Acceptability of mixed reality technology as a delivery mechanism for psychological intervention in adolescents with asthma: a qualitative study using the Theoretical Framework of Acceptability. (Preprint)

BACKGROUND Interactive, mixed-reality technologies such as augmented reality (AR), virtual reality (VR) and holographic technology may provide a novel, low-cost solution to fast-track the translation of evidence into practice; and may help overcome barriers to both mental health and asthma management service uptake. OBJECTIVE The aim of this study was to investigate if mixed reality technology is an acceptable mechanism for the delivery of a component of CBT for the management of symptoms of elevated psychological distress among young people with asthma. METHODS To explore the perceived acceptability of these technologies, mixed reality tools were evaluated via qualitative, one-on-one interviews with young people with asthma and symptoms of psychological distress, parents/caregivers of young people with asthma and symptoms of psychological distress, and relevant health professionals. The Theoretical Framework of Acceptability (TFA) was used for deductive coding of recorded interview transcripts. RESULTS Three young people with asthma and symptoms of psychological distress (2 female, mean age (years) = 14, SD= 1.73), four parents/caregivers of individuals with asthma (1 female, mean age (years) = 55, SD= 14.58) and six health professionals (4 females, mean age = 40.8, SD= 4.32) consented to participate. Four constructs – experienced affective attitude, experienced effectiveness, self-efficacy and intervention coherence – were coded in all participant transcripts. The most frequently coded constructs were experienced affective attitude and intervention coherence; both reported a total of 96 times, while the least frequently coded construct was anticipated opportunity cost; reported a total of 5 times. Participants were mostly positive about the mixed reality resources. However, some concerns were raised regarding ethicality, particularly in relation to privacy, accessibility, and messaging. Participants noted the need for technology to be used in conjunction with face-to-face engagement with health professionals, and that some patients would respond to this type of delivery mechanism better than others. CONCLUSIONS These results suggest that mixed reality technology for the purposes of delivery of psychological intervention may be an acceptable addition to current healthcare practices for young people with asthma and symptoms of psychological distress. CLINICALTRIAL The study was prospectively registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620001109998.

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Mixed Reality Technology as a Delivery Mechanism for Psychological Intervention in Adolescents With Asthma: A Qualitative Protocol

International Journal of Qualitative Methods ◽

10.1177/16094069211008333 ◽

2021 ◽

Vol 20 ◽

pp. 160940692110083

Author(s):

Kelsey Sharrad ◽

Zoe Kopsaftis ◽

Andrew Tai ◽

Nicola Spurrier ◽

Ross Smith ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Young People ◽

Mixed Reality ◽

Psychological Intervention ◽

Low Cost ◽

Asthma Management ◽

Mental Wellbeing ◽

Asthma Prevalence ◽

Evidence Based

Australia has one of the highest asthma prevalence rates in the world, with this chronic and debilitating condition affecting one in nine people. The health and mental wellbeing of young people with asthma are worse than not only their peers without asthma but also worse than that of people with asthma at other ages. Psychological interventions could be beneficial in treating symptoms of elevated psychological distress in patients with asthma. However, evidence suggests that engagement with mental health services is low in this population. Technology-based solutions that engage youth may overcome barriers to service uptake for both mental health and asthma management. To fast-track the successful translation of evidence-based treatment into practice, interactive, mixed-reality technologies such as augmented reality (AR), virtual reality (VR) and holographic technology may provide a novel, low-cost solution, yet to date, methodological rigor in the evaluation of mixed reality for this purpose is lacking. To evaluate the perceived usability and acceptability of these technologies, mixed reality tools will be developed by the author team to deliver a component of a psychological intervention for treatment of elevated psychological distress among young people with asthma. Qualitative research will be conducted through one-on-one interviews with young people with asthma, parents/caregivers of young people with asthma, and with health professionals, during which participants will have time to interact with the resources. Moderator guides will be used to direct interviews, and will be supplemented with a questionnaire, including Likert-type measures of usability and acceptability to facilitate triangulation of data. Understanding and data obtained through this study will be used to develop version 2.0 mixed reality tools, which will be tested for feasibility in a RCT. Improving access to and uptake of evidence-based treatments for elevated psychological distress in young people with asthma may reduce the burden of this highly prevalent disease.

