Co-design and Evaluation of an Online Personalised Feedback Intervention Toolkit to Increase Help-seeking for Mental Health Problems among Students

心理健康问题和糟糕的幸福感在英国大学生中正在增加，并且以比普通人群更快的速度增加(Cuijpers等人)。2019年)。英国政府已宣布学生心理健康是国家优先事项(Gyimah 2018)，世界卫生组织确定了基于网络的干预战略的必要性(Cuijpers等人)。2019年)。大学学习期间的心理健康问题会影响学业成绩和辍学(Cuijpers等人。2019年；哈特利2010年)，以及长期生活和职业运作(Kernan等人)。2008年)。心理健康问题有有效的治疗方法，但学生群体的求助行为很少(Cuijpers等人)。由于心理健康素养低、个人态度、感觉到的耻辱和卫生系统结构等因素(Reavley&Jorm，2010年)。当年轻人认识到精神健康问题并拥有寻求帮助的知识和支持时，他们更有可能寻求帮助(Kelly等人)。2007)。个性化反馈是新兴的教育干预措施，为个人提供有关症状的反馈和应对策略的建议，如自助和寻求帮助的行为(Reavley&Jorm 2010)。多项试验发现，个性化反馈会增加求助，例如，一项试验发现，接受个性化在线评估的抑郁症风险人群寻求帮助的可能性是其他人的三倍(Haas等人)。2008年)。在线自我评估工具可以克服获取面对面评估的障碍，如社交焦虑和耻辱；它们被学生广泛接受，与需要训练有素的临床医生的面对面评估相比，实施起来成本效益高。假设个性化反馈干预将增加心理健康问题的求助和/或自助行为。本项目旨在共同设计和评估一个在线干预工具包，以增加有心理健康问题或有心理健康问题风险的大学生的求助和自助行为，通过以下目标：1.探索关于个性化反馈干预的现有证据；2.共同设计可访问和参与的在线个性化反馈干预，并评估该工具包的用户观点。3.测试干预措施增加求助或自助行为的有效性。我将对证据进行系统审查，以找出增加求助或自助行为的个性化反馈干预措施。这一证据将为第二阶段提供信息。其次，我将使用迭代的小组反馈过程来与学生代表共同设计研究干预。然后，一小群学生将测试干预原型，我将通过定性访谈探索用户观点。这些证据将反馈到迭代的联合设计过程中。最后，我将在约克大学的学生队列中植入一项随机对照试验，以进行快速评估，以测试干预措施在增加求助和自助行为方面的有效性。六名英国大学生对这项提议提供了反馈。所有代表都表示，建议的干预措施是有必要的，而且它显然有可能帮助学生识别症状，并有利于他们的心理健康。面对面的评估被认为是令人焦虑的，在线干预将克服这一障碍。即时提供的个性化反馈对忙碌的学生非常有吸引力。所有代表都表示，他们宁愿使用拟议的干预措施，也不愿最初接触专业的支持来源。早期干预可能会对学生的心理健康和长期生活和职业功能产生重大好处(Kernan等人，2008年)，并对社会产生长期的健康和经济利益。调查结果将被广泛传播，目的是让英国的大学采用该工具包。

Mental health problems and poor wellbeing are increasing among UK university students and are increasing at a faster rate than in the general population (Cuijpers et al. 2019). The UK government has declared student mental health a national priority (Gyimah 2018) and the WHO identified a need for web-based intervention strategies (Cuijpers et al. 2019). Mental health problems during university study affect academic performance and dropout (Cuijpers et al. 2019; Hartley 2010), and long-term life and career functioning (Kernan et al. 2008). Effective treatments for mental health problems exist but help-seeking behaviours are low in student populations (Cuijpers et al. 2019) due to factors such as low mental health literacy, personal attitudes, perceived stigma, and health system structure (Reavley & Jorm 2010). Young people are more likely to seek help when they recognise a mental health problem and have the knowledge and support to seek help (Kelly et al. 2007). Personalised feedback are emerging educational interventions that provide individuals with feedback about symptoms and suggestions for coping strategies, such as self-help and help-seeking behaviours (Reavley & Jorm 2010). Multiple trials found that personalised feedback increases help-seeking, for example one trial found that individuals at risk of depression who received a personalised online assessment were three times more likely to seek help (Haas et al. 2008). Online self-assessment tools can overcome barriers to accessing face-to-face assessments such as social anxiety and stigma; they are widely acceptable to students and are cost-effective to implement compared to face-to-face assessments that require trained clinicians. It is hypothesised that a personalised feedback intervention will increase help-seeking and/or self-help behaviours for mental health problems.This project aims to co-design and evaluate an online intervention toolkit to increase help-seeking and self-help behaviour among university students with, or at risk of, mental health problems, via the following objectives:1. Explore existing evidence on personalised feedback interventions;2. Co-design an accessible and engaging online personalised feedback intervention and evaluate user perspectives of the toolkit; 3. Trial the intervention's effectiveness to increase help-seeking or self-help behaviours.I will perform a systematic review of the evidence to identify personalised feedback interventions that increase help-seeking or self-help behaviour. This evidence will inform stage two. Secondly, I will use an iterative group feedback process to co-design the study intervention with student representatives. A small group of students will then test an intervention prototype and I will explore user perspectives via qualitative interviews. This evidence will feed back into the iterative co-design process. Finally, I will test the intervention's effectiveness to increase help-seeking and self-help behaviours by embedding a randomised controlled trial within the York student cohort to perform a rapid evaluation. Six UK university students provided feedback on the proposal. All representatives said there was a need for the proposed intervention and that it had clear potential to help students recognise symptoms and benefit their mental health. Face-to-face assessments were perceived to be anxiety-provoking and an online intervention would overcome this barrier. The personalised feedback being provided immediately was highly attractive to students with busy schedules. All representatives said they would rather use the proposed intervention than initially approach professional sources of support. Early intervention would likely reap major benefits to student's mental health and long-term life and career functioning (Kernan et al., 2008), and has long-term health and economic benefits to society. Findings will be disseminated widely with an aim for UK universities to adopt the toolkit.