scholarly journals A novel ACT-based video game to support mental health through embedded learning: A mixed-methods feasibility study protocol

2020 ◽  
Author(s):  
Darren Edwards ◽  
Andrew Haddon Kemp
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Video Game ◽  
Emotional Regulation ◽  
Cognitive Skills ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Mental Health Disorder ◽  
Mrc Framework ◽  
Serious Video Games

Introduction: In recent years, serious video games have been utilised to promote emotional regulation in individuals with mental health issues. Though these therapeutic strategies are innovative, they are limited in the scope of treatment, often focusing on specific cognitive skills, to help remediate a specific mental health disorder. Objective: Here, a protocol is proposed, which assesses the feasibility of a novel ACT-based video game for young adults. Methods and analysis: The MRC framework will be utilised for developing a complex intervention, to design and test the feasibility of an ACT-based video game intervention using a mixed-methods approach involving qualitative and quantitative data. The primary outcomes will include feasibility testing of recruitment processes and the acceptability of the intervention through qualitative interviews, attendance, and rates of attrition. Secondary outcomes will involve a series of quantitative questionnaires to obtain effect sizes for power analysis, allowing for the ideal sample size for a full randomized controlled trial to be determined. Ethics and Dissemination: This study has received approval from the College of Human and Health Sciences at Swansea University in the United Kingdom. Dissemination activities will involve publications in peer reviewed journals, presentations at local and national conferences, and promotion through social media.

scholarly journals A novel ACT-based video game to support mental health through embedded learning: a mixed-methods feasibility study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041667
Author(s):  
Darren J Edwards ◽  
Andrew H Kemp
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Video Game ◽  
Emotional Regulation ◽  
Cognitive Skills ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Mental Health Disorder ◽  
Acceptance And Commitment ◽  
Randomised Controlled

IntroductionIn recent years, serious video games have been used to promote emotional regulation in individuals with mental health issues. Although these therapeutic strategies are innovative, they are limited with respect to scope of treatment, often focusing on specific cognitive skills, to help remediate a specific mental health disorder.ObjectiveHere, we propose a protocol for assessing the feasibility of a novel acceptance and commitment therapy (ACT)-based video game for young adults.Methods and analysisThe Medical Research Council (MRC) framework will be used for developing a complex intervention to design and test the feasibility of an ACT-based video game intervention using a mixed-methods approach involving qualitative and quantitative data. The primary outcomes will include feasibility testing of recruitment processes and the acceptability of the intervention through qualitative interviews, attendance and rates of attrition. Secondary outcomes will involve a series of quantitative questionnaires to obtain effect sizes for power analysis, allowing for the ideal sample size for an appropriately powered, randomised controlled trial to be determined.Ethics and disseminationThis study has been approved by the Psychology Department Research Ethics Committee (2020-4929-3923) at Swansea University in the UK. Dissemination activities will involve publications in peer-reviewed journals, presentations at local and national conferences and promotion through social media.Trial registration numberNCT04566042.

scholarly journals COMmunity PARticipation through Education (COMPARE): effectiveness of supported education for students with mental health problems, a mixed methods study – study protocol for a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacomijn Hofstra ◽  
Jorien van der Velde ◽  
Petra Jannette Havinga ◽  
Lies Korevaar
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Mixed Methods ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Health Problems ◽  
Secondary Outcome ◽  
Study Success ◽  
Randomized Controlled ◽  
Supported Education

Abstract Background The onset of mental health problems generally occurs between the ages of 16 and 23 – the years in which young people follow post-secondary education, which is a major channel in our society to prepare for a career and enhance life goals. Several studies have shown that students with mental health problems have a higher chance of early school leaving. Supported Education services have been developed to support students with mental health problems to remain at school. The current project aims to study the effect of an individually tailored Supported Education intervention on remaining at school, study success, and satisfaction of students with mental health problems studying at an institute for intermediate vocational education and a university of applied sciences in the Netherlands. Methods/design The design combines quantitative research (Randomized Controlled Trial; RCT) with qualitative research (monitoring, interviews, focus groups). One hundred students with mental health problems recruited from the two educational institutes will be randomly allocated to either the intervention or control condition. The students in the intervention condition receive the Supported Education intervention given by a Supported Education specialist, the students in the active control condition receive support as usual plus advice from a trained staff member on potential supportive resources regarding studying with mental health problems. The primary outcome ‘remaining at school’, and the secondary outcome ‘study success’ will be determined using data from the school’s administration. The secondary outcome ‘student satisfaction’ and other variables that will be studied in a more exploratory way, such as self-efficacy and study skills, will be determined through online questionnaires at baseline, at 6 and at 12 months follow-up. Focus groups and interviews with the students and Supported Education specialists will be carried out to complement the trial. Discussion This RCT is the first to assess the effect of Supported Education on remaining at school, next to study success and student satisfaction among students with mental health problems. The use of a mixed-methods design will result in a thorough evaluation of the effect of the intervention. Issues regarding the influx and possible attrition of students in the follow-up are discussed. Trial registration The study was registered with Trialregister.nl, no. NL8349, date registered: February 4th 2020. Register name: Community participation through education. Effectiveness of Supported Education for youth with mental health problems, a mixed methods study – Study protocol for a Randomized Controlled Trial. Protocol Version: 3, date: May 28th, 2021.

