Co-creating a large-scale adolescent health survey integrated with access to digital health interventions

Abstract

Aim This paper describes how we engaged with adolescents and health providers to integrate access to digital health interventions as part of a large-scale secondary school health and wellbeing survey in New Zealand. Methods We conducted nine participatory, iterative co-design sessions involving 29 adolescents, and two workshops with young people (n = 11), digital and health service providers (n = 11) and researchers (n = 9) to gain insights into end-user perspectives on the concept and how best to integrate digital interventions in to the survey. Results Students’ perceived integrating access to digital health interventions into a large-scale youth health survey as acceptable and highly beneficial. They did not want personalized/normative feedback, but thought that every student should be offered all the help options. Participants identified key principles: assurance of confidentiality, usability, participant choice and control, and language. They highlighted wording as important for ease and comfort, and emphasised the importance of user control. Participants expressed that it would be useful and acceptable for survey respondents to receive information about digital help options addressing a range of health and wellbeing topics. Conclusion The methodology of adolescent-practitioner-researcher collaboration and partnership was central to this research and provided useful insights for the development and delivery of adolescent health surveys integrated with digital help options. The results from the ongoing study will provide useful data on the impact of digital health interventions integrated in large-scale surveys, as a novel methodology. Future research on engaging with adolescents once interventions are delivered will be useful to explore benefits over time.

Digital Mental Health Intervention Uptake Among Distressed New Zealand High School Students in a Comprehensive Survey: Implications for Digital Help Provision

“…Emerging literature suggests that digital technology is an acceptable and effective medium to deliver mental health interventions and information to adolescents in randomised controlled trials (Donker et al, 2009;Ebert et al, 2015;Grist et al, 2019). Furthermore, adolescents already use the internet to access mental health information (Hall et al, 2019;Utter et al, 2017) and report, in general, that they are satisfied with using technology to receive mental health support (Fleming et al, 2019;Peiris-John et al, 2020;Pretorius et al, 2019).…”

“…For example, DMHI may support users to improve their mental health literacy and social skills, facilitate symptom monitoring, or may provide them with therapy (Christensen & Hickie, 2010) while delivering it in a preferred format (Fleming et al, 2019). At this intersection of technology and mental health research, the needs and preferences of the user can be measured more accurately, DMHI can be designed to address these needs and preferences, and the number and diversity of mental health help options can increase to provide suitable options for more people (Fleming et al, 2016;Hollis et al, 2015;Peiris-John et al, 2020). For example, direct and serious mental health information, and fun or gamified approaches can both be developed to provide appropriate help to adolescents depending on their age, preferences, and mental health needs (Fleming et al, 2019).…”

“…Importantly, adolescents also respond favourably to combined approaches, reporting that it could improve user autonomy and choice (Fleming et al, 2019;Peiris-John et al, 2020).…”

“…This "digital divide" is also evidenced by differences in internet use between low and high deprivation groups, the former being more likely to access the internet for health-related information (Utter et al, 2017). Thus, considering that a goal of DMHI is to reduce inequities (Muñoz et al, 2019;Peiris-John et al, 2020), it is essential that their development does not exacerbate existing disparities in access to care and mental health outcomes among New Zealand adolescents.…”

“…For example, the Youth19 Research Team proposed to include DMHI as part of the DHR offered to participants at the end of the Youth19 Smart Survey. Criteria was developed by the research team and refined with stakeholders and adolescents (Peiris-John et al, 2020). I contributed to this process by discussing criteria with the research team.…”