scholarly journals The Design and Relevance of a Computerized Gamified Depression Therapy Program for Indigenous Māori Adolescents

2020 ◽  
Author(s):  
Matthew Shepherd ◽  
Theresa Fleming ◽  
Mathijs Lucassen ◽  
Karolina Stasiak ◽  
Ian Lambie ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Behavioral Therapy ◽  
Computer Game ◽  
Indigenous Communities ◽  
Well Being ◽  
Behavioural Therapy ◽  
Cultural Relevance ◽  
Face Validity ◽  
Indigenous Adolescents

BACKGROUND: Depression is a major health issue among Māori indigenous adolescents, yet there has been little investigation into the relevance or effectiveness of psychological treatments for them. Further, consumer views are critical for engagement and adherence to therapy. However, there is little research regarding indigenous communities' opinions about psychological interventions for depression. OBJECTIVE: The objective of this study was to conduct semistructured interviews with Māori (indigenous New Zealand) young people (taitamariki) and their families to find out their opinions of a prototype computerized cognitive behavioral therapy (cCBT) program called Smart, Positive, Active, Realistic, X-factor thoughts (SPARX), a free online computer game intended to help young persons with mild to moderate depression, feeling down, stress or anxiety. The program will teach them how to resolve their issues on their own using Cognitive Behavioural Therapy as psychotherapeutic approach. METHODS: There were seven focus groups on the subject of the design and cultural relevance of SPARX that were held, with a total of 26 participants (19 taitamarki, 7 parents/caregivers, all Māori). There were five of the groups that were with whānau (family groups) (n=14), one group was with Māori teenage mothers (n=4), and one group was with taitamariki (n=8). The general inductive approach was used to analyze focus group data. RESULTS: SPARX computerized therapy has good face validity and is seen as potentially effective and appealing for Māori people. Cultural relevance was viewed as being important for the engagement of Māori young people with SPARX. Whānau are important for young peoples' well-being. Participants generated ideas for improving SPARX for Māori and for the inclusion of whānau in its delivery. CONCLUSIONS: SPARX computerized therapy had good face validity for indigenous young people and families. In general, Māori participants were positive about the SPARX prototype and considered it both appealing and applicable to them. The results of this study were used to refine SPARX prior to it being delivered to taitamariki and non-Māori young people. TRIAL REGISTRATION: The New Zealand Northern Y Regional Ethics Committee; http://ethics.health.govt.nz/home; NTY/09/003; (Archived by WebCite at http://www.webcitation/6VYgHXKaR).

scholarly journals The Design and Relevance of a Computerized Gamified Depression Therapy Program for Indigenous Māori Adolescents

2020 ◽  
Author(s):  
Matthew Shepherd ◽  
Theresa Fleming ◽  
Mathijs Lucassen ◽  
Karolina Stasiak ◽  
Ian Lambie ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Behavioral Therapy ◽  
Computer Game ◽  
Indigenous Communities ◽  
Well Being ◽  
Behavioural Therapy ◽  
Cultural Relevance ◽  
Face Validity ◽  
Indigenous Adolescents

BACKGROUND: Depression is a major health issue among Māori indigenous adolescents, yet there has been little investigation into the relevance or effectiveness of psychological treatments for them. Further, consumer views are critical for engagement and adherence to therapy. However, there is little research regarding indigenous communities' opinions about psychological interventions for depression. OBJECTIVE: The objective of this study was to conduct semistructured interviews with Māori (indigenous New Zealand) young people (taitamariki) and their families to find out their opinions of a prototype computerized cognitive behavioral therapy (cCBT) program called Smart, Positive, Active, Realistic, X-factor thoughts (SPARX), a free online computer game intended to help young persons with mild to moderate depression, feeling down, stress or anxiety. The program will teach them how to resolve their issues on their own using Cognitive Behavioural Therapy as psychotherapeutic approach. METHODS: There were seven focus groups on the subject of the design and cultural relevance of SPARX that were held, with a total of 26 participants (19 taitamarki, 7 parents/caregivers, all Māori). There were five of the groups that were with whānau (family groups) (n=14), one group was with Māori teenage mothers (n=4), and one group was with taitamariki (n=8). The general inductive approach was used to analyze focus group data. RESULTS: SPARX computerized therapy has good face validity and is seen as potentially effective and appealing for Māori people. Cultural relevance was viewed as being important for the engagement of Māori young people with SPARX. Whānau are important for young peoples' well-being. Participants generated ideas for improving SPARX for Māori and for the inclusion of whānau in its delivery. CONCLUSIONS: SPARX computerized therapy had good face validity for indigenous young people and families. In general, Māori participants were positive about the SPARX prototype and considered it both appealing and applicable to them. The results of this study were used to refine SPARX prior to it being delivered to taitamariki and non-Māori young people. TRIAL REGISTRATION: The New Zealand Northern Y Regional Ethics Committee; http://ethics.health.govt.nz/home; NTY/09/003; (Archived by WebCite at http://www.webcitation/6VYgHXKaR).