scholarly journals Users’ perceptions about receiving personalized depression risk information: findings from a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Eccles ◽  
Doaa Nadouri ◽  
Molly Nannarone ◽  
Bonnie Lashewicz ◽  
Norbert Schmitz ◽  
...  
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Risk Communication ◽  
Risk Score ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Risk Information ◽  
Depression Risk ◽  
Communication Program ◽  
The Impact

Abstract Objectives To understand users’ perceptions about receiving their personalized depression risk score and to gain an understanding about how to improve the efficiency of risk communication from the user perspective. Methods A qualitative study embedded in a randomized controlled trial (RCT) on evaluating the impact of providing personalized depression risk information on psychological harms and benefits. The participants (20 males and 20 females) were randomly selected from the intervention arm of the RCT after the 12-month assessment. The qualitative interviews were conducted through telephone, audio recorded and transcribed verbatim. We conducted a content analysis to describe the content and contextual meaning of data collected from participants. Results The first theme explained the motivation for receiving a risk score. Most participants chose to receive their personalised depression risk score with the goal of improving their self-awareness. The results revealed three sub-themes surrounding perceptions and implication of receiving their risk score: positive, negative, and neutral. Most participants found that receiving their score was positive because it improved their awareness of their mental health, but some participants could see that some people would have negative feelings when getting the score causing them to be more likely to get depression. The final theme focussed on improvements including: the best delivery methods, having resources and strategies, and targeting younger people. Conclusion The most significant motivation for, and benefit of receiving one’s personalized depression risk score was improved awareness of one’s mental health. A comprehensive risk communication program may improve the uptake and maximize the impact on behavior changes and risk reduction.

scholarly journals Burden of mental health symptoms and perceptions of their management in in-centre hemodialysis care: a mixed methods study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kara Schick-Makaroff ◽  
Lisa A. Wozniak ◽  
Hilary Short ◽  
Sara N. Davison ◽  
Scott Klarenbach ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Health Management ◽  
Controlled Trial ◽  
Health Resources ◽  
Patient Reported Outcome Measures ◽  
Anxiety Symptoms ◽  
Dialysis Unit ◽  
Patient Reported ◽  
Nurses Perceptions

Abstract Background We aimed to describe (1) depressive and anxiety symptom burdens reported by adults on in-centre hemodialysis in Northern Alberta, Canada and (2) patients’ and nurses’ perceptions of managing such symptoms using routine patient-reported outcome measures (PROMs). Methods A longitudinal mixed methods approach was employed. Cluster randomized controlled trial data exposed the prevalence of positive screens (scores ≥ 3) for depressive (PHQ-2) and anxiety (GAD-2) symptoms. A descriptive qualitative approach was used to understand patients’ and nurses’ perceptions of managing these symptoms using the ESAS-r: Renal and EQ-5D-5L. Using purposeful sampling, patients and nurses were invited for interviews. Field notes were documented from 6 dialysis unit observations. Patients’ responses to open-ended survey questions and nurses’ electronic chart notes related to mental health were compiled. Thematic and content analyses were used. Results Average age of patients (n = 408) was 64.0 years (SD 15.4), 57% were male, and 87% were not working; 29% screened positive for depressive symptoms, 21% for anxiety symptoms, and 16% for both. From patient (n = 10) and nurse (n = 8) interviews, unit observations, patient survey responses (n = 779) and nurses’ chart notes (n = 84), we discerned that PROMs (ESAS-r: Renal/EQ-5D-5L) had the potential to identify and prompt management of mental health concerns. However, opinions differed about whether mental health was within kidney care scope. Nonetheless, participants agreed there was a lack of mental health resources. Conclusions Prevalence of depressive and anxiety symptoms aligned with existing literature. Tensions regarding mental health management highlight the need for systemic decisions about how routine PROM use, including mental health assessment, may be optimized to meet patients’ needs.

scholarly journals What Impacts Perceived Stress among Canadian Farmers? A Mixed-Methods Analysis

2021 ◽  
Vol 18 (14) ◽  
pp. 7366
Author(s):  
Briana N. M. Hagen ◽  
Alex Sawatzky ◽  
Sherilee L. Harper ◽  
Terri L. O’Sullivan ◽  
Andria Jones-Bitton
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Lived Experience ◽  
Perceived Stress ◽  
Agricultural Sector ◽  
Qualitative Interviews ◽  
Health Resources ◽  
Financial Stress ◽  
Cross Sectional ◽  
Factors Associated

