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Quayle E, Larkin A, Schwannauer M, Varese F, Cartwright K, Chitsabesan P, Green V, Radford G, Richards C, Shafi S, Whelan P, Chan C, Hewins W, Newton A, Niebauer E, Sandys M, Ward J, Bucci S. Experiences of a digital health intervention for young people exposed to technology assisted sexual abuse: a qualitative study. BMC Psychiatry 2024; 24:237. [PMID: 38549096 PMCID: PMC10979588 DOI: 10.1186/s12888-024-05605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/10/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND There is growing evidence that Technology Assisted Sexual Abuse (TASA) represents a serious problem for large numbers of children. To date, there are very few evidence-based interventions available to young people (YP) after they have been exposed to this form of abuse, and access to support services remains a challenge. Digital tools such as smartphones have the potential to increase access to mental health support and may provide an opportunity for YP to both manage their distress and reduce the possibility of further victimization. The current study explores the acceptability of a digital health intervention (DHI; the i-Minds app) which is a theory-driven, co-produced, mentalization-based DHI designed for YP aged 12-18 who have experienced TASA. METHODS Semi-structured interviews were conducted with 15 YP recruited through Child and Adolescent Mental Health Services, a Sexual Assault Referral Centre and an e-therapy provider who had access to the i-Minds app as part of a feasibility clinical trial. Interviews focused on the acceptability and usability of i-Minds and were coded to themes based on the Acceptability of Healthcare Interventions framework. RESULTS All participants found the i-Minds app acceptable. Many aspects of the app were seen as enjoyable and useful in helping YP understand their abuse, manage feelings, and change behavior. The app was seen as usable and easy to navigate, but for some participants the level of text was problematic and aspects of the content was, at times, emotionally distressing at times. CONCLUSIONS The i-Minds app is useful in the management of TASA and helping change some risk-related vulnerabilities. The app was designed, developed and evaluated with YP who had experienced TASA and this may account for the high levels of acceptability seen. TRIAL REGISTRATION The trial was registered on the ISRCTN registry on the 12/04/2022 as i-Minds: a digital intervention for young people exposed to online sexual abuse (ISRCTN43130832).
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Affiliation(s)
- Ethel Quayle
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Amanda Larkin
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Matthias Schwannauer
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- NHS Lothian, Edinburgh, UK
| | - Filippo Varese
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science, The University of Manchester, Manchester, UK
| | - Kim Cartwright
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | | | | | | | | | - Pauline Whelan
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science, The University of Manchester, Manchester, UK
| | - Cindy Chan
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - William Hewins
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- NHS Lothian, Edinburgh, UK
| | - Alice Newton
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Erica Niebauer
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- NHS Lothian, Edinburgh, UK
| | - Marina Sandys
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Jennifer Ward
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- NHS Lothian, Edinburgh, UK
| | - Sandra Bucci
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science, The University of Manchester, Manchester, UK.
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Waller D, Kang M, Gibson S, Brooks F, Medlow S, Steinbeck K, Perry L. Development and implementation of Australian State, territory, and national policy on the health and wellbeing of adolescents and young adults: An exploration of policy actor perspectives using the Consolidated Framework for Implementation Research. Aust N Z J Public Health 2024; 48:100112. [PMID: 38198902 DOI: 10.1016/j.anzjph.2023.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/20/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVES Government policies that support the health and wellbeing of young people (aged 10 to 25) can have important individual and societal impacts. The aim of this study was to explore policy actor perspectives on the development and implementation of Australian government policies focussed on the health and wellbeing of young people. METHODS We utilised a qualitative research design consisting of semi-structured interviews with policy actors with experience working with Australian youth health policies. Our interview guide and analyses were informed by the Consolidated Framework for Implementation Research (CFIR). We interviewed 19 participants from various national, state, and territory bodies. RESULTS Several specific barriers and facilitators to policy development and implementation were identified using the Consolidated Framework for Implementation Research. Key policy development barriers were limited available resources (e.g. staffing and funding) and low relative priority within health and political systems. Key policy implementation barriers were limited available resources, limited policy compatibility with health services, cosmopolitanism issues related to interagency collaboration, and a lack of policy evaluation. Meaningful engagement of young people could also be improved. CONCLUSIONS Although Australian youth health policies are perceived as evidence-based and comprehensively developed, the ability to promote implementation remains stalled. IMPLICATIONS FOR PUBLIC HEALTH The development of policy implementation plans, monitoring and evaluation mechanisms, funding and resources, and a strong commitment to removing barriers to working across multiple departments and systems is required to improve outcomes for young people.
