exploring User Perspectives on Brief Reflective Questioning Activities for Stress Management: Mixed Methods Study. JMIR Form Res 2024; 8:e47360. [PMID: 38329800 PMCID: PMC10884911 DOI: 10.2196/47360] [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: 03/20/2023] [Revised: 10/12/2023] [Accepted: 11/05/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Current online interventions dedicated to assisting individuals in managing stress and negative emotions often necessitate substantial time commitments. This can be burdensome for users, leading to high dropout rates and reducing the effectiveness of these interventions. This highlights an urgent need for concise digital activities that individuals can swiftly access during instances of negative emotions or stress in their daily lives. OBJECTIVE The primary aim of this study was to investigate the viability of using a brief digital exercise, specifically a reflective questioning activity (RQA), to help people reflect on their thoughts and emotions about a troubling situation. The RQA is designed to be quick, applicable to the general public, and scalable without requiring a significant support structure. METHODS We conducted 3 simultaneous studies. In the first study, we recruited 48 participants who completed the RQA and provided qualitative feedback on its design through surveys and semistructured interviews. In the second study, which involved 215 participants from Amazon Mechanical Turk, we used a between-participants design to compare the RQA with a single-question activity. Our hypotheses posited that the RQA would yield greater immediate stress relief and higher perceived utility, while not significantly altering the perception of time commitment. To assess these, we measured survey completion times and gathered multiple self-reported scores. In the third study, we assessed the RQA's real-world impact as a periodic intervention, exploring engagement via platforms such as email and SMS text messaging, complemented by follow-up interviews with participants. RESULTS In our first study, participants appreciated the RQA for facilitating structured reflection, enabling expression through writing, and promoting problem-solving. However, some of the participants experienced confusion and frustration, particularly when they were unable to find solutions or alternative perspectives on their thoughts. In the second study, the RQA condition resulted in significantly higher ratings (P=.003) for the utility of the activity and a statistically significant decrease (P<.001) in perceived stress rating compared with the single-question activity. Although the RQA required significantly more time to be completed (P<.001), there was no statistically significant difference in participants' subjective perceived time commitment (P=.37). Deploying the RQA over 2 weeks in the third study identified some potential challenges to consider for such activities, such as the monotony of doing the same activity several times, the limited affordances of mobile phones, and the importance of having the prompts align with the occurrence of new troubling situations. CONCLUSIONS This paper describes the design and evaluation of a brief online self-reflection activity based on cognitive behavioral therapy principles. Our findings can inform practitioners and researchers in the design and exploration of formats for brief interventions to help people with everyday struggles.
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Affiliation(s)
| | - Pan Chen
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Abhijoy Mandal
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Anne Hsu
- School of Electronic Engineering and Computer Science, Queen Mary University, London, United Kingdom
| | | | - Alex Mariakakis
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
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Lo B, Teferi B, Wong HW, Abi-Jaoude A, Chopra J, Charow R, Zhang M, Shi J, Johnson A, Levinson A, Cleverley K, Henderson J, Voineskos A, Wiljer D. Enhancing the value of digital health tools for mental health help-seeking in Canadian transitional aged youth during the pandemic: Qualitative study. Int J Med Inform 2024; 182:105299. [PMID: 38061186 DOI: 10.1016/j.ijmedinf.2023.105299] [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: 06/06/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 01/07/2024]
Abstract
While the COVID-19 pandemic has greatly exacerbated the mental health challenges of transition-aged youth (TAY) between 17 and 29 years old, it has also led to the rapid adoption of digital tools for mental health help-seeking and treatment. However, to date, there has been limited work focusing on how this shift has impacted perceptions, needs and challenges of this population in using digital tools. The current study aims to understand their perspectives on mental health help-seeking during the pandemic and emerging issues related to digital tools (e.g., digital health equity, inclusivity). A total of 16 TAY were invited from three post-secondary institutions in the Greater Toronto Area. A total of two streams of focus groups were held and participants were invited to share their perceptions, needs and experiences. Five main themes were identified: 1) Helpfulness of a centralized resource encompassing a variety of diverse mental health supports help-seeking; 2) The impact of the shift to online mental health support on the use of informal supports; 3) Digital tool affordability and availability; 4) Importance of inclusivity for digital tools; and 5) Need for additional support for mental health seeking and digital tool navigation. Future work should examine how these needs can be addressed through new and existing digital mental health help-seeking tools for TAY.
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Affiliation(s)
- Brian Lo
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada; Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario M5T 3M7, Canada; Information Management Group, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario M6J 1H4, Canada.
| | - Bemnet Teferi
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada; Dalla Lana School of Public Health, 155 College St, Toronto, Ontario M5T 3M7, Canada.
| | - Howard W Wong
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada.
| | - Alexxa Abi-Jaoude
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada.
| | - Jasmine Chopra
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada.
| | - Rebecca Charow
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario M5T 3M7, Canada; UHN Digital, University Health Network, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
| | - Melody Zhang
- UHN Digital, University Health Network, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
| | - Jenny Shi
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada.
| | - Andrew Johnson
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada.
| | - Andrea Levinson
- Health and Wellness, University of Toronto, 700 Bay Street, Toronto, ON M5G 1Z6, Canada; Department of Psychiatry, Temerty Faculty of Medicine, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada.
| | - Kristin Cleverley
- Department of Psychiatry, Temerty Faculty of Medicine, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, Ontario M5T 3M7, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, Ontario M6J 1H4, Canada.
| | - Jo Henderson
- Department of Psychiatry, Temerty Faculty of Medicine, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, 80 Workman Way, Toronto, Ontario M6J 1H4, Canada.
| | - Aristotle Voineskos
- Department of Psychiatry, Temerty Faculty of Medicine, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, Ontario, M6J 1H4, Canada.
| | - David Wiljer
- Office of Education, Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario, Canada; Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, Ontario M5T 3M7, Canada; Department of Psychiatry, Temerty Faculty of Medicine, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada; UHN Digital, University Health Network, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
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Basnet S, Chaiton M. Effectiveness of the Wellness Together Canada Portal as a Digital Mental Health Intervention in Canada: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e48703. [PMID: 38289642 PMCID: PMC10865206 DOI: 10.2196/48703] [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: 05/03/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The Wellness Together Canada (WTC) portal is a digital mental health intervention that was developed in response to an unprecedented rise in mental health and substance use concerns due to the COVID-19 pandemic, with funding from the Government of Canada. It is a mental health and substance use website to support people across Canada providing digital interventions and services at no cost. Two million people have visited the WTC portal over the course of 1 year since launching; however, rigorous evaluation of this potential solution to access to mental health care during and after the COVID-19 pandemic is urgently required. OBJECTIVE This study aims to better understand the effectiveness of the existing digital interventions in improving population mental health in Canada. METHODS The Let's Act on Mental Health study is designed as a longitudinal fully remote, equally randomized (1:1), double-blind, alternative intervention-controlled, parallel-group randomized controlled trial to be conducted between October 2023 and April 2024 with a prospective follow-up study period of 26 weeks. This trial will evaluate whether a digital intervention such as the WTC improves population mental health trajectories over time. RESULTS The study was approved by the research ethics board of CAMH (Centre for Addiction and Mental Health, Toronto, Ontario, Canada). It is ongoing and participant recruitment is underway. As of August 2023, a total of 453 participants in the age group of 18-72 years have participated, of whom 70% (n=359) are female. CONCLUSIONS This initiative provides a unique opportunity to match people's specific unmet mental health and substance use needs to evidence-based digital interventions.
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Affiliation(s)
- Syaron Basnet
- Centre For Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Michael Chaiton
- Centre For Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Dimitropoulos G, Bassi EM, Bright KS, Gondziola J, Bradley J, Fersovitch M, Stamp L, LaMonica HM, Iorfino F, Gaskell T, Tomlinson S, Johnson DW. Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders. JMIR Ment Health 2024; 11:e49099. [PMID: 38231558 PMCID: PMC10831665 DOI: 10.2196/49099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Youth, aged 15 to 24 years, are more likely to experience mental health (MH) or substance use issues than other age groups. This is a critical period for intervention because MH disorders, if left unattended, may become chronic and serious and negatively affect many aspects of a young person's life. Even among those who are treated, poor outcomes will still occur for a percentage of youth. Electronic MH (eMH) tools have been implemented in traditional MH settings to reach youth requiring assistance with MH and substance use issues. However, the utility of eMH tools in school settings has yet to be investigated. OBJECTIVE The objective of this study was to gain an understanding of the perspectives of key school staff stakeholders regarding barriers and facilitators to the implementation of the Innowell eMH platform in secondary schools across the province of Alberta, Canada. METHODS Guided by a qualitative descriptive approach, focus groups were conducted to elicit stakeholder perspectives on the perceived implementation challenges and opportunities of embedding the Innowell eMH platform in secondary school MH services. In total, 8 focus groups were conducted with 52 key school staff stakeholders. RESULTS Themes related to barriers and facilitators to youth and school MH care professional (MHCP) capacity in implementing and using eMH tools were identified. With respect to youth capacity barriers, the following themes were inductively generated: (1) concerns about some students not being suitable for eMH services, (2) minors requiring consent from parents or caregivers to use eMH services as well as confidentiality and privacy concerns, and (3) limited access to technology and internet service among youth. A second theme related to school MHCP barriers to implementation, which included (1) feeling stretched with high caseloads and change fatigue, (2) concerns with risk and liability, and (3) unmasking MH issues in the face of limited resources. In contrast to the barriers to youth and MHCP capacity, many facilitators to implementation were discussed. Youth capacity facilitators included (1) the potential for youth to be empowered using eMH tools, (2) the platform fostering therapeutic relationships with school personnel, and (3) enhancing access to needed services and resources. MHCP capacity facilitators to implementation were (1) system transformation through flexibility and problem-solving, (2) opportunities for collaboration with youth and MHCPs and across different systems, and (3) an opportunity for the continuity of services. CONCLUSIONS Our findings highlight nuanced school MHCP perspectives that demonstrate critical youth and MHCP capacity concerns, with consideration for organizational factors that may impede or enhance the implementation processes for embedding eMH in a school context. The barriers and facilitators to implementation provide future researchers and decision makers with challenges and opportunities that could be addressed in the preimplementation phase.
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Affiliation(s)
- Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
- Calgary Eating Disorders Program, Alberta Health Services, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Emilie M Bassi
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Katherine S Bright
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, AB, Canada
- Heroes in Mind, Advocacy, and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Jason Gondziola
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Jessica Bradley
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Melanie Fersovitch
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Leanne Stamp
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | | | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Tanya Gaskell
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Sara Tomlinson
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - David Wyatt Johnson
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
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Cortés-Álvarez NY, Garduño AS, Sánchez-Vidaña DI, Marmolejo-Murillo LG, Vuelvas-Olmos CR. A Longitudinal Study of the Psychological State of Teachers Before and During the COVID-19 Outbreak in Mexico. Psychol Rep 2023; 126:2789-2820. [PMID: 35570577 PMCID: PMC9111914 DOI: 10.1177/00332941221100458] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 outbreak significantly impacted people's lives. Within the education system, the teaching mode drastically changed to adapt to the social distancing restrictions due to the pandemic. Consequently, teachers have been facing challenges associated with remote learning in addition to those of the pandemic. The aim of the present study was to assess the psychological state among teachers at two stages: pre-pandemic (November 2019) and during the pandemic (June-July 2020 and June-July 2021). Information regarding demographic data, depression, anxiety, and stress (DASS-21), and burnout syndrome (MBI-ES) was collected using validated questionnaires. Results showed a significantly higher scores as well as a higher prevalence in the DASS-21 and the MBI-ES scales, on the second measurement taken during the pandemic compared to the pre-pandemic period and the first evaluation during the pandemic. During the second evaluation on pandemic stage, female teachers of ≥45 years of age with a college-level of education, 11 years of teaching experience, and currently teaching at preschools and primary schools were significantly associated with higher anxiety, stress, EE, and burnout scores. In addition, female teachers aged ≥45 years reported higher PD and PA scores. Finally, an association between burnout syndrome and depression was identified in the evaluations carried out during the pandemic considering both the total sample and the analysis per gender. The study shows that teachers' mental health has been negatively affected by the pandemic. Efforts from the education system and health authorities are crucial to design and implement strategies to improve teachers' mental health during the fight against COVID-19.
