YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study

Rhiannon Mary Martel; Margot Louise Darragh; Aniva Joanne Lawrence; Matthew John Shepherd; Tracey Wihongi; Felicity Anne Goodyear-Smith

doi:10.2196/12108

YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study

JMIR Res Protoc. 2019 Jan 9;8(1):e12108. doi: 10.2196/12108.

Authors

Rhiannon Mary Martel¹, Margot Louise Darragh¹, Aniva Joanne Lawrence^{2

3}, Matthew John Shepherd^#⁴, Tracey Wihongi⁵, Felicity Anne Goodyear-Smith¹

Affiliations

¹ Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand.
² Manaia Health Primary Health Organisation, Whangarei, New Zealand.
³ Te Tai Tokerau Primary Health Organisation, Kerikeri, New Zealand.
⁴ Faculty of Education and Social Work, Department of Counselling, Human Services and Social Work, The University of Auckland, Auckland, New Zealand.
⁵ Ngati Hine Health Trust, Whangarei, New Zealand.

^# Contributed equally.

PMID: 30626568
PMCID: PMC6329425
DOI: 10.2196/12108

Abstract

Background: In New Zealand (NZ), 1 in 4 adolescents is affected by mental health issues (eg, depression and anxiety) and engages in risk behaviors (eg, harmful drinking and substance abuse), with rates among Māori youth being significantly higher. The majority of NZ secondary school students visit their local primary health care providers (PHPs) at least annually, yet most do not seek help for mental health and risk behavior (MHB) concerns. While youth think it acceptable to discuss sensitive issues during a consultation with their PHPs, unless problems are severe, such conversations are not initiated by PHPs. Early intervention for MHB concerns can prevent long-term health and well-being issues. However, this relies on the early identification of developing problems and youth being offered and accepting help. YouthCHAT is an electronic, multi-item screening tool developed in 2016 to assess MHB concerns among youth. YouthCHAT is completed before a consultation with the PHP, who can access a summary report straight away. A help question allows young people to identify issues that need addressing. A resource pack uses stepped care pathways to guide providers to use appropriate brief interventions.

Objective: This study aimed to explore the utility, feasibility, and acceptability of YouthCHAT when tailored for use with youth in primary care settings with large Māori populations. Objectives of the study are to evaluate the implementation of YouthCHAT in nurse-led youth clinics, school-based clinics, and general practice in Te Tai Tokerau (Northland, NZ); to develop a framework for the scaling up of YouthCHAT across further settings; to assess health provider and youth acceptability of the tool; to improve screening rates for mental health and help-seeking behavior; to enable early identification of emerging problems; and to improve brief intervention delivery.

Methods: Using a bicultural mixed-methods co-design approach, 3 phases over a 3-year period will provide an iterative evaluation of the utility, feasibility, and acceptability of YouthCHAT, aiming to create a framework for wider-scale rollout and implementation.

Results: Recruitment for the first phase began in September 2018. YouthCHAT was implemented at the first site in October 2018 and is expected to be at a further two sites in late January to early February 2019. The study is due for completion at the end of 2021.

Conclusions: YouthCHAT has potential as a user-friendly, time efficient, and culturally safe screening tool for early detection of MHB issues in NZ youth. The resource pack assists the clinician to provide appropriate interventions for emerging and developed youth mental health and lifestyle issues. Involving input from community providers, users, and stakeholders will ensure that modifiable elements of YouthCHAT are tailored to meet the health needs specific to each context and will have a positive influence on future mental, physical, and social outcomes for NZ youth.

International registered report identifier (irrid): PRR1-10.2196/12108.

Keywords: YouthCHAT; adolescents; brief intervention; co-design; mental health; primary health care; protocol; risk behavior.

©Rhiannon Mary Martel, Margot Louise Darragh, Aniva Joanne Lawrence, Matthew John Shepherd, Tracey Wihongi, Felicity Anne Goodyear-Smith. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 09.01.2019.