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Augmented Reality Technology As A Delivery Mechanism For Psychological Intervention In Adolescents With Asthma: A Randomised Controlled Feasibility Trial Protocol

10.21203/rs.3.rs-1122342/v1 ◽

2021 ◽

Author(s):

Kelsey Sharrad ◽

Caitlin Martini ◽

Zoe Kopsaftis ◽

Andrew Tai ◽

Nicola Spurrier ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Distress ◽

Augmented Reality ◽

Young People ◽

Linear Models ◽

Psychological Intervention ◽

Mixed Effects ◽

Feasibility Trial ◽

Life Questionnaire

Abstract Background: Australia has one of the highest rates of asthma prevalence worldwide, with almost one in 10 children affected. The mental health and wellbeing of asthmatic children is reported to be significantly more impacted than non-asthmatic peers; affecting both asthma management and their overall quality of life. The relationship between asthma and psychological distress is likely bi-directional, therefore requiring an intervention that addresses both psychological and physiological factors. Technology-based psychological interventions provide a potential solution that may increase engagement with treatment amongst adolescents. In particular, augmented reality (AR) is a novel technology that can be tailored to individual populations and has been proven effective in the management of other conditions. No evidence exists currently on the feasibility of AR in the management of psychological wellbeing within the asthmatic community.Methods: An 80-page workbook has been developed based on best-practice asthma guidelines and through consultation with field experts in Psychology and Paediatric Respiratory Medicine, AR tools have been developed following a needs assessment, and a bespoke smartphone app has been developed by Portal Australia. Forty (n=40) young people aged 13-17 years with persistent asthma will be recruited from the Respiratory Department at the Women’s and Children’s Hospital. Participants will be required to download a smartphone application (YOLO de-stress) and will be encouraged to use the app for a month. Participants will be required to complete the Youth Asthma-related Anxiety Scale, Paediatric Asthma Quality of Life Questionnaire and the Asthma Control Questionnaire at baseline and one-month post-intervention. Data analysis will be descriptive, with counts and percentages for categorical data, and means and standard deviations for continuous data compared between baseline and follow-up. For continuous outcome variables mixed effects linear models will be used. For other outcome measures mixed effects generalized linear models will be used. Discussion: This study will explore the feasibility of AR tools to aid delivery of psychological intervention to manage symptoms of elevated psychological distress among young people with asthma, and inform development of a fully powered RCT. Trial registration: This project was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620001109998

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Faculty Opinions recommendation of Overweight, race, and psychological distress in children in the Childhood Asthma Management Program.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1101043.557016 ◽

2008 ◽

Author(s):

Andreina Bruno

Keyword(s):

Psychological Distress ◽

Childhood Asthma ◽

Asthma Management ◽

Management Program ◽

Childhood Asthma Management Program

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Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465817000443 ◽

2017 ◽

Vol 46 (2) ◽

pp. 182-194 ◽

Cited By ~ 8

Author(s):

Laura Pass ◽

Carl W. Lejuez ◽

Shirley Reynolds

Keyword(s):

Mental Health ◽

Pilot Study ◽

Young People ◽

Adolescent Depression ◽

Psychological Intervention ◽

Clinical Effectiveness ◽

Evidence Based ◽

Behavioural Activation ◽

Evidence Based Treatments ◽

The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

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M.I.C.E—Mental Health Intervention for Children with Epilepsy: a randomised controlled, multi-centre clinical trial evaluating the clinical and cost-effectiveness of MATCH-ADTC in addition to usual care compared to usual care alone for children and young people with common mental health disorders and epilepsy—study protocol

Trials ◽

10.1186/s13063-020-05003-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sophie D. Bennett ◽

◽

J. Helen Cross ◽

Anna E. Coughtrey ◽

Isobel Heyman ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Usual Care ◽

Psychological Intervention ◽

Mental Health Disorders ◽

Long Term Conditions ◽

Children And Young People ◽

Health Disorders ◽

Randomised Controlled

Abstract Background Mental health disorders in the context of long-term conditions in children and young people are currently overlooked and undertreated. Evidence-based psychological treatments for common childhood mental health disorders (anxiety, depression and disruptive behaviour disorders) have not been systematically evaluated in young people with epilepsy despite their high prevalence in this population. The aim of this multi-site randomised controlled trial is to determine the clinical and cost-effectiveness of adding a modular psychological intervention to usual care for the mental health disorders in comparison to assessment-enhanced usual care alone. Methods In total, 334 participants aged 3–18 years attending epilepsy services will be screened for mental health disorders with the Strengths and Difficulties Questionnaire (SDQ) and the diagnostic Development and Wellbeing Assessment (DAWBA). Those identified as having a mental health disorder and consenting to the trial will be randomised to either receive up to 22 sessions of the modular psychological intervention (MATCH-ADTC) delivered over the telephone over 6 months by non-mental health professionals in addition to usual care or to assessment-enhanced usual care alone. Outcomes will be measured at baseline, 6 months and 12 months post-randomisation. It is hypothesised that MATCH-ADTC plus usual care will be superior to assessment-enhanced usual care in improving emotional and behavioural symptoms. The primary outcome is the SDQ reported by parents at 6 months. Secondary outcomes include parent-reported mental health measures such as the Revised Children’s Anxiety and Depression Scale, quality of life measures such as the Paediatric Quality of Life Inventory and physical health measures such as the Hague Seizure Severity Scale. Outcome assessors will be blinded to group assignment. Qualitative process evaluations and a health economic evaluation will also be completed. Discussion This trial aims to determine whether a systematic and integrated approach to the identification and treatment of mental health disorders in children and young people with epilepsy is clinically and cost-effective. The findings will contribute to policies and practice with regard to addressing mental health needs in children and young people with other long-term conditions. Trial registration ISRCTN ISRCTN57823197. Registered on 25 February 2019.