scholarly journals The Design and Relevance of a Computerized Gamified Depression Therapy Program for Indigenous Māori Adolescents

2020 ◽  
Author(s):  
Matthew Shepherd ◽  
Theresa Fleming ◽  
Mathijs Lucassen ◽  
Karolina Stasiak ◽  
Ian Lambie ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Behavioral Therapy ◽  
Computer Game ◽  
Indigenous Communities ◽  
Well Being ◽  
Behavioural Therapy ◽  
Cultural Relevance ◽  
Face Validity ◽  
Indigenous Adolescents

BACKGROUND: Depression is a major health issue among Māori indigenous adolescents, yet there has been little investigation into the relevance or effectiveness of psychological treatments for them. Further, consumer views are critical for engagement and adherence to therapy. However, there is little research regarding indigenous communities' opinions about psychological interventions for depression. OBJECTIVE: The objective of this study was to conduct semistructured interviews with Māori (indigenous New Zealand) young people (taitamariki) and their families to find out their opinions of a prototype computerized cognitive behavioral therapy (cCBT) program called Smart, Positive, Active, Realistic, X-factor thoughts (SPARX), a free online computer game intended to help young persons with mild to moderate depression, feeling down, stress or anxiety. The program will teach them how to resolve their issues on their own using Cognitive Behavioural Therapy as psychotherapeutic approach. METHODS: There were seven focus groups on the subject of the design and cultural relevance of SPARX that were held, with a total of 26 participants (19 taitamarki, 7 parents/caregivers, all Māori). There were five of the groups that were with whānau (family groups) (n=14), one group was with Māori teenage mothers (n=4), and one group was with taitamariki (n=8). The general inductive approach was used to analyze focus group data. RESULTS: SPARX computerized therapy has good face validity and is seen as potentially effective and appealing for Māori people. Cultural relevance was viewed as being important for the engagement of Māori young people with SPARX. Whānau are important for young peoples' well-being. Participants generated ideas for improving SPARX for Māori and for the inclusion of whānau in its delivery. CONCLUSIONS: SPARX computerized therapy had good face validity for indigenous young people and families. In general, Māori participants were positive about the SPARX prototype and considered it both appealing and applicable to them. The results of this study were used to refine SPARX prior to it being delivered to taitamariki and non-Māori young people. TRIAL REGISTRATION: The New Zealand Northern Y Regional Ethics Committee; http://ethics.health.govt.nz/home; NTY/09/003; (Archived by WebCite at http://www.webcitation/6VYgHXKaR).

scholarly journals Indigenous Adolescents� Perception of an eMental Health Program (SPARX): Exploratory Qualitative Assessment (Preprint)

2017 ◽  
Author(s):  
Matthew Shepherd ◽  
Sally Merry ◽  
Ian Lambie ◽  
Andrew Thompson
Keyword(s):  
New Zealand ◽  
Young People ◽  
Behavioral Therapy ◽  
Qualitative Assessment ◽  
Psychological Interventions ◽  
Semistructured Interview ◽  
Therapy Program ◽  
Computerized Intervention ◽  
Indigenous Adolescents

BACKGROUND Depression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Māori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Māori. OBJECTIVE The aim was to conduct an exploratory qualitative study of Māori adolescents’ opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program. METHODS Taitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes. RESULTS Taitamariki participating in the interviews found SPARX to be helpful. The Māori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Māori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whānau (Māori word for family) members with reported beneficial effect. CONCLUSIONS Overall, this small group of Māori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.

Health and well-being of young people who attend secondary school in Aotearoa, New Zealand: What has changed from 2001 to 2007?

