None listed
Conditions
Brief summary
YouthCHAT is an electronic screening tool developed in 2016 to assess mental health and risky health behaviours among youth attending primary care. Many young people in New Zealand are affected by depression and anxiety but the majority do not access help. For Maori, the burden of morbidity and mortality associated with mental health is considerably higher. This study aims to explore the utility, feasibility, and acceptability of YouthCHAT when tailored for use in primary care settings with large Maori populations. The objectives of the study are: to evaluate the use of YouthCHAT in nurse-led youth clinics, school-based clinics, and general practice in rural New Zealand; to develop a framework for the scaling up of YouthCHAT across further settings; to assess health provider and youth acceptability of the tool; and to identify changes in screening rates for mental health, help-seeking behaviour, early identification of emerging problems and brief intervention delivery. This study will use an implementation, co-design participatory research approach, with a mixed method design to evaluate the use of the YouthCHAT programme in primary health clinics in Te Tai Tokerau. The roll out of YouthCHAT by a rural primary health organisation (PHO) will be pragmatic, starting with five nurse-led clinics, scaling up to school-based clinics and general practices over three years. The YouthCHAT programme is being implemented into the youth screening policies and procedures across all Northland clinics participating in this study. The evaluation of this process will involve consultation and partnership between researchers, clinicians, young people, support staff, community stakeholders, managers and policymakers in research planning and adaptation of YouthCHAT processes and resources in response to user feedback. Acceptability and feasibility data will be gathered via surveys and focus groups. Utility measures, such as changes in screening and help-seeking behaviour, will be gathered via comparison with retrospective deidentified data collection. Inherent in the design of this project is the iterative evaluation of the utility, feasibility, and acceptability of the implementation of YouthCHAT, with the aim of creating a framework for wider scale rollout and implementation. It is anticipated that YouthCHAT will be a culturally acceptable, cost-effective and time-saving screening tool within primary care settings, increasing youth mental health screening and improving access to care. The systematic approach of screening and provision of algorithms for stepped care intervention will lead to early and more comprehensive intervention of youth mental health, substance misuse and other lifestyle issues, which will have a large impact on subsequent physical, mental and social health and well-being.
Interventions
YouthCHAT is a rapid (5-15 min) self-report screening tool that covers smoking, drinking, recreational drug use, problematic gambling, depression, anxiety, sexual health and identity, exposure to abuse, conduct and eating issues, anger management and physical inactivity. Positive screens lead to branching logic linking users to validated assessment tools. A key feature is the help question, which enables youth to indicate areas where they would like help and prioritise issues where they have pro
YouthCHAT is a rapid (5-15 min) self-report screening tool that covers smoking, drinking, recreational drug use, problematic gambling, depression, anxiety, sexual health and identity, exposure to abuse, conduct and eating issues, anger management and physical inactivity. Positive screens lead to branching logic linking users to validated assessment tools. A key feature is the help question, which enables youth to indicate areas where they would like help and prioritise issues where they have problems in more than one domain. Young people self-administer YouthCHAT electronically prior to their consultation a clinical summary report is generated immediately on completion of a YouthCHAT screen and is sent straight to the clinician before they meet with the young person. YouthCHAT provides the clinician with a guide to effective evidence-based interventions using a stepped-care management model ranging from self-help, to GP or primary care nurse brief interventions or provision of relevant medication, to referral to community agencies, and services, and finally referral to secondary care. YouthCHAT is being implemented into participating sites and all youth meeting the clinic's screening criteria will complete a YouthCHAT screen irrespective of participation in the study. YouthCHAT data will be stored using an electronic data management system and from this the number of YouthCHAT screens completed at each site can be compared to deidentified historical data retrieved from the clinics' practice management systems as a means of monitoring adherence to YouthCHAT screening Clinicians using YouthCHAT will be invited to take part in an anonymous survey and/or an semi-structured interview to provide feasibility and acceptability data of the implementation process. Youth attending the clinics who have undergone a YouthCHAT screen will be invited to participate in a focus group to discuss acceptability of YouthCHAT processes. Utility measures, such as changes in screening and help-seeking behaviour, will be gathered via comparison with retrospective deidentified data collection. The project will run for three years and it is anticipated that data collection will be completed by the beginning of the third year. This study is using a co-design approach, in which the research team will work with primary healthcare organisations, clinic staff, local agencies, cultural and community groups to determine optimal processes for conducting the study which will include duration/frequency of observation at each participating clinic.
Sponsors
The University of Auckland
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Youth enrolled at the clinic who have undertaken a YouthCHAT screen , clinic staff who use the YouthCHAT tool and the Clinical Educator who provides training and support in the use of YouthCHAT
Exclusion criteria
No exclusion criteria other than not meeting the inclusion criteria -
Outcome results
None listed