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Affiliation(s)
- Nadia Yanet Cortés-Álvarez
- Department of Nursing and Midwifery, Division of Natural and Exact Sciences, University of Guanajuato, Mexico
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Parsons CE, Purves KL, Davies MR, Mundy J, Bristow S, Eley TC, Breen G, Hirsch CR, Young KS. Seeking help for mental health during the COVID-19 pandemic: A longitudinal analysis of adults' experiences with digital technologies and services. PLOS DIGITAL HEALTH 2023; 2:e0000402. [PMID: 38055730 DOI: 10.1371/journal.pdig.0000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023]
Abstract
The COVID-19 pandemic brought about dramatic changes in how patients access healthcare from its outset. Lockdown restrictions and remote working led to a proliferation of digital technologies and services, which also impacted mental health provisions. Against the backdrop of new and changing support services, along with an unprecedented emphasis on mental health, relatively little is known about how adults sought out and received support for their mental health during this period. With a sample of 27,574 adults assessed longitudinally online over 12 months of the pandemic in the UK, we analysed reports of help-seeking for mental health, as well as sources of treatment or support and the perceived helpfulness of treatments received. We observed that the proportions of participants who reported seeking help remained relatively consistent throughout the 12-month period (ranging from 12.6% to 17.0%). Online talking therapies were among the most frequently sought sources (15.3%), whereas online self-guided treatments were among the least frequently sought sources (5%). Telephone lines, both NHS and non-governmental, had marked treatment 'gaps'. These treatment gaps, where individuals sought treatment but did not receive it, were especially evident for men and older adults. Our findings underscore online talking therapies as being a widely-sought and helpful source of mental health support. This is important given the current global need for accessible treatment options.
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Affiliation(s)
- Christine E Parsons
- Department of Clinical Medicine, Interacting Minds Center, Aarhus University, Aarhus, Denmark
| | - Kirstin L Purves
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Molly R Davies
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Shannon Bristow
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Thalia C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
| | - Colette R Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Katherine S Young
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- NIHR Maudsley Biomedical Research Centre, King's College London, United Kingdom
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Toh SHY, Lee SC, Sündermann O. Mobile Behavioral Health Coaching as a Preventive Intervention for Occupational Public Health: Retrospective Longitudinal Study. JMIR Form Res 2023; 7:e45678. [PMID: 37862086 PMCID: PMC10625093 DOI: 10.2196/45678] [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: 01/12/2023] [Revised: 08/17/2023] [Accepted: 08/31/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Researchers have recently proposed that behavioral health coaching (BHC) is effective in promoting proactive care among employees. However, to qualify as a preventive workplace intervention, more research is needed to evaluate whether BHC can further elevate well-being among moderately mentally healthy employees. OBJECTIVE Using real-world data, this study evaluates the preliminary effectiveness of app-based BHC against a nonrandomized control group with open access to self-help tools in improving well-being (ie, mood levels and perceived stress). The study also explores the active ingredients of BHC and dose-response associations between the number of BHC sessions and well-being improvements. METHODS Employees residing across Asia-Pacific countries (N=1025; mean age 30.85, SD 6.97 y) who reported moderately positive mood and medium levels of perceived stress in their first week of using the mental health app Intellect were included in this study. Users who were given access by their organizations to Intellect's BHC services were assigned to the "Coaching" condition (512/1025, 49.95%; mean age 31.09, SD 6.87 y), whereas other employees remained as "Control" participants (513/1025, 50.05%; mean age 30.61, SD 7.06 y). To evaluate effectiveness, monthly scores from the validated mood and stress sliders were aggregated into a composite well-being score and further examined using repeated-measure conditional growth models. Postcoaching items on "Perceived Usefulness of the BHC session" and "Working Alliance with my Coach" were examined as active ingredients of BHC using 1-1-1 multilevel mediation models. Finally, 2-way repeated-measure mixed ANOVA models were conducted to examine dose-response effects on well-being improvements between groups (coaching and control) across time. RESULTS Growth curve analyses revealed significant time by group interaction effects for composite well-being, where "Coaching" users reported significantly greater improvements in well-being than "Control" participants across time (composite well-being: F1,391=6.12; ηp2=0.02; P=.01). Among "Coaching" participants, dependent-sample 2-tailed t tests revealed significant improvements in composite well-being from baseline to 11 months (t512=1.98; Cohen d=0.17; P=.049). Improvements in "Usefulness of the BHC session" (β=.078, 95% Cl .043-.118; P<.001) and "Working Alliance" (β=.070, 95% Cl .037-.107; P<.001) fully mediated within-level well-being enhancements over time. Comparing against baseline or first month scores, significant time by group interactions were observed between the second and sixth months, with the largest effect size observed at the fifth month mark (first month vs fifth month: F1,282=15.0; P<.001; ηp2=0.051). CONCLUSIONS We found preliminary evidence that BHC is an effective preventive workplace intervention. Mobile-based coaching may be a convenient, cost-effective, and scalable means for organizations and governments to boost public mental health.
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Affiliation(s)
| | - Sze Chi Lee
- Intellect Private Limited Company, Singapore, Singapore
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11
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Versteegden DPA, Van Himbeeck MJJ, Luyer MD, van Montfort G, de Zoete JPJGM, Smulders JF, Nienhuijs SW. A randomized clinical trial evaluating eHealth in bariatric surgery. Surg Endosc 2023; 37:7625-7633. [PMID: 37474829 DOI: 10.1007/s00464-023-10211-w] [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: 01/21/2023] [Accepted: 06/12/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Supporting patients before, and long after, their bariatric treatment contributes a lot to successful outcome. eHealth interventions have a hypothetical benefit in addition to standard care. This could lead to increased weight loss, reduction of obesity-related diseases, patient adherence, and quality of life. This randomized controlled trial aims to evaluate the value of an eHealth platform and self-monitoring devices as additions to standard bariatric care. MATERIALS AND METHODS Two-hundred-and-five patients who underwent primary bariatric surgery were randomized (2:1:1) to receive standard care (control group), additional access to an educational patient eHealth platform (online group), or additional access to eHealth platform as well as self-monitoring devices (device group). The platform consisted of an interactive educational environment with informational videos, dietary advice, news, and more. The self-monitoring devices used were a weight scale, blood pressure monitor, pulse oximeter, and activity bracelet. The primary endpoint was weight loss and secondary outcomes included reduction of obesity-related diseases, quality of life, and eHealth use. RESULTS Postoperative weight loss, reduction of obesity-related diseases, frequency of consultations, and quality of life were similar between groups. Participation to the eHealth platform was high (online group 90%, device group 98%). Most frequently accessed contents were informational messages, videos, and the treatment preparation modules. The percentage of active users of the self-monitoring devices dropped from 62% in the first postoperative month to 19% after 2 years. Thirteen patients in the device group withdrew due to unwillingness to use self-monitoring devices. CONCLUSION Participation to the eHealth intervention in addition to the standard post-bariatric guidance program was high, however, had no significant impact on clinical outcomes such as weight loss, reduction of obesity-related diseases, and quality of life. Trial registration ClinicalTrials.gov (identifier number NL56992.100.16) https://clinicaltrials.gov/ct2/show/NCT03394638.
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Affiliation(s)
- Dirk P A Versteegden
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - Magaly J J Van Himbeeck
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - Misha D Luyer
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - Gust van Montfort
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - Jean-Paul J G M de Zoete
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | | | - Simon W Nienhuijs
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
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Wurz A, Ellis K, Duchek D, Bansal M, Carrier ME, Tao L, Dyas L, Kwakkenbos L, Levis B, El-Baalbaki G, Rice DB, Wu Y, Henry RS, Bustamante L, Harb S, Hebblethwaite S, Patten SB, Bartlett SJ, Varga J, Mouthon L, Markham S, Thombs BD, Culos-Reed SN. Exploring research team members' and trial participants' perceptions of acceptability and implementation within one videoconference-based supportive care program for individuals affected by systemic sclerosis during COVID-19: a qualitative interview study. Transl Behav Med 2023; 13:442-452. [PMID: 36999812 PMCID: PMC10314727 DOI: 10.1093/tbm/ibac091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
The SPIN-CHAT Program was designed to support mental health among individuals with systemic sclerosis (SSc; commonly known as scleroderma) and at least mild anxiety symptoms at the onset of COVID-19. The program was formally evaluated in the SPIN-CHAT Trial. Little is known about program and trial acceptability, and factors impacting implementation from the perspectives of research team members and trial participants. Thus, the propose of this follow-up study was to explore research team members' and trial participants' experiences with the program and trial to identify factors impacting acceptability and successful implementation. Data were collected cross-sectionally through one-on-one, videoconference-based, semi-structured interviews with 22 research team members and 30 purposefully recruited trial participants (Mage = 54.9, SD = 13.0 years). A social constructivist paradigm was adopted, and data were analyzed thematically. Data were organized into seven themes: (i) getting started: the importance of prolonged engagement and exceeding expectations; (ii) designing the program and trial: including multiple features; (iii) training: research team members are critical to positive program and trial experiences; (iv) offering the program and trial: it needs to be flexible and patient-oriented; (v) maximizing engagement: navigating and managing group dynamics; (vi) delivering a videoconference-based supportive care intervention: necessary, appreciated, and associated with some barriers; and (vii) refining the program and trial: considering modification when offered beyond the period of COVID-19 restrictions. Trial participants were satisfied with and found the SPIN-CHAT Program and Trial to be acceptable. Results offer implementation data that can guide the design, development, and refinement of other supportive care programs seeking to promote psychological health during and beyond COVID-19.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mannat Bansal
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Marie-Eve Carrier
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Lydia Tao
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Laura Dyas
- National Scleroderma Foundation, Michigan Chapter, Southfield, MI, USA
| | - Linda Kwakkenbos
- Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboudumc Center for Mindfulness, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brooke Levis
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | - Ghassan El-Baalbaki
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Yin Wu
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Richard S Henry
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Laura Bustamante
- Department of Applied Human Sciences, Concordia University, Montreal, QC, Canada
| | - Sami Harb
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute and O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - John Varga
- University of Michigan, Ann Arbor, MI, USA
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-immunes et Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique, Hôpitaux de Paris (APHP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King’s College London, London, UK
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB, Canada
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Haro-Ramos AY, Rodriguez HP, Aguilera A. Effectiveness and implementation of a text messaging intervention to reduce depression and anxiety symptoms among Latinx and Non-Latinx white users during the COVID-19 pandemic. Behav Res Ther 2023; 165:104318. [PMID: 37146444 PMCID: PMC10105646 DOI: 10.1016/j.brat.2023.104318] [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: 06/22/2022] [Revised: 03/24/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023]
Abstract
Text messaging interventions are increasingly used to help people manage depression and anxiety. However, little is known about the effectiveness and implementation of these interventions among U.S. Latinxs, who often face barriers to using mental health tools. The StayWell at Home (StayWell) intervention, a 60-day text messaging program based on cognitive behavioral therapy (CBT), was developed to help adults cope with depressive and anxiety symptoms during the COVID-19 pandemic. StayWell users (n = 398) received daily mood inquiries and automated skills-based text messages delivering CBT-informed coping strategies from an investigator-generated message bank. We conduct a Hybrid Type 1 mixed-methods study to compare the effectiveness and implementation of StayWell for Latinx and Non-Latinx White (NLW) adults using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Effectiveness was measured using the PHQ-8 depression and GAD-7 anxiety scales, assessed before starting and after completing StayWell. Guided by RE-AIM, we conducted a thematic text analysis of responses to an open-ended question about user experiences to help contextualize quantitative findings. Approximately 65.8% (n = 262) of StayWell users completed pre-and-post surveys. On average, depressive (-1.48, p = 0.001) and anxiety (-1.38, p = 0.001) symptoms decreased from pre-to-post StayWell. Compared to NLW users (n = 192), Latinx users (n = 70) reported an additional -1.45 point (p < 0.05) decline in depressive symptoms, adjusting for demographics. Although Latinxs reported StayWell as relatively less useable (76.8 vs. 83.9, p = 0.001) than NLWs, they were more interested in continuing the program (7.5 vs. 6.2 out of 10, p = 0.001) and recommending it to a family member/friend (7.8 vs. 7.0 out of 10, p = 0.01). Based on the thematic analysis, both Latinx and NLW users enjoyed responding to mood inquiries and sought bi-directional, personalized text messages and texts with links to more information to resources. Only NLW users stated that StayWell provided no new information than they already knew from therapy or other sources. In contrast, Latinx users suggested that engagement with a behavioral provider through text or support groups would be beneficial, highlighting this group's unmet need for behavioral health care. mHealth interventions like StayWell are well-positioned to address population-level disparities by serving those with the greatest unmet needs if they are culturally adapted and actively disseminated to marginalized groups. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04473599.