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ENgage YOung people earlY (ENYOY): a mixed-method study design for a digital transdiagnostic clinical – and peer- moderated treatment platform for youth with beginning mental health complaints in the Netherlands

BMC Psychiatry ◽

10.1186/s12888-021-03315-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

M. van Doorn ◽

A. Popma ◽

T. van Amelsvoort ◽

C. McEnery ◽

J. F. Gleeson ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Young People ◽

The Netherlands ◽

Study Design ◽

Mixed Method ◽

Mixed Method Study ◽

Health Complaints ◽

Stress Biomarkers ◽

Smart Watch

Abstract Background The onset of mental disorders typically occurs between the ages of 12 and 25, and the burden of mental health problems is the most consequential for this group. Indicated prevention interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders, even leading to suicide, have shown to be effective. However, the threshold to seek help appears to be high. Digital interventions could offer a solution, especially during the Covid-19 pandemic. This implementation study will investigate the digital indicated prevention intervention ENgage YOung people Early (ENYOY), the Dutch version of the original Moderated Online Social Therapy Platform (MOST+) from Australia. In addition, the relationship between stress biomarkers, symptoms and outcome measures of youth using the platform will be investigated in this study. Methods The MOST+ platform will be adapted, translated and developed for the situation in the Netherlands in collaboration with a Youth Panel. A prospective cohort of 125 young people (16–25 years) with beginning mental health complaints will be on the platform and followed for a year, of which 10 participants will have an additional smart watch and 10 participants will be asked to provide feedback about the platform. Data will be collected at baseline and after 3, 6 and 12 months. Outcome measures are Psychological Distress assessed with the Kessler Psychological Distress Scale (K10), Social and occupational functioning (measures by the SOFAS), positive mental health indicators measured by the Positive Health Instrument, stress biomarkers with a smart-watch, website journeys of visitors, and feedback of youth about the platform. It will be a mixed-method study design, containing qualitative and quantitative measures. Discussion This trial will specifically address young people with emerging mental health complaints, and offers a new approach for treatment in the Netherlands. Considering the waiting lists in (child and adolescent)-psychiatry and the increase in suicides among youth, early low-threshold and non-stigmatizing help to support young people with emerging psychiatric symptoms is of crucial importance. Moreover, this project aims to bridge the gap between child and adolescent and adult psychiatry. Trial registration Netherlands Trial Register ID NL8966, retrospectively registered on the 19th of October 2020.

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Pilot Testing the Theoretical Framework of Acceptability in a Process Evaluation of a Community Pharmacy–Based Men’s Mental Health Promotion Program

SAGE Open ◽

10.1177/2158244019885129 ◽

2019 ◽

Vol 9 (4) ◽

pp. 215824401988512

Author(s):

Andrea Lynn Murphy ◽

David Martin Gardner

Keyword(s):

Mental Health ◽

Health Promotion ◽

Process Evaluation ◽

Theoretical Framework ◽

Mental Health Promotion ◽

Health Promotion Program ◽

Perceived Effectiveness ◽

Pilot Testing ◽

Promotion Program ◽

Affective Attitude

The objective of this study was to assess men’s acceptability of a men’s mental health promotion program in community pharmacies through pilot testing the theoretical framework of acceptability (TFA) as part of the process evaluation. Five men were interviewed about their experiences with the Headstrong program to learn about the acceptability of the program. The TFA was used as the deductive coding scheme and consists of seven constructs including affective attitude, burden, intervention coherence, ethicality, opportunity costs, perceived effectiveness, and self-efficacy. Three constructs, affective attitude, perceived effectiveness, and intervention coherence, from the TFA were coded in all five transcripts. The most frequently coded constructs were affective attitude and perceived effectiveness, coded 19 and 17 times, respectively. Interviewees all reported good relationships with their pharmacists, which influenced their willingness, attitude, and low burden for participation in Headstrong. Each of the men expressed comments reflecting anticipated effectiveness of the program outside of their own experience and how it could impact other men. Use of the TFA as part of a process evaluation of men’s experiences in a men’s mental health program was useful in identifying men’s perceptions of the program’s acceptability. Further research regarding how the quality of existing relationships with clinicians and patients impacts the TFA constructs of affective attitudes, perceived effectiveness, and burden would be useful.

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