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Affiliation(s)
- Daniel Waller
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2006, Australia; The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, 2145, Australia.
| | - Melissa Kang
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, 2145, Australia
| | - Sally Gibson
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2006, Australia
| | - Fiona Brooks
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, 2007, Australia; Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, 0627, New Zealand
| | - Sharon Medlow
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2006, Australia; The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, 2145, Australia
| | - Katharine Steinbeck
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2006, Australia; The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, 2145, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, 2007, Australia
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Ferdous F, Arthurs N, Tully L, O’Brien S, Smith SM, Walsh A, O’Gorman CS, O’Malley G. Addressing child and adolescent obesity management in Ireland: identifying facilitators and barriers in clinical practice. Front Pediatr 2023; 11:1222604. [PMID: 37492613 PMCID: PMC10365269 DOI: 10.3389/fped.2023.1222604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/22/2023] [Indexed: 07/27/2023] Open
Abstract
Background Ireland's Model of Care for the Management of Overweight and Obesity outlines a plan for treating adolescent and child obesity (CO). However, engagement with key stakeholders is required to support its implementation and improve health services. Aim This study aims to map the perceived barriers and facilitators related to CO management across healthcare settings, professional disciplines, and regions in the Republic of Ireland (ROI). Materials and methods An online cross-sectional survey of registered healthcare professionals (HPs), designed to adhere to the Consolidated Framework for Implementation Research (CFIR), was co-developed by a project team consisting of researchers, healthcare professionals, and patient advocates. The survey was pilot tested with project stakeholders and distributed online to professional groups and via a social media campaign, between September 2021 and May 2022, using "SurveyMonkey." Data were summarised using descriptive statistics and thematic analyses. Themes were mapped to the CFIR framework to identify the type of implementation gaps that exist for treating obesity within the current health and social care system. Results A total of 184 HPs completed the survey including nurses (18%), physicians (14%), health and social care professionals (60%), and other HPs (8%). The majority were female (91%), among which 54% reported conducting growth monitoring with a third (32.6%) giving a diagnosis of paediatric/adolescent obesity as part of their clinical practice. Nearly half (49%) of the HPs reported having the resources needed for clinical assessment. However, 31.5% of the HPs reported having enough "time," and almost 10% of the HPs reported having no/limited access to suitable anthropometric measurement tools. Most HPs did not conduct obesity-related clinical assessments beyond growth assessment, and 61% reported having no paediatric obesity training. CFIR mapping identified several facilitators and barriers including time for clinical encounters, suitable materials and equipment, adequate training, perceived professional competency and self-efficacy, human equality and child-centredness, relative priorities, local attitudes, referral protocols, and long waiting times. Conclusions The findings provide actionable information to guide the implementation of the Model of Care for the Management of Overweight and Obesity in Ireland. Survey findings will now inform a qualitative study to explore implementation barriers and facilitators and prioritise actions to improve child and adolescent obesity management.