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Affiliation(s)
- Alein Y Haro-Ramos
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Hector P Rodriguez
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Adrian Aguilera
- Digital Health Equity and Access Lab, School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
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Crompton D, Kohleis P, Shakespeare-Finch J, FitzGerald G, Young R. Opportunistic Mental Health Screening: Is there a Role Following a Disaster? Lessons from the 2010-2011 Queensland (Australia) Floods and Cyclones. Prehosp Disaster Med 2023; 38:223-231. [PMID: 36691688 PMCID: PMC10027488 DOI: 10.1017/s1049023x23000092] [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] [Indexed: 01/25/2023]
Abstract
BACKGROUND Following the 2010-2011 floods and cyclones that affected 78% of Queensland, Australia, a State-wide mental health response was established. The response plan included a 24-hour access line. This study examines the effectiveness of the mental health screening program conducted via the State-wide health call center (13HEALTH) in 2012. METHODS Callers to the 13HEALTH line were screened to assess the impact of the disaster. The 13HEALTH clinicians administered the Primary Care-Posttraumatic Stress Disorder Scale (PC-PTSD) screening measure. Those scoring more than two on the PC-PTSD Scale were provided information on the emotional impact of disasters and a referral to the post-disaster specialist mental health program (SMHP). For calls related to those under 18, a single-item question assessed behavioral or emotional changes since the natural disasters. Those with identified changes were offered a referral to a post-disaster SMHP.The study evaluates the relationship between disaster exposure and the likelihood of 13HEALTH callers experiencing physical health concerns and unacknowledged mental health symptoms. The program's cost for the 12 months of 2012 was assessed using data from the financial contract. RESULTS In 2012, there were 205,064 calls to 13HEALTH: 19,708 identified as residing in a flood or cyclone-affected area, 7,315 adults indicated they were personally affected, and 907 scored more than two on the PC-PTSD Scale. Only 700 agreed to a referral to the SMHP. There were 290 children under 18 assessed as at risk; 207 accepted a referral to a SMHP.Regions that experienced a greater impact from the floods and cyclones were 1.3-2.3 times more likely to report being personally affected by the floods and cyclones. Similarly, these regions had more callers scoring more than two on the PC-PTSD Scale. The total cost of the 13HEALTH program for 2012 was $53,284 (AU) across all age groups. CONCLUSION The 13HEALTH general health post-disaster screening program demonstrates opportunistic screening may assist identification of those with unmet mental health needs. The data indicate an increased likelihood of personal exposure in the more affected regions with an increased risk of unrecognized psychological symptoms as assessed by the PC-PTSD Scale. However, more than 20% declined referral to a SMHP.
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Affiliation(s)
- David Crompton
- Queensland University of Technology, Brisbane, Queensland, Australia
- Griffith University, Nathan, Queensland, Australia
| | - Peter Kohleis
- Metro South Hospital and Health Service, Woolloongabba, Queensland, Australia
| | | | - Gerard FitzGerald
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ross Young
- Queensland University of Technology, Brisbane, Queensland, Australia
- Griffith University, Nathan, Queensland, Australia
- University Sunshine Coast, Maroochydore DC, Queensland, Australia
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Thabrew H, Kumar H, Steadman E. Acceptability and Feasibility of "Village," a Digital Communication App for Young People Experiencing Low Mood, Thoughts of Self-harm, and Suicidal Ideation to Obtain Support From Family and Friends: Mixed Methods Pilot Open Trial. JMIR Form Res 2023; 7:e41273. [PMID: 36912882 PMCID: PMC10131861 DOI: 10.2196/41273] [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: 07/21/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Young people experiencing low mood, thoughts related to self-harm, and suicidal ideation often struggle to communicate their emotions and receive timely support from family and friends. Technologically delivered support interventions may be useful in addressing this need. OBJECTIVE This paper aimed to evaluate the acceptability and feasibility of "Village," a communication app co-designed with young people and their family and friends from New Zealand. METHODS A mixed methods pilot open trial design was adopted. Participants were primarily recruited via social media advertisements and clinicians in specialist mental health services over an 8-month period. The primary outcomes were acceptability of the app (via thematically analyzed qualitative feedback and retention rates) and feasibility of conducting a larger randomized controlled trial gauged via effectiveness of recruitment methods, completion of chosen outcome measures, and occurrence of unanticipated operational issues. Secondary outcomes were app usability, safety, and changes in symptoms of depression (via the Patient Health Questionnaire-9 modified for adolescents), suicidal ideation (on the Suicidal Ideation Questionnaire), and functioning (using the World Health Organization Disability Assessment Schedule 2.0 or Child and Youth version). RESULTS A total of 26 young people ("users") were enrolled in the trial, of which 21 recruited friends and family members ("buddies") and completed quantitative outcome measures at baseline, 4 weeks, and 3 months. Furthermore, 13 users and 12 buddies also provided qualitative feedback about the app, identifying the key themes of appeal of app features and layout, usefulness of its content, and technological challenges (primarily with onboarding and notifications). Users gave Village a mean rating of 3.8 (range 2.7-4.6) out of 5 on a 5-point scale for app quality and an overall star rating of 3.4 out of 5 for subjective quality. Within this limited sample, users reported a clinically significant reduction in depressive symptoms (P=.007), but nonsignificant changes in suicidal ideation and functioning. The embedded risk detection software was activated on 3 occasions, and no additional support was required for users. CONCLUSIONS During this open trial, Village was found to be acceptable, usable, and safe. The feasibility of a larger randomized controlled trial was also confirmed after some modifications to the recruitment strategy and app. TRIAL REGISTRATION Australian New Zealand Clinical Trials Network Registry ACTRN12620000241932p; https://tinyurl.com/ya6t4fx2.
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Affiliation(s)
- Hiran Thabrew
- Department of Psychological Medicine, The University go Auckland, Auckland, New Zealand
| | - Harshali Kumar
- Department of Psychological Medicine, The University go Auckland, Auckland, New Zealand
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16
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Li J. Digital technologies for mental health improvements in the COVID-19 pandemic: a scoping review. BMC Public Health 2023; 23:413. [PMID: 36859184 PMCID: PMC9976664 DOI: 10.1186/s12889-023-15302-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Digital technologies have been used to support mental health services for two decades, but the COVID-19 pandemic created a particular opportunity for greater utilization and more data-driven assessment of these digital technologies. This research aims to offer a scoping review of the characteristics and effectiveness of digital interventions that were employed to improve mental health in the real context of COVID-19 pandemic. A combination of search terms was applied for automatic search of publications in the relevant databases. The key features of included studies were extracted, including the intervention, participant, and study details. A total of 20 eligible studies were included in the final review, which were conducted across different geographic regions and among diverse cultural groups. Among them, fourteen studies mainly reported the impact of digital technologies on general population, while only one published study developed specific interventions for the isolated COVID-19 depressed patients in hospitals. Digital technologies identified in this review were mainly developed via web-based and mobile-based platforms, such as social networking and video conferencing applications. But less than half of them were aligned with theoretical approaches from standardized psychological treatments. Most of the studies have reported positive effects of digital technologies, either on improving general mental and emotional well-being or addressing specific conditions (e.g., depression, stress, and anxiety). This scoping review suggests that digital technologies hold promise in bridging the mental health-care gap during and after the COVID-19 pandemic, and calls for more rigorous studies to identify pertinent features that are likely to achieve more effective mental health outcomes.
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Affiliation(s)
- Jinhui Li
- School of Journalism and Communication, Jinan University, 601 Huangpu Ave West, 510632, Guangzhou, Guangdong, China. .,National Media Experimental Teaching Demonstration Center, Jinan University, 601 Huangpu Ave West, 510632, Guangzhou, Guangdong, China.
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17
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Kahn CB, James D, George S, Johnson T, Kahn-John M, Teufel-Shone NI, Begay C, Tutt M, Bauer MC. Diné (Navajo) Traditional Knowledge Holders' Perspective of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3728. [PMID: 36834423 PMCID: PMC9964790 DOI: 10.3390/ijerph20043728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
From the start of the COVID-19 pandemic on the Navajo Nation, Diné (Navajo) traditional knowledge holders (TKHs), such as medicine men and women and traditional practitioners, contributed their services and healing practices. Although TKHs are not always fully acknowledged in the western health care system, they have an established role to protect and promote the health of Diné people. To date, their roles in mitigating the COVID-19 pandemic have not been fully explored. The purpose of this research was to understand the social and cultural contexts of the COVID-19 pandemic and vaccines based on the roles and perspectives of Diné TKHs. A multi-investigator consensus analysis was conducted by six American Indian researchers using interviews with TKHs collected between December 2021-January 2022. The Hózhó Resilience Model was used as a framework to analyze the data using four parent themes: COVID-19, harmony and relationships, spirituality, and respect for self and discipline. These parent themes were further organized into promoters and/or barriers for 12 sub-themes that emerged from the data, such as traditional knowledge, Diné identity, and vaccine. Overall, the analysis showed key factors that could be applied in pandemic planning and public health mitigation efforts based on the cultural perspective of TKHs.
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Affiliation(s)
- Carmella B. Kahn
- College of Population Health, University of New Mexico, Albuquerque, NM 87131, USA
| | - DeeDee James
- Center for Health Equity and Research, Northern Arizona University, Flagstaff, AZ 86011, USA
| | | | | | | | | | - Chassity Begay
- Center for Health Equity and Research, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Marissa Tutt
- Center for Health Equity and Research, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Mark C. Bauer
- Public Health Program, Diné College, Shiprock, NM 87420, USA
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18
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Piers R, Williams JM, Sharpe H. Review: Can digital mental health interventions bridge the 'digital divide' for socioeconomically and digitally marginalised youth? A systematic review. Child Adolesc Ment Health 2023; 28:90-104. [PMID: 36510375 DOI: 10.1111/camh.12620] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Digital mental health interventions (DMHIs) have the potential to improve the efficiency, accessibility and effectiveness of mental health services for young people, with the potential to reach socioeconomically and digitally marginalised young people with mental health needs who would otherwise not seek help in person. This review aims to investigate the characteristics, acceptability and efficacy of DMHIs specifically developed for socioeconomically and digitally marginalised youth. METHOD Key databases were searched widely and systematically (EMBASE, MEDLINE, PsycINFO, OpenGrey). Final inclusion in this review required studies to evaluate DMHIs specifically targeting socioeconomically and digitally marginalised children and young people through a broad range of research designs. RESULTS Ten studies, describing seven DHMIs, were included in this review. Studies varied in terms of methodology, population, intervention, outcome measures, technologies used and methodological quality. Qualitative and quantitative results are synthesised across three key phenomena of interest: effectiveness, acceptability and feasibility. Findings suggest that there is moderate but limited evidence supporting DMHIs for improving mental health outcomes among these populations. CONCLUSIONS While there is moderate evidence suggesting that digitally delivered interventions can be effective in improving mental health outcomes among socioeconomically and digitally marginalised youth, more high-quality research is needed in order to determine whether DMHIs can fully bridge the so-called 'digital divide'.
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Affiliation(s)
- Rowena Piers
- Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Joanne M Williams
- Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Helen Sharpe
- Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
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19
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Cardona M, Fien S, Myooran J, Hunter C, Dillon A, Lewis E, Browning M, Lewis L, Ní Chróinín D. Clinical and cost-effectiveness of telehealth for Indigenous and culturally and linguistically diverse (CALD) people: a scoping review. ETHNICITY & HEALTH 2023; 28:114-135. [PMID: 34983256 DOI: 10.1080/13557858.2021.2023111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To examine the modalities and clinical and non-clinical effectiveness of telehealth services available to people from Indigenous and culturally and linguistically diverse backgrounds (CALD). MATERIALS AND METHODS A scoping review of peer-reviewed publications (2000-2021) on the effectiveness of telehealth interventions for Indigenous and CALD groups based on searches of Medline, CINAHL, and PsycInfo and manual searches from reference lists of captured literature reviews. RESULTS Of the initial 601 articles, 10 met the inclusion criteria (seven of clinical effectiveness and three of non-clinical effectiveness), with participants from the USA, Australia, New Zealand, and Canada, with sample sizes ranging from 19 to 1,665 participants (overall 327 Indigenous and 2,030 CALD patients). Telehealth was delivered via telephone or by videoconference-with or without data uploads-and follow-up ranging from 6 months to 5 years. DISCUSSION The findings suggest that telehealth shows some promise in: diabetes, depression, neuro/cognitive assessment, and health program adherence/service utilisation/cost. However, our confidence in the accuracy of the results is undermined by the mixed quality of designs and outcome measurements, and the high risk of bias derived from not proper random selections and small sample sizes. CONCLUSIONS The available literature suggests acceptable clinical and non-clinical effectiveness of telehealth against usual care in Indigenous and/or CALD groups but methodological limitations diminish their value in informing practice. Therefore, we consider it is premature to use the findings of these primary studies to draw conclusive recommendations about clinical or other effectiveness of telehealth for the two target groups. Further randomised trials with adequate sampling frames and objective outcome assessments are warranted.