2011 ◽  
Vol 47 (4) ◽  
pp. 191-197 ◽  
Author(s):  
Simon J Denny ◽  
Sue Grant ◽  
Jennifer Utter ◽  
Elizabeth M Robinson ◽  
Theresa M Fleming ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Secondary School ◽  
Well Being ◽  
Aotearoa New Zealand ◽  
Health And Well Being

scholarly journals Evaluation of a Healthy Relationship Smartphone App With Indigenous Young People: Protocol for a Co-designed Stepped Wedge Randomized Trial (Preprint)

2020 ◽  
Author(s):  
Jane Koziol-McLain ◽  
Denise Wilson ◽  
Alain C Vandal ◽  
Moana Eruera ◽  
Shyamala Nada-Raja ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Secondary Schools ◽  
Self Efficacy ◽  
General Health ◽  
Primary Outcome ◽  
Well Being ◽  
Smartphone App ◽  
Stepped Wedge ◽  
Partner Relationship

BACKGROUND We co-designed a smartphone app, Harmonised, with taitamariki (young people aged 13-17 years) to promote healthy intimate partner relationships. The app also provides a pathway for friends and family, or whānau (indigenous Māori extended family networks), to learn how to offer better support to taitamariki. OBJECTIVE The aim of our taitamariki- and Māori-centered study is to evaluate the implementation of the app in secondary schools. The study tests the effectiveness of the app in promoting taitamariki partner relationship self-efficacy (primary outcome). METHODS We co-designed a pragmatic, randomized, stepped wedge trial (retrospectively registered on September 12, 2019) for 8 Aotearoa, New Zealand, secondary schools (years 9 through 13). The schools were randomly assigned to implement the app in 1 of the 2 school terms. A well-established evaluation framework (RE-AIM [Reach, Effectiveness, Adoption, Implementation, Maintenance]) guided the selection of mixed data collection methods. Our target sample size is 600 taitamariki enrolled across the 8 schools. Taitamariki will participate by completing 5 web-based surveys over a 15-month trial period. Taitamariki partner relationship self-efficacy (primary outcome) and well-being, general health, cybersafety management, and connectedness (secondary outcomes) will be assessed with each survey. The general effectiveness hypotheses will be tested by using a linear mixed model with nested participant, year-group, and school random effects. The primary analysis will also include testing effectiveness in the Māori subgroup. RESULTS The study was funded by the New Zealand Ministry of Business, Innovation, and Employment in October 2015 and approved by the Auckland University of Technology Ethics Committee on May 3, 2017 (application number: 17/71). CONCLUSIONS This study will generate robust evidence evaluating the impact of introducing a healthy relationship app in secondary schools on taitamariki partner relationship self-efficacy, well-being, general health, cybersafety management, and connectedness. This taitamariki- and indigenous Māori–centered research fills an important gap in developing and testing strengths-based mobile health interventions in secondary schools. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12619001262190; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377584 INTERNATIONAL REGISTERED REPORT RR1-10.2196/24792

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 ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Well Being ◽  
Post Intervention ◽  
Factors Affecting ◽  
Self Compassion ◽  
Qualitative Feedback ◽  
The Look

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.

An Open Trial of Immersive Reality Experiences (IRE) Technology for Reducing Social Isolation and Improving the Social Connectedness and Well-Being of Hospitalized Children and Young People (Preprint)

2021 ◽  
Author(s):  
Hiran Thabrew ◽  
Christa Fouché ◽  
Laura Ann Chubb ◽  
Stacey Yates ◽  
Harshali Kumar ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Social Isolation ◽  
Social Inclusion ◽  
Social Connectedness ◽  
Well Being ◽  
Hospitalized Children ◽  
Post Intervention ◽  
Children And Young People ◽  
The Social

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

From vulnerability to risk: Consolidating state interventions towards Māori children and young people in New Zealand

2020 ◽  
Vol 40 (4) ◽  
pp. 526-545
Author(s):  
Elizabeth Stanley ◽  
Sarah Monod de Froideville
Keyword(s):  
New Zealand ◽  
Young People ◽  
Well Being ◽  
Best Interests ◽  
The Political ◽  
Children And Families ◽  
Children And Young People ◽  
Policy Interventions ◽  
Progressive Policy ◽  
State Interventions

Vulnerability has been a guiding narrative to state interventions towards children and their families in New Zealand. This article shows how this progressive notion has been systematically managed to fit pre-established political and policy priorities. These processes have emphasised: (i) categorisations of risk to those who demonstrate vulnerabilities; (ii) pre-emptive, multi-agency involvement in the lives of those deemed potentially ‘vulnerable’; and (iii) a responsibilising expectation that children and families will avoid vulnerable situations and comply with interventions. This individualising logic of vulnerability has solidified policy interventions towards Māori, and re-emphasised colonial practices of viewing Māori children and young people as deficit-laden risks to be managed. With a late 2017 change in government, the political dalliance with vulnerability appears to be in decline. A new progressive policy discourse – of child ‘well-being’ and ‘best interests’ – is being engaged. Yet, the emphasis on risk, and its corresponding elements of pre-emption and responsibility, persist. These discursive and institutional arrangements will ensure that Māori remain perilously entrenched in welfare and justice systems.

