A national evaluation of a multi‐modal, blended, digital intervention integrated within Australian youth mental health services

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2024-09-12 DOI:10.1111/acps.13751

M. Alvarez‐Jimenez, J. Nicholas, L. Valentine, P. Liu, S. Mangelsdorf, S. Baker, T. Gilbertson, G. O'Loughlin, C. McEnery, P. D. McGorry, J. F. Gleeson, S. P. Cross

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引用次数: 0

Abstract

BackgroundYouth mental health (YMH) services have been established internationally to provide timely, age‐appropriate, mental health treatment and improve long‐term outcomes. However, YMH services face challenges including long waiting times, limited continuity of care, and time‐bound support. To bridge this gap, MOST was developed as a scalable, blended, multi‐modal digital platform integrating real‐time and asynchronous clinician‐delivered counselling; interactive psychotherapeutic content; vocational support; peer support, and a youth‐focused online community. The implementation of MOST within Australian YMH services has been publicly funded.ObjectiveThe primary aim of this study was to evaluate the real‐world engagement, outcomes, and experience of MOST during the first 32 months of implementation.MethodYoung people from participating YMH services were referred into MOST. Engagement metrics were derived from platform usage. Symptom and satisfaction measures were collected at baseline, 6, and 12 (primary endpoint) weeks. Effect sizes were calculated for the primary outcomes of depression and anxiety and secondary outcomes of psychological distress and wellbeing.ResultsFive thousand seven hundred and two young people from 262 clinics signed up and used MOST at least once. Young people had an average of 19 login sessions totalling 129 min over the first 12 weeks of use, with 71.7% using MOST for at least 14 days, 40.1% for 12 weeks, and 18.8% for 24 weeks. There was a statistically significant, moderate improvement in depression and anxiety at 12 weeks as measured by the PHQ4 across all users irrespective of treatment stage (d = 0.41, 95% CI 0.35–0.46). Satisfaction levels were high, with 93% recommending MOST to a friend. One thousand one hundred and eighteen young people provided written feedback, of which 68% was positive and 31% suggested improvement.ConclusionsMOST is a highly promising blended digital intervention with potential to address the limitations and enhance the impact of YMH services.

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对纳入澳大利亚青少年心理健康服务的多模式混合数字干预措施进行全国性评估

背景国际上已经建立了青少年心理健康（YMH）服务，以提供及时、适龄的心理健康治疗，并改善长期疗效。然而，青少年心理健康服务面临着各种挑战，包括等待时间长、护理的连续性有限以及有时限的支持。为了弥补这一差距，MOST 被开发成一个可扩展的、混合的、多模式的数字平台，整合了临床医生提供的实时和异步咨询、互动式心理治疗内容、职业支持、同伴支持以及一个以青少年为中心的在线社区。这项研究的主要目的是评估社会变革管理计划实施 32 个月来的实际参与情况、成果和体验。参与度指标来自平台使用情况。在基线、6周和12周（主要终点）收集症状和满意度指标。结果来自 262 家诊所的 5702 名年轻人注册并至少使用了一次 MOST。在使用的前 12 周内，年轻人平均登录了 19 次，总计 129 分钟，其中 71.7% 的人至少使用了 14 天，40.1% 的人使用了 12 周，18.8% 的人使用了 24 周。根据PHQ4的测量结果，无论治疗阶段如何，所有用户在12周时的抑郁和焦虑情况都有了明显的改善（d = 0.41，95% CI 0.35-0.46）。满意度很高，93%的人向朋友推荐社会变革管理计划。118名青少年提供了书面反馈，其中68%为正面反馈，31%建议改进。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.