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Affiliation(s)
- Magnolia Cardona
- Evidence-Based Practice Professorial Unit, Gold Coast University Hospital, Southport, Australia
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Samantha Fien
- Faculty of Health, Medical and Applied Sciences, Central Queensland University, Mackay, Australia
| | - Jananee Myooran
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
| | - Carol Hunter
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
- UNSW Medicine, University of New South Wales, Kensington, Australia
- South Western Sydney Clinical School, UNSW Medicine, Kensington, Australia
| | - Anne Dillon
- UNSW Medicine, University of New South Wales, Kensington, Australia
| | - Ebony Lewis
- School of Psychology, Faculty of Science, University of New South Wales, Kensington, Australia
- School of Population Health, Faculty of Medicine & Health, University of New South Wales Kensington, Sydney, Australia
| | - Melissa Browning
- Aboriginal and Torres Strait Islander Health Service, Gold Coast Hospital and Health Service, Southport, Australia
| | - Lou Lewis
- Matraville Medical Centre, Sydney, Australia
| | - Danielle Ní Chróinín
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
- South Western Sydney Clinical School, UNSW Medicine, Kensington, Australia
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20
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COVID-19-related mental health difficulties among marginalised populations: A literature review. Glob Ment Health (Camb) 2023; 10:e2. [PMID: 36843877 PMCID: PMC9947635 DOI: 10.1017/gmh.2022.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic has had negative consequences on the mental health of the population, which has been documented. Marginalised groups that are at risk of poor mental health overall have been particularly impacted. The purpose of this review is to describe the mental health impact of the COVID-19 pandemic on marginalised group (i.e. persons who are socio-economically disadvantaged, migrants and members of ethno-racial minorities, experience homelessness) and identified interventions which could be well-suited to prevent and address mental health difficulties. We conducted a literature review of systematic reviews on mental health difficulties since the beginning of the COVID-19 epidemic and appropriate interventions among marginalised groups published from January 1, 2020 to May 2, 2022, using Google Scholar and PubMed (MEDLINE). Among 792 studies on mental health difficulties among members of marginalised groups identified by keywords, 17 studies met our eligibility criteria. Twelve systematic reviews examining mental health difficulties in one or several marginalised groups during the COVID-19 pandemic and five systematic reviews on interventions that can mitigate the mental health impact of the COVID-19 pandemic were retained in our literature review. The mental health of marginalised groups was severely affected during the COVID-19 pandemic. Most frequently reported mental health difficulties included symptoms of anxiety and depression. Additionally, there are interventions that appear effective and well-suited for marginalised populations, which should be disseminated on a large scale to mitigate the psychiatric burden in these groups and at the population level.
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21
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Goodyear T, Richardson C, Aziz B, Slemon A, Gadermann A, Daly Z, McAuliffe C, Pumarino J, Thomson KC, Jenkins EK. Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada. Digit Health 2023; 9:20552076231173528. [PMID: 37163172 PMCID: PMC10164262 DOI: 10.1177/20552076231173528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/14/2023] [Indexed: 05/11/2023] Open
Abstract
Objective This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress. Methods Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use. Results Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons. Conclusions This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.
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Affiliation(s)
- Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
| | - Bilal Aziz
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Allie Slemon
- School of Nursing, University of Victoria, Victoria, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Zachary Daly
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Corey McAuliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Javiera Pumarino
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kimberly C Thomson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Emily K Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
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22
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Currie G, Finlay B, Seth A, Roth C, Elsabbagh M, Hudon A, Hunt M, Jodoin S, Lach L, Lencucha R, Nicholas DB, Shakako K, Zwicker J. Mental health challenges during COVID-19: perspectives from parents with children with neurodevelopmental disabilities. Int J Qual Stud Health Well-being 2022; 17:2136090. [PMID: 36309898 PMCID: PMC9629071 DOI: 10.1080/17482631.2022.2136090] [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] [Indexed: 11/06/2022] Open
Abstract
Background The global pandemic and subsequent denials, delays, and disruptions in essential daily activities created significant challenges for children with neurodevelopmental disorders (NDDs) and their parents. Public health restrictions during the COVID-19 pandemic limited access to supports and services required by children with NDDs to maintain their health and well-being. Objective This study sought to understand the impacts of these public health measures and restrictions on mental health from the perspective of parents with children with NDDs to inform pathways for public health policies responsive to the needs of this population. Method Interpretive descriptive design was used to guide data collection and data analysis. Forty caregivers were interviewed about their experience with pandemic restrictions. Findings Generic policy measures contributed to many gaps in families’ social support systems and contributed to mental health challenges for children and their parents. Four themes emerged: 1) lack of social networks and activities, 2) lack of access to health and social supports, 3) tension in the family unit, and 4) impact on mental health for children and their parents. Recommendations Emergency preparedness planning requires a disability inclusive approach allocating resources for family supports in the home and community. Families identified supports to minimize further pandemic disruptions and enhance recovery.
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Affiliation(s)
- Genevieve Currie
- School of Public Policy, University of Calgary, Calgary, AB, Canada.,School of Nursing and Midwifery, Mount Royal University, Calgary, AB, Canada
| | - Brittany Finlay
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Ashish Seth
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Christiane Roth
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Myada Elsabbagh
- Faculty of Medicine, McGill University, Montreal, Que., Canada
| | - Anne Hudon
- Faculty of Medicine, Universite de Montreal, Montreal, Que., Canada
| | - Matthew Hunt
- Faculty of Medicine and Health Sciences School of Physical and Occupational Therapy, McGill University, Montreal, Que., Canada
| | | | - Lucyna Lach
- School of Social Work, McGill University, Montreal, Que., Canada
| | - Raphael Lencucha
- Faculty of Medicine and Health Sciences School of Physical and Occupational Therapy, McGill University, Montreal, Que., Canada
| | - David B Nicholas
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Keiko Shakako
- Faculty of Medicine and Health Sciences School of Physical and Occupational Therapy, McGill University, Montreal, Que., Canada
| | - Jennifer Zwicker
- School of Public Policy; Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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23
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du Toit RE, de Klerk W. Guidelines for conducting rapid reviews in psychology research. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2121468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Ryan Evan du Toit
- School of Psychosocial Health, Community Psychosocial Research (COMPRES), North-West University, Potchefstroom, South Africa
| | - Werner de Klerk
- School of Psychosocial Health, Community Psychosocial Research (COMPRES), North-West University, Potchefstroom, South Africa
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24
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Psychological distress during the COVID-19 pandemic in Canada. PLoS One 2022; 17:e0277238. [PMID: 36395148 PMCID: PMC9671380 DOI: 10.1371/journal.pone.0277238] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND During major pandemics such as COVID-19, the fear of being infected, uncertain prognoses, and the imposition of restrictions may result in greater odds of emotional and psychological distress. Hence, the present study examines the predictors of psychological distress during the COVID-19 pandemic in Canada, and how they differ by gender. METHODS Data of 2,756 adults aged 18 years and above from a cross-sectional online survey conducted between July and October 2020 was used for this study. A multivariable logistic regression analysis was carried out. The results were presented as adjusted odds ratio (aOR) with their respective confidence interval (CI). RESULTS Lower odds of psychological distress were found among males compared to females and among individuals aged 45-64 or 65-84 years compared to those aged 18-44. The odds of psychological distress decreased with a rise in income, with individuals whose annual income was greater than or equal to $100,000 being less likely to experience psychological distress compared to those whose income was less than $20,000. The odds of psychological distress were higher among residents of Ontario compared to residents of Quebec. Similarly, the odds of psychological distress were higher among individuals who reported experiencing COVID-19 symptoms compared to those who did not report any COVID-19 symptoms. The disaggregated results by gender showed that age, province, and self-reported COVID-19 symptoms had significant associations with psychological distress in both males and females, but these effects were more pronounced among females compared to males. In addition, income was negatively associated with psychological distress for both males and females, with this effect being stronger among males. CONCLUSION Five exposure variables (gender, age, province, experiencing COVID-19 symptoms, and total annual income in 2019) significantly predicted the likelihood of reporting psychological distress during the COVID-19 pandemic in Canada. Clearly, there is an imminent need to provide mental health support services to vulnerable groups. Additionally, interventions and policies aimed at combating psychological distress during pandemics such as COVID-19 should be gender specific.
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25
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Yu E, Xu B, Sequeira L. Determinants of e-Mental Health Use During COVID-19: Cross-sectional Canadian Study. J Med Internet Res 2022; 24:e39662. [DOI: 10.2196/39662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/30/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background
Access to mental health treatment across Canada remains a challenge, with many reporting unmet care needs. National and provincial e-Mental health (eMH) programs have been developed over the past decade across Canada, with many more emerging during COVID-19 in an attempt to reduce barriers related to geography, isolation, transportation, physical disability, and availability.
Objective
The aim of this study was to identify factors associated with the utilization of eMH services across Canada during the COVID-19 pandemic using Andersen and Newman’s framework of health service utilization.
Methods
This study used data gathered from the 2021 Canadian Digital Health Survey, a cross-sectional, web-based survey of 12,052 Canadians aged 16 years and older with internet access. Bivariate associations between the use of eMH services and health service utilization factors (predisposing, enabling, illness level) of survey respondents were assessed using χ2 tests for categorical variables and t tests for the continuous variable. Logistic regression was used to predict the probability of using eMH services given the respondents’ predisposing, enabling, and illness-level factors while adjusting for respondents’ age and gender.
Results
The proportion of eMH service users among survey respondents was small (883/12,052, 7.33%). Results from the logistic regression suggest that users of eMH services were likely to be those with regular family physician access (odds ratio [OR] 1.57, P=.02), living in nonrural communities (OR 1.08, P<.001), having undergraduate (OR 1.40, P=.001) or postgraduate (OR 1.48, P=.003) education, and being eHealth literate (OR 1.05, P<.001). Those with lower eMH usage were less likely to speak English at home (OR 0.06, P<.001).
Conclusions
Our study provides empirical evidence on the impact of individual health utilization factors on the use of eMH among Canadians during the COVID-19 pandemic. Given the opportunities and promise of eMH services in increasing access to care, future digital interventions should both tailor themselves toward users of these services and consider awareness campaigns to reach nonusers. Future research should also focus on understanding the reasons behind the use and nonuse of eMH services.
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26
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Rush KL, Burton L, Seaton CL, Smith MA, Li EPH, Ronquillo CE, Hasan K, Davis S, Mattei M. A cross-sectional study of the preventive health care activities of western Canadian rural-living patients unattached to primary care providers. Prev Med Rep 2022; 29:101913. [PMID: 35879934 PMCID: PMC9300582 DOI: 10.1016/j.pmedr.2022.101913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Prevention services, such as screening tests and vaccination, are underutilized, especially by rural populations and patients without a usual primary care provider. Little is known about the compounding impacts on preventive care of being unattached and living in a rural area and there has been no comprehensive exploration of this highly vulnerable population’s prevention activities. The twofold purpose of this research was to examine rural unattached patients’ prevention activity self-efficacy and completion and to explore their experiences accessing healthcare, including COVID-19 impacts. Two thirds of patients had been unattached for over one year, and over 20 % had been unattached for over 5 years; males experienced longer unattachment compared to females. Completion rates of prevention activities were relatively low, ranging from 5.9 % (alcohol screening) to 59 % (vision test). Most participants did not complete their prevention care activities in line with the Lifetime Prevention Schedule timeline: 65 % of participants had less than half of their activities up-to-date and only 6.7 % of participants were up to date on 75 % or more of their prevention activities. Participants with higher prevention self-efficacy scores were more likely to be up-to-date on associated prevention activities but the longer patients had been unattached, the fewer their up-to-date prevention activities. Patients expressed negative impacts of COVID-19 including walk-in clinics shutting down limiting access to care. These results suggest serious gaps in rural unattached patients’ preventive care and highlight the need for support when they are without a usual primary care provider, which can be lengthy.
