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Brooks H, Irmansyah I, Syarif AK, Pedley R, Renwick L, Rahayu AP, Manik C, Prawira B, Hann M, Brierley H, Lovell K, Bee P. Evaluating a prototype digital mental health literacy intervention for children and young people aged 11-15 in Java, Indonesia: a mixed methods, multi-site case study evaluation. Child Adolesc Psychiatry Ment Health 2023; 17:79. [PMID: 37365594 DOI: 10.1186/s13034-023-00608-9] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The Improving Mental Health Literacy Among Children and Young People in Indonesia (IMPeTUs) intervention is a co-produced, evidence-based digital intervention designed to improve anxiety and depression focused mental health literacy and self-management among people aged 11-15 in Java, Indonesia. This study aimed to evaluate the usability, feasibility and preliminary impact of our intervention. METHODS Mixed methods, multi-site case studies based on a theory of change. Pre-and post-assessments of a range of outcomes and qualitative interviews/focus groups with children and young people (CYP), parents and facilitators. The intervention was implemented in 8 health, school and community sites across Java, Indonesia (Megelang, Jakarta and Bogor). Quantitative data designed to understand the impact of and feasibility of evaluating the intervention collected from 78 CYP who used the intervention were analysed descriptively. Qualitative data from interviews and focus groups collected from 56 CYP, 49 parents/caregivers and 18 facilitators were analysed using framework analysis. RESULTS Qualitative data analysis indicated high levels of usability and acceptability for the interface aesthetic, personalisation, message presentation and navigation. Participants reported minimal burden and no negative outcomes associated with the intervention. CYP, parents and facilitators identified a range of direct and spill over effects of interventions engagement, some of which were not anticipated at study outset. Quantitative data highlighted the feasibility of intervention evaluation, with high levels of recruitment and retention across study time points. Minimal changes were identified in outcomes pre-to-post intervention, which may in part be due to a lack of scale relevance and/or sensitivity to the intervention mechanisms indicated in the qualitative data. CONCLUSIONS Digital mental health literacy applications are potentially an acceptable and feasible way to prevent burdens of common mental health problems amongst CYP in Indonesia. Our intervention and evaluative processes will be further refined prior to definitive evaluation.
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Affiliation(s)
- Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK.
| | | | | | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
| | | | | | - Benny Prawira
- Independent Psychological Researcher, Jakarta, Indonesia
| | - Mark Hann
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Helen Brierley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
- Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, UK
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Ibitoye BM, Garrett B, Ranger M, Stinson J. Conducting Patient-Oriented Research in Low-Income and Middle-Income Countries: A Scoping Review. Patient 2023; 16:19-29. [PMID: 35869330 DOI: 10.1007/s40271-022-00592-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Patient-oriented research involves extensive collaboration with patients, their families, caregivers, clinicians and other relevant stakeholders to identify and investigate problems and outcomes relevant to patients. Patient-oriented research can help develop effective patient-centred interventions. Patient-oriented research is an increasingly used approach in high-income countries, but it is unclear how patients are engaged in research in low-income and middle-income countries (LMICs). OBJECTIVES The aim of this scoping review was to explore how patient-oriented research is conducted in LMICs. The objectives were to determine the levels of involvement of patients in the research, how studies have impacted healthcare and patient outcomes in these countries, the reported benefits of patient-oriented research on the research process and the reported challenges of conducting patient-oriented research in LMICs. METHODS A scoping review was conducted using the methodological framework suggested by Arksey and O'Malley and the Joanna Briggs Institute guidelines for conducting scoping reviews. The eligibility criteria were any healthcare research using any research design that involved patients of any age group in the research process. Six databases were searched from their inception till January 4, 2022: MEDLINE, Embase, Cumulated Index to Nursing and Allied Health Literature, PsychInfo, Cochrane Central Register of Controlled Trials and EBM Reviews. The reference lists of relevant articles and Google Scholar were combed as well. Data extraction was performed with a self-developed data extraction guide. The findings were narratively summarised. RESULTS Thirteen articles were included in this scoping review, representing eight LMICs in Africa and Asia. The majority of studies (38%, n = 5) focused on patients living with human immunodeficiency virus. More than half of the studies (n = 8, 62%) were conducted in the adult population, 31% (n = 4) of the studies involved children and/or adolescents. For most of the studies (92%, n = 12), the participants served as consultants; for one study, the authors identified the participants as co-researchers. Across the studies, information regarding patient-oriented research activities was not consistently reported in the same manner (i.e. different locations in the article), with very limited information in some cases. None of the studies used a patient-oriented research framework and the majority did not report on how patient-oriented research impacted healthcare and patient outcomes. Patient-oriented research was beneficial in identifying relevant patients' needs and improving collaboration among stakeholders, but it also led to extended research timelines and increased financial costs for the researchers and patients. CONCLUSIONS Researchers in LMICs are incorporating patient-oriented research in their research; however, there is a need for improved reporting practices in published articles, and the use of frameworks to guide patient-oriented research in LMICs. In LMICs, patient-oriented research enhances collaboration across stakeholders and gives patients a sense of ownership over the interventions and research process. Future work should focus on developing contextually relevant conceptual frameworks and further studies should explore the impact of patient-oriented research on healthcare and patient outcomes in the LMIC context.