scholarly journals Coping Skills Mobile App to Support the Emotional Well-Being of Young People During the COVID-19 Pandemic: Protocol for a Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Anna Serlachius ◽  
Kiralee Schache ◽  
Anna Boggiss ◽  
David Lim ◽  
Kate Wallace-Boyd ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
New Zealand ◽  
Young People ◽  
Well Being ◽  
Psychological Outcomes ◽  
Mobile App ◽  
Mixed Methods Study ◽  
Second Phase ◽  
Web Based

BACKGROUND The COVID-19 pandemic is likely to increase anxiety and distress in young people worldwide. It is important to prioritize mental health during crisis events to mitigate the negative and often long-term effects of the crises on young people, families, and society. Mental health and well-being apps represent a scalable approach for improving psychological outcomes in young people and have potential to improve the equity of service access. OBJECTIVE The Whitu: 7 Ways in 7 Days well-being app was recently developed by our group to address the urgent need for innovative approaches to reach young New Zealanders who are struggling to cope with the COVID-19 pandemic. The aim of this study is twofold: to evaluate the acceptability of the prototype app and to examine the effectiveness of the refined app at improving mental and emotional well-being and reducing depression, anxiety, and stress in young people in New Zealand. METHODS A two-phase mixed methods study will be undertaken to achieve these aims. During the first phase, 20 young people aged 16-30 years (including those of Māori and Pacific ethnicity) will participate in a qualitative study to help refine the prototype app. During the second phase, 90 young people aged 16-30 years will participate in a randomized waitlist-controlled trial (RCT) to evaluate the efficacy of the refined Whitu app at 4 weeks and 3 months after baseline. Outcomes will be evaluated using validated web-based questionnaires at baseline, 4 weeks, and 3 months. RESULTS The study received ethics approval in May 2020, and recruitment for the focus groups commenced in June 2020. Recruitment for the RCT is expected to commence in October 2020. Participants for both study phases will be recruited via social media and web-based communities. Data collection for the RCT is expected to be completed by January 2021, and analyses are expected to be completed by March 2021. Linear mixed modelling will be used to determine between-group differences in psychological outcomes. CONCLUSIONS There is an urgent need to develop culturally appropriate, scalable mental health interventions to address the psychological consequences of the COVID-19 pandemic. In this study, we will develop and test an evidence-based well-being app that, if effective, can be made available to all young people in New Zealand and internationally. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ACTRN12620000516987); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379597. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/23716

Siblings of Young People With Cancer in NZ: Experiences That Positively and Negatively Support Well-Being

2018 ◽  
Vol 36 (2) ◽  
pp. 119-130
Author(s):  
Eleanor Porteous ◽  
Elizabeth R. Peterson ◽  
Claire Cartwright
Keyword(s):  
New Zealand ◽  
Young People ◽  
Well Being ◽  
Public Understanding ◽  
Positive Events ◽  
Knowing That ◽  
Pediatric Cancer Survivors ◽  
Receive Treatment ◽  
Cancer Experience ◽  
The Impact

Siblings of young people with cancer experience significant distress and these effects often exist long after their sibling’s treatment has successfully been completed. In New Zealand, many families must travel several hours to receive treatment, with some having to live away from home for extended periods which can create additional strains. We interviewed 10 siblings of pediatric cancer survivors drawn from a larger quantitative study, to investigate what made siblings’ experiences more difficult and to find out what was helpful in supporting their adjustment. The selected participants came from across New Zealand, represented a mix of gender and age, and had a range of depression scores. Our thematic analysis found that experiences that were associated with the most distress included concurrent stressors, and feeling left out, rejected, or isolated. Experiences that were most helpful to their well-being were feeling involved, knowing that they were still important and a priority for their parents, connecting with people through their experiences, and focusing on positive experiences. Our findings suggest that professionals working with these families could help siblings of a child with cancer by promoting hope, acknowledging positive growth, drawing attention to positive events to promote benefit finding, and providing opportunities to have fun. Increasing parental awareness of the impact of differential treatment and improving the public understanding of sibling issues might also be helpful.

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