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Affiliation(s)
- Kathy L Rush
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Lindsay Burton
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Cherisse L Seaton
- School of Nursing, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Mindy A Smith
- Patient Voices Network, British Columbia, Canada and Department of Family Medicine, Michigan State University, East Lansing, MI, United States
| | - Eric P H Li
- Faculty of Management and Principal's Research Chair (Tier 2) in Social Innovation for Health Equity and Food Security, University of British Columbia, Okanagan, Kelowna, Canada
| | - Charlene E Ronquillo
- Patient Voices Network, British Columbia, Canada and Department of Family Medicine, Michigan State University, East Lansing, MI, United States
| | - Khalad Hasan
- Department of Computer Science, University of British Columbia, Okanagan, Canada
| | - Selena Davis
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mona Mattei
- Division of Family Practice, Kootenay Boundary, Grand Forks, British Columbia, Canada
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Minian N, Gayapersad A, Saiva A, Dragonetti R, Kidd SA, Strudwick G, Selby P. An e-Mental Health Resource for COVID-19-Associated Stress Reduction: Mixed Methods Study of Reach, Usability, and User Perceptions. JMIR Ment Health 2022; 9:e39885. [PMID: 35960596 PMCID: PMC9422265 DOI: 10.2196/39885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND COVID-19 and its public health response are having a profound effect on people's mental health. To provide support during these times, Canada's largest mental health and addiction teaching hospital (Centre for Addiction and Mental Health [CAMH]) launched the Mental Health and COVID-19 Pandemic website on March 18, 2020. This website was designed to be a nonstigmatizing psychoeducational resource for people experiencing mild to moderate distress due to COVID-19 and the public health response to the pandemic. OBJECTIVE The aim of this study was to examine the reach, usability, and user perceptions of the CAMH Mental Health and COVID-19 Pandemic website. METHODS This study used a mixed methods sequential explanatory design approach, which consisted of the following 2 distinct phases: (1) quantitative data collection and analysis and (2) qualitative semistructured interviews. In phase 1, we analyzed Google Analytics data to understand how many people visited the website and which were the most visited pages. We conducted a survey to identify users' sociodemographic backgrounds, and assess the usability of the website using the System Usability Scale and users' subjective stress levels using the Perceived Stress Scale (PSS-10). For phase 2, we conducted semistructured interviews to explore user experiences; user motivation, engagement, satisfaction, and perception of the stress reduction strategies; reflections of the website's functionality, ease of use, navigation, and design; and recommendations for improvement. RESULTS Google Analytics results showed 146,978 unique users from June 2020 to March 2021. Most users were from Canada (130,066, 88.5%). Between February 20, 2021, and June 4, 2021, 152 users completed the survey. Most users identified as white, female, and having at least a college degree. Based on the PSS-10 scores, most participants were experiencing moderate to high stress when they visited the website. Users rated the usability of the website as acceptable. Ten users completed in-depth interviews between May 2021 and June 2021. Positive feedback related to the content was that the website was a trustworthy source of mental health information with helpful evidence-based stress reduction strategies. Areas for improvement included the text heavy design of the website, wider dissemination/marketing, and greater accessibility of the website to meet the needs of diverse populations. CONCLUSIONS Adding stress reduction resources to a website from a well-respected institution may be a practical method to increase awareness and access to evidence-based stress reduction resources during times of crisis, where there is severe disruption to usual health care contacts. Efforts to ensure that these resources are more widely accessed, especially by diverse populations, are needed.
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Affiliation(s)
- Nadia Minian
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Allison Gayapersad
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Anika Saiva
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Sean A Kidd
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gillian Strudwick
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Aziz M, Erbad A, Almourad MB, Altuwairiqi M, McAlaney J, Ali R. Did Usage of Mental Health Apps Change during COVID-19? A Comparative Study Based on an Objective Recording of Usage Data and Demographics. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081266. [PMID: 36013444 PMCID: PMC9409797 DOI: 10.3390/life12081266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
This paper aims to objectively compare the use of mental health apps between the pre-COVID-19 and during COVID-19 periods and to study differences amongst the users of these apps based on age and gender. The study utilizes a dataset collected through a smartphone app that objectively records the users' sessions. The dataset was analyzed to identify users of mental health apps (38 users of mental health apps pre-COVID-19 and 81 users during COVID-19) and to calculate the following usage metrics; the daily average use time, the average session time, the average number of launches, and the number of usage days. The mental health apps were classified into two categories: guidance-based and tracking-based apps. The results include the increased number of users of mental health apps during the COVID-19 period as compared to pre-COVID-19. Adults (aged 24 and above), compared to emerging adults (aged 15-24 years), were found to have a higher usage of overall mental health apps and guidance-based mental health apps. Furthermore, during the COVID-19 pandemic, males were found to be more likely to launch overall mental health apps and guidance-based mental health apps compared to females. The findings from this paper suggest that despite the increased usage of mental health apps amongst males and adults, user engagement with mental health apps remained minimal. This suggests the need for these apps to work towards improved user engagement and retention.
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Affiliation(s)
- Maryam Aziz
- College of Science and Engineering, Hamad Bin Khalifa University, Doha P.O. Box 5825, Qatar
- Correspondence: (M.A.); (R.A.)
| | - Aiman Erbad
- College of Science and Engineering, Hamad Bin Khalifa University, Doha P.O. Box 5825, Qatar
| | - Mohamed Basel Almourad
- College of Technological Innovation, Zayed University, Dubai P.O. Box 144534, United Arab Emirates
| | - Majid Altuwairiqi
- College of Computer and Information Technology, University of Taif, Taif 21974, Saudi Arabia
| | - John McAlaney
- Faculty of Science and Technology, Bournemouth University, Bournemouth BH12 5BB, UK
| | - Raian Ali
- College of Science and Engineering, Hamad Bin Khalifa University, Doha P.O. Box 5825, Qatar
- Correspondence: (M.A.); (R.A.)
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Noble JM, Zamani A, Gharaat M, Merrick D, Maeda N, Lambe Foster A, Nikolaidis I, Goud R, Stroulia E, Agyapong VIO, Greenshaw AJ, Lambert S, Gallson D, Porter K, Turner D, Zaiane O. Developing, Implementing, and Evaluating an Artificial Intelligence-Guided Mental Health Resource Navigation Chatbot for Health Care Workers and Their Families During and Following the COVID-19 Pandemic: Protocol for a Cross-sectional Study. JMIR Res Protoc 2022; 11:e33717. [PMID: 35877158 PMCID: PMC9361145 DOI: 10.2196/33717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 02/11/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Approximately 1 in 3 Canadians will experience an addiction or mental health challenge at some point in their lifetime. Unfortunately, there are multiple barriers to accessing mental health care, including system fragmentation, episodic care, long wait times, and insufficient support for health system navigation. In addition, stigma may further reduce an individual’s likelihood of seeking support. Digital technologies present new and exciting opportunities to bridge significant gaps in mental health care service provision, reduce barriers pertaining to stigma, and improve health outcomes for patients and mental health system integration and efficiency. Chatbots (ie, software systems that use artificial intelligence to carry out conversations with people) may be explored to support those in need of information or access to services and present the opportunity to address gaps in traditional, fragmented, or episodic mental health system structures on demand with personalized attention. The recent COVID-19 pandemic has exacerbated even further the need for mental health support among Canadians and called attention to the inefficiencies of our system. As health care workers and their families are at an even greater risk of mental illness and psychological distress during the COVID-19 pandemic, this technology will be first piloted with the goal of supporting this vulnerable group. Objective This pilot study seeks to evaluate the effectiveness of the Mental Health Intelligent Information Resource Assistant in supporting health care workers and their families in the Canadian provinces of Alberta and Nova Scotia with the provision of appropriate information on mental health issues, services, and programs based on personalized needs. Methods The effectiveness of the technology will be assessed via voluntary follow-up surveys and an analysis of client interactions and engagement with the chatbot. Client satisfaction with the chatbot will also be assessed. Results This project was initiated on April 1, 2021. Ethics approval was granted on August 12, 2021, by the University of Alberta Health Research Board (PRO00109148) and on April 21, 2022, by the Nova Scotia Health Authority Research Ethics Board (1027474). Data collection is anticipated to take place from May 2, 2022, to May 2, 2023. Publication of preliminary results will be sought in spring or summer 2022, with a more comprehensive evaluation completed by spring 2023 following the collection of a larger data set. Conclusions Our findings can be incorporated into public policy and planning around mental health system navigation by Canadian mental health care providers—from large public health authorities to small community-based, not-for-profit organizations. This may serve to support the development of an additional touch point, or point of entry, for individuals to access the appropriate services or care when they need them, wherever they are. International Registered Report Identifier (IRRID) PRR1-10.2196/33717
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Affiliation(s)
- Jasmine M Noble
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada.,Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ali Zamani
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada.,Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - MohamadAli Gharaat
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada.,Alberta Machine Intelligence Institute, Edmonton, AB, Canada
| | - Dylan Merrick
- Department of Indigenous Studies, University of Saskatchewan, Regina, SK, Canada
| | - Nathanial Maeda
- Rehabilitation Robotics Lab, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | | | | | - Rachel Goud
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Eleni Stroulia
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Asia-Pacific Economic Cooperation Digital Hub for Mental Health, Vancouver, BC, Canada
| | - Simon Lambert
- Department of Indigenous Studies, University of Saskatchewan, Regina, SK, Canada.,Network Environments for Indigenous Health Research National Coordinating Centre, Saskatoon, SK, Canada
| | - Dave Gallson
- Mood Disorders Society of Canada, Ottawa, ON, Canada
| | - Ken Porter
- Mood Disorders Society of Canada, Ottawa, ON, Canada
| | - Debbie Turner
- Mood Disorders Society of Canada, Ottawa, ON, Canada
| | - Osmar Zaiane
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada.,Alberta Machine Intelligence Institute, Edmonton, AB, Canada
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Managing the COVID-19 pandemic in people with mental disorders: An exploratory telephone interview study in a psychiatric outpatient department. Compr Psychiatry 2022; 116:152313. [PMID: 35429763 PMCID: PMC8993418 DOI: 10.1016/j.comppsych.2022.152313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/28/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and associated lockdown measures reduced well-being in the general population significantly and led to an increase in anxiety and depression symptoms, however, results on the impact on people with mental disorders are heterogeneous to date. The aim of this study was to investigate the mental health status, social support, perceived stress, and the medical care provision of people with mental disorders during the time period immediately after the first COVID-19 lockdown in spring 2020 in Germany. METHODS Participants were people with mental disorders currently receiving treatment in the psychiatric outpatient department of the University Hospital Leipzig, Germany. Structured telephone interviews were administered to assess depressive symptoms, self-rated medical care provision, attitudes and social and emotional aspects of the pandemic (social support, perceived stress, loneliness, resilience, and agreeableness). RESULTS A total of N = 106 people completed the telephone interview. The most frequent clinician-rated diagnoses were attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD; n = 29, 27.4%) and obsessive-compulsive disorder (OCD; n = 24, 22.6%). The mean Patient Health Questionnaire-9 sum score was 10.91 (SD = 5.71) and the majority of participants (n = 56, 52.8%) reported clinically relevant depressive symptoms. A low self-rated medical care provision was significantly associated with higher depressive symptom load. In a regression analysis, higher perceived stress levels and low medical care provision significantly predicted depressive symptoms. Furthermore, 38.1% (n = 40) reported to feel relieved as a result of the restrictions and, due to previous experience in dealing with crisis, half of the participants (n = 53, 50.5%) stated they were better able to deal with the current situation than the general population. CONCLUSIONS This study emphasizes the importance of maintenance of medical care provision for people with mental disorders, as cancelled or postponed treatment appointments and perceived stress were associated with higher depressive symptoms. Regular treatment services showed to have a protective effect. In addition, a majority of people with mental disorders felt prepared for managing the COVID pandemic due to existing crisis management abilities. These resources should also be taken into account for further future treatment considerations. TRIAL REGISTRATION German Clinical Trials Register (DRKS00022071).
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Polhemus A, Simblett S, Dawe-Lane E, Gilpin G, Elliott B, Jilka S, Novak J, Nica R, Temesi G, Wykes T. Health tracking via mobile apps for depression self-management: a qualitative content analysis of user reviews (Preprint). JMIR Hum Factors 2022; 9:e40133. [DOI: 10.2196/40133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/19/2022] [Accepted: 08/06/2022] [Indexed: 11/13/2022] Open
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Riley BL, Valaitis RF, Abramowicz A, d'Avernas E, Jolin MA. Pause, re-think, go virtual … pandemic adaptations from 20 diverse mental health promotion intervention projects across Canada. MENTAL HEALTH & PREVENTION 2022; 26:200235. [PMID: 36570868 PMCID: PMC9764095 DOI: 10.1016/j.mhp.2022.200235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/12/2022] [Accepted: 03/12/2022] [Indexed: 12/27/2022]
Abstract
The Government of Canada's Mental Health Promotion Innovation Fund (MHP-IF) is a platform for learning across diverse projects, facilitated by a Knowledge Development and Exchange Hub. MHP-IF projects were getting underway before the COVID-19 pandemic escalated in 2020 and dramatically shifted their circumstances and activities. Using storytelling methods, this study explored 20 project experiences during the first year of the pandemic, including how and why assumptions, plans, and activities were adapted; early signals about what was working well or not; and how adaptations influenced equity, access, and cultural safety. Project teams generally navigated through four stages: pausing, re-thinking, adapting, and settling into adjustments. Within and across these stages, projects addressed similar processes, including meeting fundamental needs of participants and project teams, managing unanticipated benefits, and engaging with online formats. All projects experienced the pandemic's influence of amplifying both inequities and public and political attention on mental health. This study provides experiential evidence from diverse settings and populations in Canada about pandemic adaptations. The multi-project model and storytelling methods can usefully contribute to additional research, including ways to address inequities and promote cultural safety.
