Detection of risk for depression among adolescents in diverse global settings: protocol for the IDEA qualitative study in Brazil, Nepal, Nigeria and the UK

Abstract

IntroductionGlobally, depression is a leading cause of disability among adolescents, and suicide rates are increasing among youth. Treatment alone is insufficient to address the issue. Early identification and prevention efforts are necessary to reduce morbidity and mortality. The Identifying Depression Early in Adolescence (IDEA) consortium is developing risk detection strategies that incorporate biological, psychological and social factors that can be evaluated in diverse global populations. In addition to epidemiological and neuroscience research, the IDEA consortium is conducting a qualitative study to explore three domains of inquiry: (1) cultural heterogeneity of biopsychosocial risk factors and lived experience of adolescent depression in low-income and middle-income countries (LMIC); (2) the feasibility, acceptability and ethics of a risk calculator tool for adolescent depression that can be used in LMIC and high-income countries and (3) capacity for biological research into biomarkers for depression risk among adolescents in LMIC. This is a multisite qualitative study being conducted in Brazil, Nepal, Nigeria and the UK.Methods and analysisA systematic set of qualitative methods will be used in this study. The Delphi method, Theory of Change (ToC) workshops, key-informant interviews and focus group discussions will be used to elicit perspectives on the study topics from a broad range of stakeholders (adolescents, parents, policy-makers, teachers, health service providers, social workers and experts). Delphi panellists will participate in three survey rounds to generate consensus through facilitated feedback. Stakeholders will create ToC models via facilitated workshops in the LMIC sites. The framework approach will be used to analyse data from the study.Ethics and disseminationEthical approvals were received from the Ethics Review Board of George Washington University and from site-specific institutions in Brazil, Nepal, Nigeria and the UK. The findings generated from this study will be reported in highly accessed, peer-reviewed, scientific and health policy journals.

Identifying risk factors and detection strategies for adolescent depression in diverse global settings: A Delphi consensus study

“…The IDEA Delphi objectives are presented in Table 1 . Methods for all qualitative components of the IDEA project and the a priori Delphi design for this study are available in a published protocol ( Wahid et al., 2020 ).…”

Social isolation as a core feature of adolescent depression: a qualitative study in Porto Alegre, Brazil

“…The present study was designed following the Framework Method (Gale et al, 2013 ) to explore the experience of adolescent depression at the individual level through key informant interviews (KII) and focus group discussions (FGD). This study was developed as part of the Identifying Depression Early in Adolescence (IDEA) consortium (Kieling et al, 2019 ), which includes a qualitative component, a protocol described in detail elsewhere (Wahid et al, 2020 ).…”

Understanding Youth’s Lived Experience of Anxiety through Metaphors: A Qualitative, Arts-Based Study

“…Upwards of 50% of adult mental health disorders have their onset during adolescence [ 1 ], making timely and effective intervention key to lessening the burden of illness over the long term [ 9 , 10 ]. The need for context-specific understandings of the mental health experiences of adolescents has been identified as a one of the major gaps in global research [ 11 ]. Measures such as scales and questionnaires are necessary to quantify anxiety, yet these approaches risk not adequately reflecting the lived experience of psychological distress across individuals and settings [ 12 ].…”