Pilot study of a well-being app to support New Zealand young people during the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Anna Serlachius ◽  
Anna Boggiss ◽  
David Lim ◽  
Kiralee Schache ◽  
Kate Wallace-Boyd ◽  
...  

BACKGROUND Well-being apps represent a promising and scalable approach for improving mental health outcomes in youth, especially during a global pandemic when access to face-to-face interventions may be limited. Whitu (seven in the New Zealand Māori language Te Reo) is a newly developed well-being app with seven modules that support young people to learn and practice evidence-based coping skills, including relaxation, mindfulness, self-compassion, healthy eating, and goal-setting. OBJECTIVE During this pilot, we explored the acceptability, usability, and preliminary efficacy of Whitu before refining the app for a randomized controlled trial (RCT). METHODS We recruited 20 New Zealand young people aged 16-25 years via social media to trial the first prototype of the Whitu app over 6 weeks. Within-group differences from baseline to 2- and 6-weeks post intervention in self-reported well-being, depression, anxiety, stress, self-compassion, and optimism were evaluated using repeated-measures ANOVA. A further 21 participants aged 16-30 years were recruited to participate in 4 focus groups to give feedback on the app’s usability and cultural acceptability. Feedback was analyzed using directed content analysis. RESULTS Statistically significant improvements in anxiety (p=.024) and stress (p=.017) were observed from baseline to 2-weeks post intervention. Improvements in well-being (p=.021), depression (p=.031), anxiety (p=.005), and stress (p=.004) were also observed from baseline to 6-weeks. No statistically significant changes were seen in self-compassion, optimism, or sleep. Qualitative feedback comprised of five key themes, namely: factors affecting engagement, issues with functionality, preferences regarding aesthetics, effectiveness and adverse effects, and cultural acceptability. CONCLUSIONS Our preliminary results suggest that Whitu may be an effective app for improving multiple dimensions of young people’s well-being. Modifications to the look and feel, cultural content, and onboarding have been undertaken based on the qualitative feedback, and an RCT is currently underway.

2021 ◽  
Author(s):  
Hiran Thabrew ◽  
Christa Fouché ◽  
Laura Ann Chubb ◽  
Stacey Yates ◽  
Harshali Kumar ◽  
...  

BACKGROUND Hospitalized children and young people can feel disconnected from their peers and families, which can in turn predispose them to psychological problems including anxiety and depression. Immersive Reality Experiences (IRE) technology, recently developed by the New Zealand Patience Project Charitable Trust may help to overcome these issues. IRE technology uses immersive 360-degree live-streaming and a virtual reality (VR) headset to enable hospitalized children and young people to connect with cameras located in either their school or home environment. OBJECTIVE This trial was undertaken to 1) quantitatively evaluate the effectiveness of IRE technology in reducing social isolation and improving social connectedness and wellbeing using validated outcome measures and 2) expand qualitative findings from a previous smaller ‘proof of concept’ trial to ascertain the views of hospitalized New Zealand children and young people, their caregivers and teachers regarding IRE technology. METHODS An open trial of IRE technology was conducted between December 2019 and December 2020 and included 19 New Zealand children and young people aged 13-18, who had been hospitalized at Starship Hospital, a specialist pediatric hospital in Auckland, for at least 2-weeks. All participants completed the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), an abbreviated version of the Social Connectedness Scale (SCS) and the Social Inclusion Scale (SIS) and at baseline. Ten participants used IRE technology as often as they wished over a 6-week period and completed post-intervention measures. Semi-structured interviews with a subset of participants, caregivers and teachers were conducted immediately post-intervention. RESULTS Participants reported improvements in social inclusion (mean change 3.9, SD 2.8, p 0.057), social connectedness (mean change 14.2, SD 10.0, p 0.002) and well-being (mean change 5.7, SD 4.0, p 0.003). Key themes from interviews with participants, caregivers and teachers were: the importance of support for using IRE technology, connecting vs connectedness, choice and connection, and the value of setting it up and getting it right. A number of recommendations for improving connectedness via IRE and related technology were also provided. CONCLUSIONS IRE technology can improve the social inclusion, social connectedness and well-being of hospitalized New Zealand children and young people. With some technological modifications and simplified implementation, IRE technology could become part of standard care and support hospitalized children and young people in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems and more easily return to normal life following completion of treatment. CLINICALTRIAL This study has been registered with the Australian New Zealand Clinical Trials Network Registry: ACTRN12619000252112p


2021 ◽  
pp. 154596832110231
Author(s):  
Kishoree Sangarapillai ◽  
Benjamin M. Norman ◽  
Quincy J. Almeida

Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson’s disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson’s Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 910
Author(s):  
Dorthe Djernis ◽  
Mia S. O’Toole ◽  
Lone O. Fjorback ◽  
Helle Svenningsen ◽  
Mimi Y. Mehlsen ◽  
...  