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Strudwick G, Risling T, Kassam I, Shin HD, Moss T, Carlberg C, Zhou W. Lessons learned developing and deploying a provincial virtual mental health support during the COVID-19 pandemic. Healthc Manage Forum 2022; 35:231-235. [PMID: 35603509 PMCID: PMC9127448 DOI: 10.1177/08404704221092691] [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] [Indexed: 11/21/2022]
Abstract
Significant efforts have been put into implementing virtual forms of healthcare
and supports since the beginning of the pandemic. However, limited information
has been shared with health leaders about how this has taken place, and what can
be learned from this to move forward into the future. The purpose of this
article is to describe lessons learned co-designing and developing a virtual
health support during the COVID-19 pandemic in the province of Saskatchewan. In
this article, we anchor these lessons learned on a specific virtual health
service support, “SaskWell,” which offers a digital service, and aims to connect
residents of the province to digital mental health supports and resources.
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Affiliation(s)
- Gillian Strudwick
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Tracie Risling
- University of Calgary, Calgary, Alberta, Canada
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Iman Kassam
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Hwayeon Danielle Shin
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Tyler Moss
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Wenjia Zhou
- MEMOTEXT Corporation, Toronto, Ontario, Canada
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Bonardi O, Wang Y, Li K, Jiang X, Krishnan A, He C, Sun Y, Wu Y, Boruff JT, Markham S, Rice DB, Thombs-Vite I, Tasleem A, Santo TD, Yao A, Azar M, Agic B, Fahim C, Martin MS, Sockalingam S, Turecki G, Benedetti A, Thombs BD. Effects of COVID-19 Mental Health Interventions Among Children, Adolescents, and Adults Not Quarantined or Undergoing Treatment Due to COVID-19 Infection: A Systematic Review of Randomised Controlled Trials. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:336-350. [PMID: 35275494 PMCID: PMC9065490 DOI: 10.1177/07067437211070648] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Our objective was to assess the effects of mental health interventions for children, adolescents, and adults not quarantined or undergoing treatment due to COVID-19 infection. METHODS We searched 9 databases (2 Chinese-language) from December 31, 2019, to March 22, 2021. We included randomised controlled trials of interventions to address COVID-19 mental health challenges among people not hospitalised or quarantined due to COVID-19 infection. We synthesized results descriptively due to substantial heterogeneity of populations and interventions and risk of bias concerns. RESULTS We identified 9 eligible trials, including 3 well-conducted, well-reported trials that tested interventions designed specifically for COVID-19 mental health challenges, plus 6 other trials with high risk of bias and reporting concerns, all of which tested standard interventions (e.g., individual or group therapy, expressive writing, mindfulness recordings) minimally adapted or not specifically adapted for COVID-19. Among the 3 well-conducted and reported trials, 1 (N = 670) found that a self-guided, internet-based cognitive-behavioural intervention targeting dysfunctional COVID-19 worry significantly reduced COVID-19 anxiety (standardized mean difference [SMD] 0.74, 95% confidence interval [CI], 0.58 to 0.90) and depression symptoms (SMD 0.38, 95% CI, 0.22 to 0.55) in Swedish general population participants. A lay-delivered telephone intervention for homebound older adults in the United States (N = 240) and a peer-moderated education and support intervention for people with a rare autoimmune condition from 12 countries (N = 172) significantly improved anxiety (SMD 0.35, 95% CI, 0.09 to 0.60; SMD 0.31, 95% CI, 0.03 to 0.58) and depressive symptoms (SMD 0.31, 95% CI, 0.05 to 0.56; SMD 0.31, 95% CI, 0.07 to 0.55) 6-week post-intervention, but these were not significant immediately post-intervention. No trials in children or adolescents were identified. CONCLUSIONS Interventions that adapt evidence-based strategies for feasible delivery may be effective to address mental health in COVID-19. More well-conducted trials, including for children and adolescents, are needed.
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Affiliation(s)
- Olivia Bonardi
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yutong Wang
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kexin Li
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Xiaowen Jiang
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ankur Krishnan
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Chen He
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Ying Sun
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yin Wu
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, 5620McGill University, Montreal, Quebec, Canada
| | - Sarah Markham
- Department of Biostatistics and Health Informatics, King's College London, London, United Kingdom
| | - Danielle B Rice
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Ian Thombs-Vite
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Amina Tasleem
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Tiffany Dal Santo
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Anneke Yao
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada
| | - Marleine Azar
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Branka Agic
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, 7938University of Toronto, Toronto, Ontario, Canada
| | - Christine Fahim
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
| | - Michael S Martin
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada.,Correctional Service of Canada, Ottawa, Ontario, Canada
| | - Sanjeev Sockalingam
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,149914Department of Psychiatry, 7938University of Toronto, Toronto, Ontario, Canada
| | - Gustavo Turecki
- Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada.,McGill Group for Suicide Studies, Douglas Mental Health University Institute, 5620McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, 5620McGill University, Montreal, Quebec, Canada.,Department of Medicine, 5620McGill University, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, 5620McGill University Health Centre, Montreal, Quebec, Canada
| | - Brett D Thombs
- 113635Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychiatry, 5620McGill University, Montreal, Quebec, Canada.,Department of Psychology, 5620McGill University, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, 5620McGill University, Montreal, Quebec, Canada.,Department of Medicine, 5620McGill University, Montreal, Quebec, Canada.,Department of Educational and Counselling Psychology, 5620McGill University, Montreal, Quebec, Canada.,Biomedical Ethics Unit, 5620McGill University, Montreal, Quebec, Canada
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Montesanti S, Fitzpatrick K, Fayant B, Pritchard C. Identifying priorities, directions and a vision for Indigenous mental health using a collaborative and consensus-based facilitation approach. BMC Health Serv Res 2022; 22:406. [PMID: 35346187 PMCID: PMC8958486 DOI: 10.1186/s12913-022-07682-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/24/2022] [Indexed: 12/19/2022] Open
Abstract
Background Mental health disparities between Indigenous and non-Indigenous people in Canada are related to underlying economic, social, and political inequities that are legacies of colonization and the oppression of Indigenous cultures. It also widely acknowledged that mental health services currently available may not be culturally appropriate in supporting the health needs of Indigenous Canadians. A two-day Indigenous mental health forum examined mental health needs and gaps among Indigenous communities across the Regional Municipality of Wood Buffalo (RMWB) on Treaty 8 territory, in northern Alberta, Canada. This paper outlines the insights generated by stakeholder engagement at the forum to identify and prioritize directions for Indigenous mental health and build a vision and strategy for improving mental health services and programs for the region’s diverse Indigenous population. Methods We applied a modified nominal group technique (NGT) consensus method embedded within Indigenous knowledge to determine key priorities and directions for Indigenous-focused mental health and synthesize information from discussions that occurred at the forum. Following the NGT, a participatory community visioning exercise was conducted with participants to develop a vision, guiding principles, and components of an action plan for an Indigenous mental health strategy for the RMWB. Results Four key themes for setting priorities and directions for Indigenous mental health emerged from roundtable group discussions: 1) understand the realities of mental health experiences for Indigenous peoples, 2) design a holistic and culturally rooted mental health system, 3) foster cross-sectoral engagement and collaboration on mental health service delivery, and 4) focus on children and youth. The community visioning exercise helped stakeholders to visualize a direction or path forward for addressing existing gaps in the mental health system and opportunities for strengthening Indigenous mental health in the region. Conclusions Forum participants described mental health and well-being around holistic concepts of social and emotional well-being. Addressing Indigenous mental health and wellness involves multi-sectoral action in various settings including community and school through programs, policies, and other interventions that promote mental health for all Indigenous peoples, as well as for those at greater risk such as children and youth. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07682-3.
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Sockalingam S, Leung SE, Ma C, Hawa R, Wnuk S, Dash S, Jackson T, Cassin SE. The Impact of Telephone-Based Cognitive Behavioral Therapy on Mental Health Distress and Disordered Eating Among Bariatric Surgery Patients During COVID-19: Preliminary Results from a Multisite Randomized Controlled Trial. Obes Surg 2022; 32:1884-1894. [PMID: 35218006 PMCID: PMC8880302 DOI: 10.1007/s11695-022-05981-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
Background Patients undergoing bariatric surgery have high rates of psychiatric comorbidity, which may increase their vulnerability to COVID-19-related mental health distress. Exacerbation of mental health distress and disordered eating could have significant negative effects on long-term weight management and quality of life for these patients if untreated. Objective To determine the efficacy of a telephone-based cognitive behavioral therapy (Tele-CBT) intervention in improving depressive, anxiety, and disordered eating symptoms during COVID-19. Methods Participants were recruited as part of a larger randomized controlled trial study (clinicaltrials.gov ID: NCT03315247) between March 2020 and March 2021 and randomized 1:1 to receive Tele-CBT or standard bariatric care. Outcomes of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Emotional Eating Scale (EES), and Binge Eating Scale (BES) were measured at baseline, immediately post-intervention, and 3 months post-intervention. Linear mixed models were used to test the effect of intervention group, time, and group-by-time interaction for each outcome. Results Eighty-one patients were included in the intention-to-treat analysis. Mean (SD) age of participants was 47.68 (9.36) years and 80.2% were female. There were significant group-by-time interactions for all outcomes and significant differences between groups across time. There were significant decreases in mean GAD-7 (p = 0.001), PHQ-9 (p < 0.001), EES-Total (p = 0.001), EES-Anger (p = 0.003), EES-Anxiety (p < 0.001), EES-Depression (p < 0.001), and BES (p = 0.002) scores for the Tele-CBT group at post-intervention and follow-up when compared to baseline and the control group. Conclusion Tele-CBT is a feasible and effective treatment for improving psychological distress and disordered eating among post-operative bariatric surgery patients during the COVID-19 pandemic. Graphical abstract ![]()
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Affiliation(s)
- Sanjeev Sockalingam
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. .,Centre for Addiction and Mental Health, ON, M6J 1H4, Toronto, Canada. .,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada.
| | - Samantha E Leung
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada
| | - Clement Ma
- Centre for Addiction and Mental Health, ON, M6J 1H4, Toronto, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
| | - Raed Hawa
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada
| | - Susan Wnuk
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada
| | - Satya Dash
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Medicine, University of Toronto, Toronto, ON, M5S 3H2, Canada
| | - Timothy Jackson
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, M5T 2S8, Canada
| | - Stephanie E Cassin
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada.,Department of Psychology, Ryerson University, Toronto, ON, M5B 2K3, Canada
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Spagnolo J, Beauséjour M, Fleury MJ, Clément JF, Gamache C, Sauvé C, Couture L, Fleet R, Knight S, Gilbert C, Vasiliadis HM. Perceptions on barriers, facilitators, and recommendations related to mental health service delivery during the COVID-19 pandemic in Quebec, Canada: a qualitative descriptive study. BMC PRIMARY CARE 2022; 23:32. [PMID: 35189813 PMCID: PMC8860461 DOI: 10.1186/s12875-022-01634-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/24/2022] [Indexed: 01/26/2023]
Abstract
Background There was an increase in self-reported mental health needs during the COVID-19 pandemic in Canada, with research showing reduced access to mental health services in comparison to pre-pandemic levels. This paper explores 1) barriers and facilitating factors associated with mental health service delivery via primary care settings during the first two pandemic waves in Quebec, Canada, and 2) recommendations to addressing these barriers. Methods A qualitative descriptive study design was used. Semi-structured interviews with 20 participants (health managers, family physicians, mental health clinicians) were conducted and coded using a thematic analysis approach. Results Barriers and facilitating factors were organized according to Chaudoir et al. (2013)‘s framework of structural, organizational, provider- and patient-related, as well as innovation (technological modalities for service delivery) categories. Barriers included relocation of mental health staff to non-mental health related COVID-19 tasks (structural); mental health service interruption (organizational); mental health staff on preventive/medical leave (provider); the pandemic’s effect on consultations (i.e., perceptions of increased demand) (patients); and challenges with the use of technological modalities (innovation). Facilitating factors included reinforcements to mental health care teams (structural); perceptions of reductions in wait times for mental health evaluations during the second wave due to diminished FP referrals in the first wave, as well as supports (i.e., management, private sector, mental health trained staff) for mental health service delivery (organizational); staff’s mental health consultation practices (provider); and advantages in increasing the use of technological modalities in practice (innovation). Conclusions To our knowledge, this is the first study to explore barriers and facilitating factors to mental health service delivery during the pandemic in Quebec, Canada. Some barriers identified were caused by the pandemic, such as the relocation of staff to non-mental health services and mental health service interruption. Offering services virtually seemed to facilitate mental health service delivery only for certain population groups. Recommendations related to building and strengthening human and technological capacity during the pandemic can inform mental health practices and policies to improve mental health service delivery in primary care settings and access to mental health services via access points. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01634-w.