Globally, farmers report high levels of occupational stress. The purpose of this study was to identify and explore factors associated with perceived stress among Canadian farmers. A sequential explanatory mixed-methods design was used. An online cross-sectional national survey of Canadian farmers (n = 1132) was conducted in 2015–2016 to collect data on mental health, demographic, lifestyle, and farming characteristics; stress was measured using the Perceived Stress Scale. A multivariable linear regression model was used to investigate the factors associated with perceived stress score. Qualitative interviews (n = 75) were conducted in 2017–2018 with farmers and agricultural sector workers in Ontario, Canada, to explore the lived experience of stress. The qualitative interview data were analyzed via thematic analysis and then used to explain and provide depth to the quantitative results. Financial stress (highest category—a lot: (B = 2.30; CI: 1.59, 3.00)), woman gender (B = 0.55; CI: 0.12, 0.99), pig farming (B = 1.07; CI: 0.45, 1.69), and perceived lack of support from family (B = 1.18; CI: 0.39, 1.98) and industry (B = 1.15; CI: 0.16–2.14) were positively associated with higher perceived stress scores, as were depression and anxiety (as part of an interaction). Resilience had a small negative association with perceived stress (B = −0.04; CI: −0.06, −0.03). Results from the qualitative analysis showed that the uncertainty around financial stress increased perceived stress. Women farmers described the unique demands and challenges they face that contributed to their overall stress. Results from this study can inform the development of mental health resources and research aimed at decreasing stress among Canadian farmers.

scholarly journals Development of a casual video game (Match Emoji) with psychological well-being concepts for young adolescents

2021 ◽  
Vol 7 ◽  
pp. 205520762110478
Author(s):  
Russell Pine ◽  
Lisa Te Morenga ◽  
Mitch Olson ◽  
Theresa Fleming
Keyword(s):  
Mental Health ◽  
Video Games ◽  
Video Game ◽  
Controlled Trial ◽  
Well Being ◽  
Learning Theories ◽  
Implicit Processes ◽  
Psychological Well Being ◽  
Randomised Controlled ◽  
Game Developers

Digital interventions for mental health and well-being have been shown to be effective in trials, yet uptake and retention in real-world settings are often disappointing. A more significant impact may be achieved by building interventions that are closer to how target groups use technology to support their own psychological well-being. Casual video games may be poised to offer an opportunity in this area as they are a highly popular activity among young people. We propose that mental health content can be integrated into the explicit content and the implicit processes used in casual video games. In this paper, we describe the design and core processes of Match Emoji, a casual video game designed to support the development of psychological well-being via gameplay and micro-messages. The iterative development of Match Emoji involved various phases, including a systematic review of the literature, consultation with target users, clinicians, game developers, and close reading of the literature. Expert collaboration was sought throughout the process to ensure gameplay and messages matched behaviour change and learning theories. An acceptability and feasibility study of Match Emoji will inform a randomised controlled trial in the future.

scholarly journals Beliefs about prescribed medication among older patients with polypharmacy: a mixed methods study in primary care

2017 ◽  
Vol 67 (660) ◽  
pp. e507-e518 ◽  
Author(s):  
Barbara Clyne ◽  
Janine A Cooper ◽  
Fiona Boland ◽  
Carmel M Hughes ◽  
Tom Fahey ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Older Patients ◽  
Qualitative Data ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Inappropriate Prescribing ◽  
Adverse Outcomes ◽  
Mixed Methods Study ◽  
Negative Attitudes

BackgroundPolypharmacy (≥5 medications) is common in older patients and is associated with adverse outcomes. Patients’ beliefs about medication can influence their expectations for medication, adherence, and willingness to deprescribe. Few studies have examined beliefs about prescribed medication among older patients with polypharmacy in primary care.AimTo explore medication-related beliefs in older patients with polypharmacy and factors that might influence beliefs.Design and settingA mixed methods study utilising data from a randomised controlled trial aiming to decrease potentially inappropriate prescribing in older patients (≥70 years) in Ireland.MethodBeliefs were assessed quantitatively and qualitatively. Participants completed the Beliefs about Medicines Questionnaire by indicating their degree of agreement with individual statements about medicines on a 5-point Likert scale. Semi-structured qualitative interviews were conducted with a purposive sample of participants. Interviews were transcribed verbatim and a thematic analysis conducted. Quantitative and qualitative data were analysed separately and triangulated during the interpretation stage.ResultsIn total, 196 patients were included (mean age 76.7 years, SD 4.9, 54% male), with a mean of 9.5 (SD 4.1) medications per patient. The majority (96.3%) believed strongly in the necessity of their medication, while 33.9% reported strong concerns. Qualitative data confirmed these coexisting positive and negative attitudes to medications and suggested the importance of patients’ trust in GPs in establishing positive beliefs and potential willingness to deprescribe.ConclusionParticipants reported strong beliefs in medications with coexisting positive and negative attitudes. The doctor–patient relationship may have influenced beliefs and attitudes towards medicines, highlighting the importance of strong doctor–patient relationships, which need to be considered in the context of deprescribing.