Here, we developed and examined a new way of disseminating mindfulness in nature to people without meditation experience, based on the finding that mindfulness conducted in natural settings may have added benefits. We evaluated a 5-day residential programme aiming to reduce stress and improve mental health outcomes. We compared an indoor and an outdoor version of the programme to a control group in a pilot randomised controlled trial (RCT). Sixty Danish university students experiencing moderate to high levels of stress were randomised into a residential mindfulness programme indoors (n = 20), in nature (n = 22), or a control group (n = 18). Participants completed the Perceived Stress Scale and the Self-Compassion Scale (primary outcomes) along with additional secondary outcome measures at the start and end of the program and 3 months after. Stress was decreased with small to medium effect sizes post-intervention, although not statistically significant. Self-compassion increased post-intervention, but effect sizes were small and not significant. At follow-up, changes in stress were not significant, however self-compassion increased for both interventions with medium-sized effects. For the intervention groups, medium- to large-sized positive effects on trait mindfulness after a behavioural task were found post-intervention, and small- to medium-sized effects in self-reported mindfulness were seen at follow-up. Connectedness to Nature was the only outcome measure with an incremental effect in nature, exceeding the control with a medium-sized effect at follow-up. All participants in the nature arm completed the intervention, and so did 97% of the participants in all three arms. Overall, the results encourage the conduct of a larger-scale RCT, but only after adjusting some elements of the programme to better fit and take advantage of the potential benefits of the natural environment.


2017 ◽  
Vol 4 ◽  
Author(s):  
S. U. Hamdani ◽  
P. Akhtar ◽  
Zill-e-Huma ◽  
H. Nazir ◽  
F. A. Minhas ◽  
...  

Background.Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan.Methods.The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by ‘family volunteers’ to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule – child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894).Discussion.This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings.Trial registration.Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental Disorders and Delays. Identifier: NCT02792894 Registered on 6 July 2016.


2020 ◽  
pp. 135910452096337
Author(s):  
Fiona Duffy ◽  
Helen Sharpe ◽  
Emily Beveridge ◽  
Kate Osborne ◽  
Cathy Richards

Body dissatisfaction is common in adolescence and associated with poor outcomes. The aim of this mixed method pilot evaluation was to determine acceptability, feasibility and preliminary efficacy of Interpersonal Psychotherapy for Body Image (IPT-BI), a school-based group intervention for young people with high levels of body dissatisfaction. Eighteen participants (11–13 years, 78% female) took part in two IPT-BI groups ( n = 10; n = 8). Feasibility was measured by recruitment and attrition rates; acceptability using a treatment satisfaction questionnaire and focus groups; and clinical outcomes at baseline, each session and post intervention. The majority of young people (72%, n = 18/25) who were referred or expressed interest went on to take part. Average session attendance was 100% and 89%. Participants expressed high levels of treatment satisfaction with 94% ( n = 16/17) rating IPT-BI as ‘quite helpful’ or ‘very helpful’ and 94% ( n = 16/17) stating they would recommend it to others. Preliminary exploration of efficacy showed significant improvements in body image and significant reductions in interpersonal difficulties and appearance-based conversations. Young people valued specific IPT-BI skills (role play, communication strategies), alongside generic therapeutic factors (therapeutic alliance, group cohesion). IPT-BI is feasible and acceptable with promising provisional clinical outcomes indicating the need for a fully powered randomised controlled trial.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S272-S272
Author(s):  
James McLoughlin ◽  
Paula Martin ◽  
Geraldine McCarthy ◽  
Chee Lin Piong