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Affiliation(s)
- Jessica Spagnolo
- Université de Sherbrooke, Sherbrooke, Canada. .,Centre de recherche Charles-LeMoyne, Université de Sherbrooke, Campus Longueuil, Longueuil, Canada.
| | - Marie Beauséjour
- Université de Sherbrooke, Sherbrooke, Canada.,Centre de recherche Charles-LeMoyne, Université de Sherbrooke, Campus Longueuil, Longueuil, Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Montreal, Canada.,McGill University, Montreal, Canada
| | - Jean-François Clément
- Université de Sherbrooke, Sherbrooke, Canada.,Centre de recherche Charles-LeMoyne, Université de Sherbrooke, Campus Longueuil, Longueuil, Canada.,CISSS de la Montérégie-Est, Saint-Hyacinthe, Canada
| | | | - Carine Sauvé
- CISSS de la Montérégie-Centre, Taschereau, Canada
| | - Lyne Couture
- CIUSSS du Centre-Sud-de-l'Ile-de-Montréal, Montreal, Canada
| | | | - Shane Knight
- Initiative Patients-Partenaires, Université de Sherbrooke, Sherbrooke, Canada
| | - Christine Gilbert
- Initiative Patients-Partenaires, Université de Sherbrooke, Sherbrooke, Canada
| | - Helen-Maria Vasiliadis
- Université de Sherbrooke, Sherbrooke, Canada.,Centre de recherche Charles-LeMoyne, Université de Sherbrooke, Campus Longueuil, Longueuil, Canada
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Shen N, Kassam I, Chen S, Ma C, Wang W, Boparai N, Jankowicz D, Strudwick G. Canadian perspectives of digital mental health supports: Findings from a national survey conducted during the COVID-19 pandemic. Digit Health 2022; 8:20552076221102253. [PMID: 35646379 PMCID: PMC9131389 DOI: 10.1177/20552076221102253] [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: 01/19/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives The impact of the COVID-19 pandemic on population mental health has highlighted the potential for digital mental health to support the needs of those requiring care. This study sought to understand the digital mental health experiences and priorities of Canadians affected by mental health conditions (i.e. seekers, patients, and care partners). Methods A national cross-sectional electronic survey of Canadians was administered through a market research firm's survey panel. Seekers, patients, and care partners were asked about their digital mental health experiences (e.g. uptake, barriers to access) and priorities. Survey responses were summarized using descriptive statistics. Results Overall, 1003 participants completed the survey. 70.2% of participants routinely use digital mental health supports to support themselves or those they care for; however, only 28.6% of participants are satisfied with the available digital mental health supports. Most participants (73.3%) have encountered some barriers when accessing digital mental health supports. Awareness of digital mental health supports was a top barrier identified by participants. The top digital mental health priorities consisted of digital mental health curation, navigation, and a digital mental health passport. Conclusions Most participants use digital mental health supports for themselves or others, however, many are unaware of digital mental health supports available. Efforts to improve navigating access to digital and in-person mental health services are seen as a top priority, highlighting the need to enable seekers, patients, and care partners to find the appropriate support and make decisions on how to best improve their mental health.
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Affiliation(s)
- Nelson Shen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Iman Kassam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sheng Chen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Clement Ma
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Navi Boparai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Damian Jankowicz
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Abstract
PURPOSE OF REVIEW To describe examples of adapting apps for use in mental healthcare and to formulate recommendations for successful adaptation in mental healthcare settings. RECENT FINDINGS International examples are given to explore implementation procedures to address this multitude of challenges. There are only few published examples of adapting apps for use in mental healthcare. From these examples and from results of studies in implementation science in general clinical settings, it can be concluded that the process of adapting apps for mental healthcare needs to address clinician training and information needs, user needs which include cultural adaptation and go beyond mere translation, and organizational needs for blending app use into everyday clinical mental healthcare workflows.
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Ortega AC, Valtierra E, Rodríguez-Cuevas FG, Aranda Z, Preciado G, Mohar S. Protecting vulnerable communities and health professionals from COVID-19 associated mental health distress: a comprehensive approach led by a public-civil partnership in rural Chiapas, Mexico. Glob Health Action 2021; 14:1997410. [PMID: 34889715 PMCID: PMC8667903 DOI: 10.1080/16549716.2021.1997410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has stricken mental health worldwide. Marginalized populations in low- and middle-income countries have been the most affected, as they were already experiencing barriers to accessing mental health care prior to the pandemic and are unequally exposed to the stressors associated with the health emergency, such as economic ravages or increased risk of complicated disease outcomes. OBJECTIVE The aim of this paper is to describe a comprehensive initiative resulting from a public-civil partnership to address the increased burden of mental health illness associated with the COVID-19 pandemic in rural Chiapas, Mexico. METHODS To address the emerging health needs of the general population and health professionals resulting from the pandemic, Compañeros En Salud (CES), a non-profit civil society organization based in Chiapas, implemented a comprehensive strategy to compensate for the shortage of mental health services in the region in collaboration with the Chiapas Ministry of Health. The strategy included three components: capacity building in mental health care delivery, psychosocial support to the general population, and provision of mental health care to CES collaborating staff. In this capacity building article, implementers from CES and the government share descriptive information on the specific interventions carried out and their beneficiaries, as well as a critical discussion of the strategy followed. RESULTS Through this strategy, we have been successful in filling the gaps in the public health system to ensure that CES-served populations and CES-collaborating health professionals have access to mental health care. However, further studies to quantify the impact of this intervention in alleviating the burden of mental health illnesses associated with the pandemic are needed. CONCLUSIONS The current situation represents an opportunity to reimagine global mental health. Only through the promotion of community-based initiatives and the development of integrated approaches will we ensure the well-being of marginalized populations.
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Affiliation(s)
- Ana Cecilia Ortega
- Mental Health Program, Partners In Health Mexico/Compañeros En Salud, Ángel Albino Corzo, México
| | - Erika Valtierra
- Mental Health Program, Partners In Health Mexico/Compañeros En Salud, Ángel Albino Corzo, México
| | - Fátima Gabriela Rodríguez-Cuevas
- Mental Health Program, Partners In Health Mexico/Compañeros En Salud, Ángel Albino Corzo, México
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Zeus Aranda
- Research and Impact Program, Partners in Health Mexico/Compañeros En Salud, Ángel Albino Corzo, México
| | - Gisela Preciado
- Mental Health Program, Partners In Health Mexico/Compañeros En Salud, Ángel Albino Corzo, México
| | - Sebastián Mohar
- Hospital Básico Comunitario de Ángel Albino Corzo, Chiapas Ministry of Health, Ángel Albino Corzo, México
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Ellis LA, Meulenbroeks I, Churruca K, Pomare C, Hatem S, Harrison R, Zurynski Y, Braithwaite J. The Application of e-Mental Health in Response to COVID-19: Scoping Review and Bibliometric Analysis. JMIR Ment Health 2021; 8:e32948. [PMID: 34666306 PMCID: PMC8651237 DOI: 10.2196/32948] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and its mitigation measures and impacts, such as shelter-in-place orders, social isolation, restrictions on freedoms, unemployment, financial insecurity, and disrupted routines, have led to declines in mental health worldwide and concomitant escalating demands for mental health services. Under the circumstances, electronic mental health (e-mental health) programs and services have rapidly become the "new normal." OBJECTIVE The aim of this study was to assess key characteristics and evidence gaps in the e-mental health literature published in relation to the COVID-19 pandemic via a scoping review and bibliometric analysis. METHODS We conducted a search of four academic databases (ie, MEDLINE, Embase, PsycInfo, and CINAHL) for documents published from December 31, 2019, to March 31, 2021, using keywords for e-mental health and COVID-19. Article information was extracted that was relevant to the review objective, including journal, type of article, keywords, focus, and corresponding author. Information was synthesized by coding these attributes and was then summarized through descriptive statistics and narrative techniques. Article influence was examined from Altmetric and CiteScore data, and a network analysis was conducted on article keywords. RESULTS A total of 356 publications were included in the review. Articles on e-mental health quickly thrived early in the pandemic, with most articles being nonempirical, chiefly commentaries or opinions (n=225, 63.2%). Empirical publications emerged later and became more frequent as the pandemic progressed. The United States contributed the most articles (n=160, 44.9%), though a notable number came from middle-income countries (n=59, 16.6%). Articles were spread across 165 journals and had above-average influence (ie, almost half of the articles were in the top 25% of output scores by Altmetric, and the average CiteScore across articles was 4.22). The network analysis of author-supplied keywords identified key topic areas, including specific mental disorders, eHealth modalities, issues and challenges, and populations of interest. These were further explored via full-text analysis. Applications of e-mental health during the pandemic overcame, or were influenced by, system, service, technology, provider, and patient factors. CONCLUSIONS COVID-19 has accelerated applications of e-mental health. Further research is needed to support the implementation of e-mental health across system and service infrastructures, alongside evidence of the relative effectiveness of e-mental health in comparison to traditional modes of care.
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Affiliation(s)
- Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Isabelle Meulenbroeks
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Chiara Pomare
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Sarah Hatem
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Reema Harrison
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- National Health and Medical Research Council Partnership Centre for Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Lee H, Noh Y, Seo JY, Park SH, Kim MH, Won S. Impact of the COVID-19 Pandemic on the Mental Health of Adolescent Students in Daegu, Korea. J Korean Med Sci 2021; 36:e321. [PMID: 34845877 PMCID: PMC8629716 DOI: 10.3346/jkms.2021.36.e321] [Citation(s) in RCA: 8] [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: 07/23/2021] [Accepted: 11/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In February 2020, as coronavirus disease 2019 (COVID-19) spread rapidly in Daegu, South Korea, students in that region experienced many emotional difficulties. In this study, we analyzed the stress and emotional crisis experienced by students during the COVID-19 pandemic, its causative factors, and the factors that affect negative emotions. METHODS We identified the demographic information related to the experiences of unbearable stress and emotional crisis and their causal factors at three points in time: before the pandemic, during its peak, and at the time of the survey (2-3 months after the peak). In addition, we analyzed the factors related to depression and anxiety experienced by students during the COVID-19 pandemic. The Korean version of the Patient Health Questionnaire 9 and the Korean version of the Generalized Anxiety Disorder 7 was used to assess for depressive and anxiety symptoms in the subject students, respectively. RESULTS A total of 8,177 students participated in the analysis, with 4,072 boys (49.8%), 4,105 girls (50.2%), and 4,463 middle school students (54.6%) and 3,177 high school students (45.4%). The percentage of students who experienced unbearable stress was 9% before the COVID-19 pandemic, increased to 16% at the peak of the COVID-19 pandemic, then decreased to 12.7% at the time of the survey. Stress was experienced more by girls (18.1% versus 13.8% in boys; χ² = 28.159, P < 0.001) and high school students (19.0% versus 13.5% in middle school students; χ² = 45.437, P < 0.001). Overall, 7.6% experienced emotional crises during the COVID-19 pandemic, which was more prevalent in girls (10.1% versus 5.2% in boys; χ² = 71.025, P < 0.001) and in high school students (8.8% versus 6.7% in middle school students; χ² = 12.996, P < 0.001). Depression and anxiety was seen in 19.8% and 12.3% of students during the COVID-19 pandemic, respectively. The risk factors for depression and anxiety included unbearable stress before the COVID-19 pandemic (P < 0.001), mental health (P = 0.044), and age (P = 0.040), whereas resilience was identified as a protective factor for depression and anxiety (P = 0.001). CONCLUSION Students in Daegu experienced lots of mental difficulties since the COVID-19 pandemic. It will be necessary to improve stress management and resilience to improve students' mental health in disasters such as the COVID-19 pandemic.
