YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study
YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study
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DOI：
10.2196/12108
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发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Goodyear-Smith, Felicity Anne
中科院分区：
文献类型：
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作者：
Martel, Rhiannon Mary;Darragh, Margot Louise;Goodyear-Smith, Felicity Anne
背景：在新西兰（NZ），四分之一的青少年受到心理健康问题（例如抑郁和焦虑）的影响，并从事危险行为（例如有害饮酒和药物滥用），毛利青少年的比例明显更高。大多数新西兰中学生至少每年拜访当地的初级卫生保健提供者 (PHP)，但大多数人不会因心理健康和危险行为 (MHB) 问题寻求帮助。虽然年轻人认为在与 PHP 协商期间讨论敏感问题是可以接受的，但除非问题很严重，否则此类对话不是由 PHP 发起的。对 MHB 问题进行早期干预可以预防长期的健康和福祉问题。然而，这依赖于及早发现正在出现的问题以及向青年提供和接受帮助。 YouthCHAT 是一款电子多项目筛查工具，于 2016 年开发，用于评估青少年对 MHB 的担忧。 YouthCHAT 在与 PHP 协商之前完成，PHP 可以立即访问摘要报告。帮助问题可以让年轻人找出需要解决的问题。资源包使用阶梯式护理途径来指导提供者使用适当的简短干预措施。 目的：本研究旨在探索 YouthCHAT 的实用性、可行性和可接受性，特别适合毛利人口众多的初级护理环境中的青少年。该研究的目的是评估 YouthCHAT 在 Te Tai Tokerau（新西兰北地）护士主导的青少年诊所、学校诊所和全科诊所中的实施情况；制定一个框架，以便在更多环境中扩大 YouthCHAT 的规模；评估医疗服务提供者和青少年对该工具的接受程度；提高心理健康和求助行为的筛查率；以便及早发现新出现的问题；方法：采用双文化混合方法共同设计方法，在三年内分三个阶段对 YouthCHAT 的实用性、可行性和可接受性进行迭代评估，旨在为更广泛的推广和实施创建一个框架。结果：第一阶段的招募于 2018 年 9 月开始。YouthCHAT 于 2018 年 10 月在第一个站点实施，预计于 1 月下旬在另外两个站点实施到 2019 年 2 月初。该研究预计于 2021 年底完成。结论：YouthCHAT 有潜力成为一种用户友好、省时且文化安全的筛查工具，用于及早发现新西兰青少年的 MHB 问题。该资源包协助临床医生针对新出现和已发展的青少年心理健康和生活方式问题提供适当的干预措施。社区提供者、用户和利益相关者的参与将确保 YouthCHAT 的可修改元素经过定制，以满足每种情况下特定的健康需求，并将对新西兰青年未来的心理、身体和社会结果产生积极影响。
Background: In New Zealand (NZ), 1 in 4 adolescents is affected by mental health issues (eg, depression and anxiety) and engages in risk behaviors (eg, harmful drinking and substance abuse), with rates among Maori youth being significantly higher. The majority of NZ secondary school students visit their local primary health care providers (PHPs) at least annually, yet most do not seek help for mental health and risk behavior (MHB) concerns. While youth think it acceptable to discuss sensitive issues during a consultation with their PHPs, unless problems are severe, such conversations are not initiated by PHPs. Early intervention for MHB concerns can prevent long-term health and well-being issues. However, this relies on the early identification of developing problems and youth being offered and accepting help. YouthCHAT is an electronic, multi-item screening tool developed in 2016 to assess MHB concerns among youth. YouthCHAT is completed before a consultation with the PHP, who can access a summary report straight away. A help question allows young people to identify issues that need addressing. A resource pack uses stepped care pathways to guide providers to use appropriate brief interventions.Objective: This study aimed to explore the utility, feasibility, and acceptability of YouthCHAT when tailored for use with youth in primary care settings with large Maori populations. Objectives of the study are to evaluate the implementation of YouthCHAT in nurse-led youth clinics, school-based clinics, and general practice in Te Tai Tokerau (Northland, NZ); to develop a framework for the scaling up of YouthCHAT across further settings; to assess health provider and youth acceptability of the tool; to improve screening rates for mental health and help-seeking behavior; to enable early identification of emerging problems; and to improve brief intervention delivery.Methods: Using a bicultural mixed-methods co-design approach, 3 phases over a 3-year period will provide an iterative evaluation of the utility, feasibility, and acceptability of YouthCHAT, aiming to create a framework for wider-scale rollout and implementation.Results: Recruitment for the first phase began in September 2018. YouthCHAT was implemented at the first site in October 2018 and is expected to be at a further two sites in late January to early February 2019. The study is due for completion at the end of 2021.Conclusions: YouthCHAT has potential as a user-friendly, time efficient, and culturally safe screening tool for early detection of MHB issues in NZ youth. The resource pack assists the clinician to provide appropriate interventions for emerging and developed youth mental health and lifestyle issues. Involving input from community providers, users, and stakeholders will ensure that modifiable elements of YouthCHAT are tailored to meet the health needs specific to each context and will have a positive influence on future mental, physical, and social outcomes for NZ youth.