AimsMindfulness-based therapies have been demonstrated to be effective in reducing anxiety, stress and depressive symptoms in adults. Depression is a chronic relapsing condition. Major depressive disorder is one of the most common causes of ill health and functional impairment.Our goal was to assess the real world clinical effectiveness of Mindfulness Based Cognitive Therapy (MBCT) for Recurrent Depressive Disorder in three domains:-Depression, anxiety and stress levels-Mindfulness level-Self-compassion levelMethodPatients with a diagnosis of Recurrent Depressive Disorder (primary or secondary diagnosis) were referred by their community mental health team to participate in an 8-week educational MBCT programme. Participants completed the Depression, Anxiety and Stress (DASS), 5-Facet Mindfulness and Self Compassion self-rated scales prior to commencing and at the end of the course. They were also invited to give qualitative feedback at the end of the course.Data were collected from four groups who completed the course over a period of twelve months. A paired samples test was used to compare pre and post intervention scores to determine effect size.ResultWe had complete data for 19 participants out of a cohort of 34. Pre intervention scores were similar for both groups.The mean age of the cohort was 47 years (SD of 10 years), 3 male, 16 female.Patients showed a clinically significant reduction of symptoms in depression, anxiety and stress, with respective reductions of 48%, 26% and 43% post intervention. Results were statistically significant for depressaion and stress p <0.001 but not for anxiety p = 0.130.Positive trends were seen in all domains of the 5-Fact Mindfulness and Self Compassions scales, with mean improvements of 28.2% and 35.3% respectively. All results were statistically significant.We also collected anonymized qualitative feedback which highlighted themes of empowerment, skill acquisition and improved coping.ConclusionNumerous studies have demonstrated poor compliance with antidepressant treatments commonly prescribed in Recurrent Depressive Disorder. This small scale study demonstrates a statistical and clinical benefit of MBCT for these patients, supporting greater use of such novel non-pharmacological therapeutic options as treatment strategies..


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035862
Author(s):  
Elizabeth Alvarez ◽  
Arielle Sutton ◽  
Bria Barton ◽  
Shailla Vaidya

IntroductionRates of mental health illnesses and burnout are increasing internationally. Therapeutic yoga is increasingly used to improve and maintain physical, mental and emotional well-being and general health. This protocol describes a study to evaluate the effectiveness of an existing primary care group-based therapeutic yoga programme, the Yoga of Stress Resilience programme, which combines yoga and psychotherapeutic techniques, in improving mental health and decreasing burnout. Implementation factors will also be evaluated for potential scale-up.Methods and analysisA pragmatic before–after interventional trial design will be used to study changes in occupational participation and mental health outcomes, including anxiety, depression, burnout, functional impairment, insomnia, perceived stress, loneliness, self-compassion and readiness for change in adults experiencing anxiety and burnout. Repeated measures analysis of variance will be used to determine changes in outcome measures over time. Regression and multivariate analyses will be conducted to examine relationships between participant characteristics and outcomes and among various outcomes. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework will be used to guide the analyses.Ethics and disseminationApproval from the Hamilton Integrated Research Ethics Board has been waived: project number 7082 (full review waived). Informed consent will be obtained prior to enrolling any participant into the study. All data will be kept confidential. Peer-reviewed publications and presentations will target researchers and health professionals.Trial registration numberThe ClinicalTrials.gov registry (NCT03973216).


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Katherine T. O’Donnell ◽  
Melanie Dunbar ◽  
Diana L. Speelman

