Personalized Help-Seeking Web Application for Chinese-Speaking International University Students: Development and Usability Study

Stepped care, stepped care "lite" & matching intervention components to individual mental health needs: A rapid scoping review of mental health and substance use interventions for post-secondary students

PURPOSE

Stepped Care Models (SCM) and other approaches for organizing the delivery of services and resources by individual mental health (MH) needs are being increasingly implemented in post-secondary institutions. However, no consensus definitions exist of what constitutes a SCM for post-secondary students (PSS), and there is little guidance for evaluation of these complex, multicomponent interventions. The purpose of this research is to identify and characterize MH and substance use interventions for PSS that apply a SCM, stepped approach (i.e., stepped care "lite"), and/or organize delivery of resources/services based on individual MH needs.

METHODS

A rapid scoping review of peer-reviewed research articles was conducted using OVID MEDLINE®, OVID Embase, EBSCO CINAHL, OVID PsycINFO®, and ERIC. Eligible studies included multicomponent interventions for improving MH or substance use among PSS applying a SCM, stepped approach or another way of organizing resources/services offered according to individual MH needs. Results: 5757 abstracts were reviewed, resulting in full text examination of 172 studies. Data were extracted from 68 eligible studies comprising 50 interventions (SCMs: n = 7, stepped care "lite": n = 13; organized delivery matched to MH needs: n = 30). Almost all involved a website/app and symptom tracking was often included within the intervention. Most addressed either alcohol use, depression, anxiety and eating disorders. A variety of evaluation models were applied, but approaches were not generally geared to look at individual-level outcomes in a manner that captured the overall effect of the SCM or outcomes related to the specific "dose" of the intervention received. Most outcomes focused on MH symptoms, satisfaction, and utilization; student-related outcomes such as academic success were rarely used. Student co-design was not often described.

CONCLUSIONS/IMPLICATIONS

Despite increasing implementation of SCMs in post-secondary settings, few studies on the model have been published. Drawing on strengths and shortcomings of studies identified, recommendations for future work in this area are presented.

Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach

PURPOSE

This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach.

DESIGN

A cross-sectional design including an online self-reported questionnaire survey was used.

METHODS

A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS.

FINDINGS

Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences.

CONCLUSIONS

Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses' perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses' help-seeking preferences and behaviors to reduce mental illness during public health emergencies.

CLINICAL EVIDENCE

Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.

Culturally contextualized suicide prevention for international students: new opportunities for research and practice

The rising incidence of suicide-related thoughts and behaviors among international students presents a significant public health challenge and growing concern among college campuses. Current intervention strategies often rely on Western-centric and colonized approaches developed and tested with primarily Western, Educated, Industrialized, Rich and Democratic (WEIRD) samples. Exclusion and historical underrepresentation of ethnoracially minoritized groups in suicide prevention treatment trials create gaps in advancing our science because they often miss the cultural contextualization crucial for effective prevention and intervention in diverse groups from different countries of origin. To address the limitations of these Western-centric strategies, we explored existing prevention recommendations and approaches through the lens of an expanded version of the newly developed Protective Factors Framework, tailored for non-Western cultural perspectives. We propose significant opportunities for enhancing current practices and point to promising future directions. The primary areas for development include: (1) bolstering community empowerment and ownership, (2) refining mechanisms of change to encompass multicultural viewpoints, and (3) focusing on effective implementation and thorough evaluation for ongoing refinement. This methodology not only shows promise for enhancing international student suicide prevention but also offers insights for broader application in suicide prevention among other culturally diverse populations.

Participatory Design in Suicide Prevention: A Qualitative Study of International Students' Experiences of Adapting the LivingWorks safeTALK Programme

BACKGROUND

Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group.

METHODS

This qualitative study investigated the experiences of international university students studying in Australia who participated in a co-consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co-consultation workshop completed semi-structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis.

RESULTS

The findings showed that participants found the co-consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heard and ensuring understanding of mental health and suicide through shared language.

CONCLUSIONS

This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations.

PATIENT OR PUBLIC CONTRIBUTION

International students were involved in the co-consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students.

Improving mental health literacy using web- or app-based interventions: A scoping review

Background

Given the rapid advancement in technology, the Internet has grown to play a significant role in the field of healthcare. Individuals can now access a profusion of easily available materials for self-management of their health. The purpose of this review is to describe Web/App-based interventions that are primarily or secondarily designed to improve mental health literacy (MHL) and to investigate the effectiveness of online interventions for improving mental health.

Materials and Method

A scoping review was conducted by searching five databases: PsycINFO, EMBASE, PubMed, CINAHL, and Web of Science. The search was limited to peer-reviewed journals published in English between 2000 and 2022. Studies focusing on enhancements of MHL or its constituent components were included.

Results

Twenty-four studies met the inclusion criteria. The interventions primarily targeted patients or individuals exhibiting symptoms of mental disorders, with a higher representation of female participants. All the interventions yielded positive outcomes. The included studies were categorized according to three themes: knowledge, attitude, and self-care skills. Although numerous studies have focused on knowledge improvement, research on interventions targeting self-care skills is scarce. Furthermore, existing literature on knowledge enhancement is limited in terms of the coverage of risk factors.

Conclusion

This review indicates gaps in web/app interventions including limited evidence on risk factors, inconsistent help-seeking awareness, and inadequate self-care skills training. Further research is critically needed to address these deficiencies and promote comprehensive MHL.