The Weathering Well App, A New Low Intensity Digital Mental Health Intervention for Australian Farmers: Formative Research

Abstract

Background Australian farming communities demonstrate significant resilience in the face of many challenges, including drought, bushfires, and more recently COVID-19. Nevertheless, worries related to financial hardship, farm viability and productivity, and remoteness render the population vulnerable to mental health problems. Despite this vulnerability, people in these communities are unlikely to seek help from mental health services due to attitudes, service access and geographic barriers. A tailored, low intensity digital mental health intervention may provide an acceptable and appropriate early wellbeing intervention for the population and help bridge the mental health service gap. Objectives This study has three objectives: 1) to adapt an existing tablet-based, therapist-guided, low intensity digital mental health intervention to address the wellbeing needs of Australian farming communities (development of the Weathering Well app), 2) to adapt, deliver, and evaluate training in utilisation of the new app, and 3) to conduct preliminary analyses on app usage data during the 12-months post-app release. Methods An Expert Advisory Group, comprising graziers, growers, rural financial counsellors, rural and remote mental health clinicians, Information Technology (IT) experts, Western Queensland Primary Health Networks representatives, Peak Body representatives (New South Wales rice growers), and drought impacted Shire Council representatives, was established. A three-day co-design workshop facilitated by the research team followed by a series of member-checking and user-testing rounds led to release of the new app. Pre-existing training resources were adapted, and the revised training workshops were delivered to service providers working with remote and rural farming communities. Pre- and post-training evaluations and app usage data were analysed. Results The final Weathering Well app received approval for public release by all stakeholders in September 2019. Following training, participant scores suggested that the app was accessible, appropriate, and effective with increased perceived knowledge and confidence in app use post-training. Analysis of app usage data indicated good app engagement, providing additional preliminary evidence for feasibility and acceptability. Trainees indicated reservations in terms of successful implementation most notably the need for organizational support for use. Conclusions This study provides an example of an intervention tailored to context through collaborative co-design. The preliminary findings suggest high levels of acceptability, providing a good foundation for implementation, further app revision and exploration of effectiveness and sustainability.