Abstract Objectives This interventional study will investigate the effect of daily use of a mindfulness app on measures of participant anxiety, well-being, and perceived outlook during the COVID-19 pandemic, by comparing pre-intervention survey responses to post-intervention survey responses. Trial design Randomized, controlled trial with parallel assignment. Adults will be assigned either to daily use of a meditation app for 30 days or to a control group (no usage of meditation app) with a 1:1 equivalence allocation ratio. Participants Inclusion Criteria: Participants must be 18 or older, have a smartphone, able to download apps to their smartphone, must be fluent in the English language, able to complete surveys on their own, and must be in the United States for the duration of the study. Exclusion Criteria: Current regular use of a mindfulness or meditation app, regular practice of mindfulness or meditation, regular therapy sessions, inability to complete surveys independently, or any mental health restrictions that would prevent participation. All data will be collected through the Insight Timer Meditation App and Google Forms. This trial is being conducted through the Lake Erie College of Osteopathic Medicine in Erie, PA, with all data collected digitally. Intervention and comparator Intervention: Participants will be sent a link to a pre-intervention survey prior to first use of the mindfulness app. Participants will be instructed to use the Insight Timer app for 10 minutes daily for 30 days. At the end of the 30-day intervention period, participants will be sent a link for the post-intervention survey. Two months after the conclusion of the 30-day intervention period, participants will be sent a link for another post-intervention survey. Comparator: Participants will receive the same surveys, but will not use any mindfulness app for the 30-day intervention period. After this 30-day period, participants are invited to use the Insight Timer app if they so choose. Main outcomes The main outcomes are (1) anxiety as assessed by survey questions adapted from the GAD7, comparing pre-intervention to post-30-days of app usage and (2) well-being as assessed by survey questions adapted from the WHO-5, comparing pre-intervention and post-30-days of app usage. Randomization Participants will be allocated to interventions via a block random sequence generator with a 1:1 allocation ratio in blocks of 8. Blinding (masking) No masking is being used in this study (open label). Numbers to be randomized (sample size) Approximately 75 participants will be randomized to each group, with an estimated enrollment of 150 participants. Trial status This study is protocol version number 27-126 and was approved on May 10, 2020. Recruitment began on August 19, 2020 and will end February 28, 2021. The study is estimated to complete on April 30, 2021. Trial registration This trial was registered to ClinicalTrials.gov on 30 April 2020. The ClinicalTrials.gov Identifier is NCT04369378. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional File 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


2020 ◽  
Vol 22 (1) ◽  
pp. 100-112 ◽  
Author(s):  
Nick Axford ◽  
Gretchen Bjornstad ◽  
Justin Matthews ◽  
Laura Whybra ◽  
Vashti Berry ◽  
...  

AbstractThe study, a two-arm, randomized controlled, parallel group, superiority trial, aimed to evaluate the implementation and effectiveness of a 12-month one-to-one volunteer mentoring program designed to improve behavioral and emotional outcomes in children aged 5 to 11 years who have teacher- and parent/carer-reported behavioral difficulties. Participants were 246 children (123 intervention, 123 control; mean age 8.4 years; 87% boys) in five sites in London, UK, scoring in the “abnormal” range on the teacher-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties measure and in the “borderline” or abnormal range on the parent-rated SDQ Total Difficulties measure. Randomization on a 1:1 ratio took place using a computer-generated sequence and stratifying by site. Data collectors and statisticians were blind to participant allocation status. Outcome measures focused on parent- and teacher-rated child behavior and emotions, and child-rated self-perception and hope. Intention-to-treat analysis on all 246 randomized participants (using imputed data where necessary) showed that at post-intervention (16 months after randomization), there were no statistically significant effects on the primary outcome—parent-rated SDQ Total Difficulties (adjusted standardized mean difference = − 0.12; 95% CI: −0.38 to 0.13; p = 0.33)—or any secondary outcomes. Results from complier average causal effect (CACE) analysis using the primary outcome indicated the intervention was not effective for children who received the recommended duration of mentoring. Exploratory analyses found no sub-group effects on the primary outcome. The article concludes that the mentoring program had no effect on children’s behavior or emotional well-being, and that program content needs revising to satisfactorily address key risk and protective factors.


2020 ◽  
Vol 64 (4) ◽  
pp. 319-330
Author(s):  
Sophia Olton-Weber ◽  
Robyn Hess ◽  
Jennifer A. Ritchotte

Gifted youth frequently experience perfectionism, which for some can affect their emotional well-being. This study evaluated the effectiveness of a 6-week mindfulness intervention for 42 middle school students who were identified as Gifted and Talented. Participants’ levels of self-oriented and socially prescribed perfectionism, as well as their use of mindfulness practices, were evaluated pre- and post- intervention, as well as at a 5-week follow-up to assess changes in perfectionism ratings and use of mindfulness. Three Bonferroni-adjusted, one-way, repeated measures analyses of variance were performed, and the results indicated a significant decrease in self-oriented perfectionism and an increase in mindfulness at both the end of the intervention and at follow-up. These findings support the use of mindfulness as an appropriate intervention to reduce self-imposed forms of perfectionism among gifted youth.


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