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Affiliation(s)
- Hojun Lee
- Department of Psychiatry, School of Medicine, Keimyung University, Daegu, Korea
- Department of Psychiatry, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Yeseul Noh
- Daegu Student Suicide Prevention Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Ji Young Seo
- Daegu Student Suicide Prevention Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Sang Hee Park
- Wee Center in Kyungpook National University Hospital, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Myoung Haw Kim
- Department of Physical Education and Health, Daegu Metropolitan Office of Education, Daegu, Korea
| | - Seunghee Won
- Daegu Student Suicide Prevention Center, Kyungpook National University Chilgok Hospital, Daegu, Korea
- Wee Center in Kyungpook National University Hospital, Kyungpook National University Chilgok Hospital, Daegu, Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea.
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Risling T, Carlberg C, Kassam I, Moss T, Janssen P, Iduye S, Strudwick G. Supporting population mental health and wellness during the COVID-19 pandemic in Canada: protocol for a sequential mixed-method study. BMJ Open 2021; 11:e052259. [PMID: 34794993 PMCID: PMC8602926 DOI: 10.1136/bmjopen-2021-052259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The global COVID-19 pandemic has reported to have a negative impact on the mental health and well-being of individuals around the world. Mental health system infrastructure, primarily developed to support individuals through in-person care, struggled to meet rising demand for services even prior to COVID-19. With public health guidelines requiring the use of physical distancing during the pandemic, digital mental health supports may be one way to address the needs of the population. Despite this, barriers exist in promoting and supporting access to existing and emerging digital resources. Text messaging may address some of these barriers, extending the potential reach of these digital interventions across divides that may separate some vulnerable or disadvantaged groups from essential mental health supports. Building on an existing knowledge synthesis project identifying key digital resources for improved mental health, this research will establish low-tech connections to assess need and better match access to services for those who need it most. The aim of this study is to codesign a customised two-way texting service to explore need and better align access to mental health supports for Canadians located in Saskatchewan during the COVID-19 pandemic. METHODS AND ANALYSIS This study will be completed in Saskatchewan, Canada. For this project, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will be used to support three phases of a sequential mixed-method study. An advisory committee of Saskatchewan residents will guide this work with the study team. A 10-week service will be launched to connect individuals with appropriately suited digital mental health interventions through the use of text messaging. In phase 1, implementation and prototyping will be conducted with collaborative codesign for key elements related to features of an enrolment survey and initial messaging content. Phase 2 will focus on advancing the effectiveness of the service using quantitative user data. In phase 3, an embedding approach will be used to integrate both qualitative and quantitative data collected to understand the overall acceptability, satisfaction and perceived benefit of the text messaging service. Thematic analysis and descriptive statistics will be used as analytic methods. ETHICS AND DISSEMINATION This study has received approval from the Research Ethics Board at the University of Saskatchewan. A knowledge dissemination plan has been developed that includes traditional academic approaches such as conference presentations, and academic publications, as well as mainstream approaches such as social media, radio and dissemination through the advisory committee.
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Affiliation(s)
- Tracie Risling
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Courtney Carlberg
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Iman Kassam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tyler Moss
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Patricia Janssen
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steve Iduye
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gillian Strudwick
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Woodford J, Karlsson M, Hagström J, Hägg Sylvén Y, Norbäck K, Grönqvist H, von Essen L. Conducting Digital Health Care Research: Document Analysis of Challenges Experienced During Intervention Development and Feasibility Study Setup of an Internet-Administered Intervention for Parents of Children Treated for Cancer. JMIR Form Res 2021; 5:e26266. [PMID: 34433524 PMCID: PMC8538021 DOI: 10.2196/26266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/16/2021] [Accepted: 05/02/2021] [Indexed: 11/19/2022] Open
Abstract
Background The design and conduct of research to develop, test, and evaluate complex health care interventions is challenging. Although the existing literature describes key challenges associated with the design and conduct of definitive (evaluation) trials, there is a lack of information concerning specific challenges associated with the intervention development phase and setup of feasibility studies. In particular, the literature is scarce concerning the challenges associated with conducting digital health care research, such as research on internet-administered interventions and research using digital features to support the execution of study procedures (eg, recruitment, consent, retention, and data collection and management). This study is conducted in the context of the intervention development and feasibility study setup phases of an internet-administered, guided, low-intensity cognitive behavioral therapy–based intervention for parents of children previously treated for cancer. Objective The aim of this study is to explore the challenges experienced during the development phase of the internet-administered intervention and digital features to support the execution of the study procedures and a feasibility study setup. Methods To explore the key challenges experienced, we conducted a document analysis of written records from all study meetings held by the research team (meeting minutes) between June 7, 2018, and January 10, 2020, guided by a thematic analysis approach. Furthermore, discussion groups with members of the research team were held to develop a more detailed understanding of the key challenges experienced. Methods and results are reported in accordance with the relevant items from the Standards for Reporting Qualitative Research checklist. Results Six main themes were identified: decision-making and communication, expertise, external constraints, flexibility, planning and scheduling, and technical constraints. Conclusions Significant challenges were experienced during the intervention development and setup phases of the feasibility study. Implications are discussed to inform future design, conduct, and planning of internet-administered intervention development and feasibility studies, especially within the context of digital health care research.
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Affiliation(s)
- Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mathilda Karlsson
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Josefin Hagström
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ylva Hägg Sylvén
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kajsa Norbäck
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Grönqvist
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Prochaska JJ, Vogel EA, Chieng A, Baiocchi M, Maglalang DD, Pajarito S, Weingardt KR, Darcy A, Robinson A. A randomized controlled trial of a therapeutic relational agent for reducing substance misuse during the COVID-19 pandemic. Drug Alcohol Depend 2021; 227:108986. [PMID: 34507061 PMCID: PMC8423936 DOI: 10.1016/j.drugalcdep.2021.108986] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/20/2021] [Accepted: 07/25/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic disrupted access to treatment for substance use disorders (SUDs), while alcohol and cannabis retail sales increased. During the pandemic, we tested a tailored digital health solution, Woebot-SUDs (W-SUDs), for reducing substance misuse. METHODS In a randomized controlled trial, we compared W-SUDs for 8 weeks to a waitlist control. U.S. adults (N = 180) who screened positive for substance misuse (CAGE-AID>1) were enrolled June-August 2020. The primary outcome was the change in past-month substance use occasions from baseline to end-of-treatment (EOT). Study retention was 84%. General linear models tested group differences in baseline-to-EOT change scores, adjusting for baseline differences and attrition. RESULTS At baseline, the sample (age M = 40, SD = 12, 65% female, 68% non-Hispanic white) averaged 30.2 (SD = 18.6) substance occasions in the past month. Most (77%) reported alcohol problems, 28% cannabis, and 45% multiple substances; 46% reported moderate-to-severe depressive symptoms. Treatment participants averaged 920 in-app text messages (SD = 892, Median = 701); 96% of completed lessons were rated positively; and 88% would recommend W-SUDs. Relative to waitlist, W-SUDs participants significantly reduced past-month substance use occasions (M = -9.1, SE = 2.0 vs. M = -3.3, SE = 1.8; p = .039). Secondary substance use and mood outcomes did not change significantly by group; however, reductions in substance use occasions correlated significantly with increased confidence and fewer substance use problems, cravings, depression and anxiety symptoms, and pandemic-related mental health effects (p-value<.05). CONCLUSIONS W-SUDs was associated with significant reductions in substance use occasions. Reduction in substance use occasions was associated with better outcomes, including improved mental health. W-SUDs satisfaction was high.
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Affiliation(s)
- Judith J. Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA,Corresponding author at: Stanford Prevention Research Center, Department of Medicine, Stanford University, Medical School Office Building, X316, 1265 Welch Road, Stanford, CA, 94305, USA
| | - Erin A. Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA
| | - Amy Chieng
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA
| | - Michael Baiocchi
- Department of Epidemiology & Population Health, School of Medicine, Stanford University, USA
| | - Dale Dagar Maglalang
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA
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Sockalingam S. Comment on: Are eHealth interventions for adults who are scheduled for or have undergone bariatric surgery as effective as usual care? A systematic review. Surg Obes Relat Dis 2021; 17:2080-2081. [PMID: 34548248 DOI: 10.1016/j.soard.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Sanjeev Sockalingam
- Centre for Addiction and Mental Health, University Health Network Bariatric Surgery Program, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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From Digital Mental Health to Digital Social and Emotional Wellbeing: How Indigenous Community-Based Participatory Research Influenced the Australian Government's Digital Mental Health Agenda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189757. [PMID: 34574678 PMCID: PMC8467479 DOI: 10.3390/ijerph18189757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/29/2021] [Accepted: 09/08/2021] [Indexed: 12/04/2022]
Abstract
This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this “top-down” project to be transformed into a ‘ground-up’ community-guided process; and how, in turn, the guidance from the local Indigenous community partners went on to influence the national government’s d-MH agenda. The CBPR partnership between five community partners and a university rural health department is described, with illustrations of how CBPR harnessed the community’s voice in making the project relevant to their wellbeing needs. The local Indigenous community’s involvement led to a number of unexpected outcomes, which impacted locally and nationally. At an early stage, the conceptual framework of the project was changed from d-MH to the culturally-relevant Indigenous framework of digital social and emotional wellbeing (d-SEWB). This led to a significant expansion of the range and type of digital resources; and to other notable outcomes such as successful advocacy for an Aboriginal-specific online therapy program and for a dedicated “one-stop-shop” d-SEWB website, Wellmob, which was funded by the Australian government in 2019–2021. Some of the implications of this project for future Indigenous CBPR projects are discussed.
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Murphy JK, Khan A, Sun Q, Minas H, Hatcher S, Ng CH, Withers M, Greenshaw A, Michalak EE, Chakraborty PA, Sandanasamy KS, Ibrahim N, Ravindran A, Chen J, Nguyen VC, Lam RW. Needs, gaps and opportunities for standard and e-mental health care among at-risk populations in the Asia Pacific in the context of COVID-19: a rapid scoping review. Int J Equity Health 2021; 20:161. [PMID: 34253198 PMCID: PMC8274266 DOI: 10.1186/s12939-021-01484-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs. Methods We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available. Results A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority at-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or “low-tech” care must also remain available. Conclusions The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.
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Affiliation(s)
- Jill K Murphy
- Department of Psychiatry, Faculty of Medicine; APEC Digital Hub for Mental Health, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
| | - Amna Khan
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 2255 Westbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Qiumeng Sun
- Sol Price School of Public Policy, University of Southern California, 650 Childs Way, Los Angeles, CA, 90089, USA
| | - Harry Minas
- Global and Cultural Mental Health, Level 4, 207 Bouverie Street, Melbourne, Australia.,The University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, 3010, Australia
| | - Simon Hatcher
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Chee H Ng
- Healthscope Chair of Psychiatry, Department of Psychiatry, The University of Melbourne, Carlton, Victoria, 3010, Australia
| | - Mellissa Withers
- USC Keck School of Medicine, USC Institute on Inequalities in Global Health, Los Angeles, USA.,APRU Global Health Program, 2001 N Soto Street SSB 318G, Los Angeles, CA, 90089, USA
| | - Andrew Greenshaw
- Department of Psychiatry, Scientific Director, APEC Digital Hub for Mental Health, Faculty of Medicine & Dentistry, 4-142M Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, Alberta, T6G 2B7, Canada
| | - Erin E Michalak
- APEC Digital Hub for Mental Health, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Karen Sharmini Sandanasamy
- Mental Health, Substance Abuse and Violence Injury Prevention, Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Level 2, Block E3, Putrajaya, Malaysia.,Precinct 1, Federal Government Administrative Complex, 62590, Putrajaya, Malaysia
| | - Nurashikin Ibrahim
- Mental Health, Substance Abuse and Violence Injury Prevention, Non-Communicable Disease Section, Disease Control Division, Ministry of Health, Level 2, Block E3, Putrajaya, Malaysia.,Precinct 1, Federal Government Administrative Complex, 62590, Putrajaya, Malaysia
| | - Arun Ravindran
- Global Mental Health Affairs & The Office of Fellowship Training, Department of Psychiatry, Graduate Faculty, Institute of Medical Sciences, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St, Toronto, ON, M6J 1H4, Canada
| | - Jun Chen
- Office for Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Xuhui District, Shanghai, China
| | - Vu Cong Nguyen
- Institute of Population, Health and Development, ICON4 Tower, 243a Đường La Thành, Láng Thượng, Đống Đa, Hà Nội, 117222, Vietnam
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, Canada.,Mood Disorders Centre, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada.,APEC Digital Hub for Mental Health, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
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