Escaping the inescapable: Risk of mental health disorder, somatic symptoms and resilience in Palestinian refugee children

2021 ◽  
pp. 136346152098707
Author(s):  
Naomi Wilson ◽  
Fiona Turner-Halliday ◽  
Helen Minnis
Keyword(s):  
Mental Health ◽  
Protective Factors ◽  
Mental Health Problems ◽  
Qualitative Interviews ◽  
Forced Migration ◽  
Mental Health Disorder ◽  
Refugee Children ◽  
Cross Sectional ◽  
Psychosomatic Complaints ◽  
Palestinian Refugee

Exposure to war, conflict and forced migration puts children at risk of mental health problems. The present study examined the levels of psychological distress and resilience factors among 106 Palestinian refugee children aged 11 to 17 in the West Bank. In a cross-sectional, mixed method design along with qualitative interviews, three questionnaires were administered: the Strength and Difficulties Questionnaire and Patient Health Questionnaire-15, assessed the risk of mental health disorders and psychosomatic complaints, and the Child and Youth Resilience Measure assessed the availability of resilience-enhancing factors. Palestinian refugee children were found to be at greater risk for mental disorders and psychosomatic complaints than were children living in non-conflict affected settings. In addition, resilience-enhancing resources were significantly reduced and were negatively correlated with both symptom outcomes. Risk factors identified included poverty, violence and marginalisation. Key protective factors were youth education, supportive relationships and social participation. Our findings support interventions that address the identified protective factors, which may promote the mental health of this vulnerable population.

scholarly journals Web-based Therapy Plus Support by a Coach in Depressed Patients Referred to Secondary Mental Health Care: Randomized Controlled Trial

2018 ◽  
Vol 5 (1) ◽  
pp. e5 ◽  
Author(s):  
Simon Hatcher ◽  
Robyn Whittaker ◽  
Murray Patton ◽  
Wayne Sylvester Miles ◽  
Nicola Ralph ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomized Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Intervention Group ◽  
Control Group ◽  
Web Based ◽  
Randomized Controlled

Background The evidence for the effectiveness of Web-based therapies comes mainly from nonclinical populations, with a few studies in primary care. There is little evidence from patients referred to secondary mental health care with depression. Adherence to Web-based therapies is often poor. One way to increase this is to create a new health service role of a coach to guide people through the therapy. Objective This study aimed to test in people referred to secondary care with depression if a Web-based therapy (The Journal) supported by a coach plus usual care would be more effective in reducing depression compared with usual care plus an information leaflet about Web-based resources after 12 weeks. Methods We conducted a randomized controlled trial with two parallel arms and a process evaluation that included structured qualitative interviews analyzed using thematic analysis. The coach had a background in occupational therapy. Participants were recruited face-to-face at community mental health centers. Results We recruited 63 people into the trial (intervention 35, control 28). There were no statistically significant differences in the change from baseline in Patient Health Questionnaire-9 (PHQ-9) scores at 12 weeks comparing The Journal with usual care (mean change in PHQ-9 score 9.4 in the intervention group and 7.1 in the control group, t41=1.05, P=.30; mean difference=2.3, 95% CI −2.1 to 6.7). People who were offered The Journal attended on average about one less outpatient appointment compared with usual care, although this difference was not statistically significant (intervention mean number of visits 2.8 (SD 5.5) compared with 4.1 (SD 6.7) in the control group, t45=−0.80, P=.43; mean difference=1.3, 95% CI −4.5 to 2.0). The process evaluation found that the mean number of lessons completed in the intervention group was 2.5 (SD=1.9; range=0-6) and the number of contacts with the coach was a mean of 8.1 (SD=4.4; range=0-17). The qualitative interviews highlighted the problem of engaging clinicians in research and their resistance to recruitment: technical difficulties with The Journal, which prevented people logging in easily; difficulty accessing The Journal as it was not available on mobile devices; participants finding some lessons difficult; and participants saying they were too busy to complete the sessions. Conclusions The study demonstrated that it is feasible to use a coach in this setting, that people found it helpful, and that it did not conflict with other care that participants were receiving. Future trials need to engage clinicians at an early stage to articulate where Web-based therapies fit into existing clinical pathways; Web-based therapies should be available on mobile devices, and logging in should be easy. The role of the coach should be explored in larger trials. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12613000015741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363351&isReview=true (Archived by WebCite at http://www.webcitation.org/6wEyCc6Ss).

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