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Affiliation(s)
- Bukola Mary Ibitoye
- School of Nursing, University of British Columbia, Vancouver, BC, Canada. .,Department of Nursing Science, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Kwara, Nigeria.
| | - Bernie Garrett
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Manon Ranger
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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Hann M, Hayes CV, Lacroix-Hugues V, Lundgren PT, McNulty C, Syeda R, Eley C, Teixeira P, Gennimata D, Truninger M, Knøchel S, Münter L, Allison R, Fehér Á, Izsó T, Kunszabó A, Kasza G, Demirjian A. Evidence-based health interventions for the educational sector: Application and lessons learned from developing European food hygiene and safety teaching resources. Food Control 2022. [DOI: 10.1016/j.foodcont.2022.109219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Brooks H, Prawira B, Windfuhr K, Irmansyah I, Lovell K, Syarif AK, Dewi SY, Pahlevi SW, Rahayu AP, Syachroni, Afrilia AR, Renwick L, Pedley R, Salim S, Bee P. Mental health literacy amongst children with common mental health problems and their parents in Java, Indonesia: a qualitative study. Glob Ment Health (Camb) 2022; 9:72-83. [PMID: 36618731 PMCID: PMC9806957 DOI: 10.1017/gmh.2022.5] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 01/11/2023] Open
Abstract
Background Optimising mental health literacy (MHL) at the individual and population level can be an effective mental health improvement and prevention tool. However, concepts of MHL are largely based on evidence from high-income countries. Little is known about the manifestation and role of MHL in countries where collectivist health and social cultures are dominant. Aim This study aimed to examine the MHL of Indonesian children and young people (CYP) with experience of common mental health problems and their parents. Methods Semi-structured interviews with 40 participants (19 CYP aged 11-15 with experience of common mental health problems and 21 parents) from three areas of Java, Indonesia. Data were analysed using framework analysis, informed by Jorm's 1997 Mental Health Literacy Framework. Results Parents and CYP demonstrated relatively low levels of MHL defined from a conventional perspective. Religiosity and spirituality were salient in participants' accounts, particularly parents, as were narratives about personal responsibility. These beliefs appeared to contribute to a high level of self-blame for mental illness, self-reliance for symptom management, the foregrounding of support from spiritual/traditional healers and a reduced propensity to access professional help. CYP were heavily reliant on family support, but parents often felt they were not best placed to communicate with their children about mental health. Providing trusted, technology-based sources of mental health information were advocated by CYP. Conclusion Robust efforts are needed to improve MHL in low- and middle-income countries drawing on culturally appropriate approaches to reduce stigma and optimise timely, effective help-seeking for CYP. Enhancing parental and family level literacy may be efficacious, especially when combined with mechanisms to facilitate open communication, as may the development of standalone interventions directly developed to reach younger generations. Future research may usefully establish the comparative efficacy and acceptability of these different approaches.
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Affiliation(s)
- Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Author for correspondence: Helen Brooks, E-mail:
| | - Benny Prawira
- Atma Jaya Catholic University of Indonesia, Jakarta, Republic of Indonesia
- Into the Light, Jakarta, Republic of Indonesia
| | - Kirsten Windfuhr
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- NHS Benchmarking Network, Manchester, UK
| | - Irman Irmansyah
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Greater Manchester Mental Health Foundation Trust, Manchester, UK
| | - Armaji Kamaludi Syarif
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
| | - Suzy Yusna Dewi
- Soeharto Heerdjan Mental Hospital, Jakarta, Republic of Indonesia
| | | | | | - Syachroni
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
| | - Annisa Rizky Afrilia
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Republic of Indonesia
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Soraya Salim
- Pulih@the Peak – Women, Youth and Family Empowerment Centre, Jakarta, Republic of Indonesia
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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