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Affiliation(s)
- Farzana Ferdous
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Niamh Arthurs
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Louise Tully
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sarah O’Brien
- Health Service Executive (HSE) Health and Wellbeing Division, Dublin, Ireland
| | - Susan M. Smith
- Discipline of Public Health and Primary Care, Trinity College, Dublin, Ireland
| | - Aisling Walsh
- Department of Epidemiology, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Clodagh S. O’Gorman
- School of Medicine, University of Limerick, Limerick, Ireland
- Department of Paediatrics, University Hospital Limerick, Limerick, Ireland
| | - Grace O’Malley
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Waller D, Bailey S, Zolfaghari E, Ho J, Feuerlicht D, Ross K, Steinbeck K. Psychosocial assessment of adolescents and young adults in paediatric hospital settings: patient and staff perspectives on implementation of the e-HEEADSSS. BMC Health Serv Res 2023; 23:683. [PMID: 37349759 DOI: 10.1186/s12913-023-09621-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The main causes of morbidity and mortality for adolescents and young adults are preventable and stem from psychosocial and behavioural concerns. Psychosocial assessments can help clinicians to identify and respond holistically to risks and strengths that may impact upon a young person's physical and mental health. Despite broad support at a policy level, the implementation of routine psychosocial screening for young people remains varied in Australian health settings. The current study focused on the pilot implementation of a digital patient-completed psychosocial assessment (the e-HEEADSSS) at the Sydney Children's Hospital Network. The aim of this research was to evaluate patient and staff barriers and facilitators to local implementation. METHODS The research used a qualitative descriptive research design. Semi-structured interviews were conducted online with 8 young patients and 8 staff members who had completed or actioned an e-HEEADSSS assessment within the prior 5 weeks. Qualitative coding of interview transcripts was carried out in NVivo 12. The Consolidated Framework for Implementation Research guided the interview framework and qualitative analyses. RESULTS Results demonstrated strong support for the e-HEEADSSS from patients and staff. Key reported facilitators included strong design and functionality, reduced time requirements, greater convenience, improved disclosure, adaptability across settings, greater perceived privacy, improved fidelity, and reduced stigma for young people. The key barriers were related to concerns over available resources, the sustainability and continuity of staff training, perceived availability of clinical pathways for follow-up and referrals, and risks related to off-site completions. Clinicians need to adequately explain the e-HEEADSSS assessment to patients, educate them about it, and make sure that they receive timely feedback on the results. Greater reassurance and education regarding the rigour of confidentiality and data handling procedures is required for patients and staff. CONCLUSIONS Our findings indicate that continued work is required to support the integration and sustainability of digital psychosocial assessments for young people at the Sydney Children's Hospital Network. The e-HEEADSSS shows promise as an implementable intervention to achieve this goal. Further research is required to determine the scalability of this intervention across the broader health system.
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Affiliation(s)
- Daniel Waller
- Sydney Children's Hospitals Network, Sydney, Australia.
- The University of Sydney, Sydney, Australia.
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | | | | | - Jane Ho
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | | | - Kirsty Ross
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | - Katharine Steinbeck
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
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Ahinkorah BO, Perry L, Brooks F, Kang M. Barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy in Ghana: an exploratory qualitative study. BMJ Open 2022; 12:e060576. [PMID: 35882458 PMCID: PMC9330328 DOI: 10.1136/bmjopen-2021-060576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study explored the perceived barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy among health and education professionals ('professionals'), grassroots workers and adolescent girls in Ghana. DESIGN AND SETTING We employed an exploratory qualitative study design involving interviews with professionals, grassroots workers and adolescent girls in the Central Region of Ghana. PARTICIPANTS This study involved 15 professionals employed in government or non-governmental organisations, 15 grassroots workers and 51 pregnant/parenting and non-pregnant adolescent girls. DATA ANALYSIS Thematic analysis was conducted deductively using the ecological framework for understanding effective implementation. RESULTS Eighteen themes mapped to the five domains of the ecological framework emerged. Perceived barriers included gender inequality, family poverty, stigma, community support for early childbearing and cohabitation, inadequate data systems, lack of collaboration between stakeholders and lack of political will. Effective implementation of community by-laws, youth involvement, use of available data, and collaboration and effective coordination between stakeholders were the perceived facilitators. CONCLUSION Political leaders and community members should be actively engaged in the implementation of adolescent sexual and reproductive health policies and programmes. Gender empowerment programmes such as education and training of adolescent girls should be implemented and strengthened at both the community and national levels. Community members should be sensitised on the negative effects of norms that support child marriage, gender-based violence and early childbearing.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Lin Perry
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Fiona Brooks
- Auckland University of Technology, Auckland, New Zealand
| | - Melissa Kang
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
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Cordova-Pozo K. The Need for Implementation Research for Community-based Interventions: Scientific Evidence Is Needed. Int J Community Based Nurs Midwifery 2022; 10:246-247. [PMID: 35855383 PMCID: PMC9287567 DOI: 10.30476/ijcbnm.2022.95868.2091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Kathya Cordova-Pozo
- Department of Research Methodology, Institute for Management Research, Radboud University, the Netherlands
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