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Trials
Published in: Trials 1/2024

Open Access 01-12-2024 | Study protocol

Increasing access to mental health supports for 12–17-year-old Indigenous youth with the JoyPop mobile mental health app: study protocol for a randomized controlled trial

Authors: Aislin R. Mushquash, Teagan Neufeld, Ishaq Malik, Elaine Toombs, Janine V. Olthuis, Fred Schmidt, Crystal Dunning, Kristine Stasiuk, Tina Bobinski, Arto Ohinmaa, Amanda Newton, Sherry H. Stewart

Published in: Trials | Issue 1/2024

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Abstract

Background

Indigenous youth in Northwestern Ontario who need mental health supports experience longer waits than non-Indigenous youth within the region and when compared to youth in urban areas. Limited access and extended waits can exacerbate symptoms, prolong distress, and increase risk for adverse outcomes. Innovative approaches are urgently needed to provide support for Indigenous youth in Northwestern Ontario. Using a randomized controlled trial design, the primary objective of this study is to determine the effectiveness of the JoyPop app compared to usual practice (UP; monitoring) in improving emotion regulation among Indigenous youth (12–17 years) who are awaiting mental health services. The secondary objectives are to (1) assess change in mental health difficulties and treatment readiness between youth in each condition to better understand the app’s broader impact as a waitlist tool and (2) conduct an economic analysis to determine whether receiving the app while waiting for mental health services reduces other health service use and associated costs.

Methods

A pragmatic, parallel arm randomized controlled superiority trial will be used. Participants will be randomly allocated in a 1:1 ratio to the control (UP) or intervention (UP + JoyPop) condition. Stratified block randomization will be used to randomly assign participants to each condition. All participants will be monitored through existing waitlist practices, which involve regular phone calls to check in and assess functioning. Participants in the intervention condition will receive access to the JoyPop app for 4 weeks and will be asked to use it at least twice daily. All participants will be asked to complete outcome measures at baseline, after 2 weeks, and after 4 weeks.

Discussion

This trial will evaluate the effectiveness of the JoyPop app as a tool to support Indigenous youth waiting for mental health services. Should findings show that using the JoyPop app is beneficial, there may be support from partners and other organizations to integrate it into usual care pathways.

Trial registration

Literature
1.
Bombay A, Matheson K, Anisman H. The intergenerational effects of Indian Residential Schools: implications for the concept of historical trauma. Transcult Psychiatry. 2014;51(3):320–38.CrossRefPubMedPubMedCentral
2.
Muir NM, Viljoen JL. Adverse childhood experiences and recidivism in Indigenous and white female and male adolescents on probation. Child Abuse Negl. 2022;126:105512.CrossRefPubMed
3.
Kidd LR, Garrard GE, Bekessy SA, Mills A, Camilleri AR, Fidler F, Fielding KS, Gordon A, Gregg EA, Kusmanoff AM, Louis W, Moon K, Robinson JA, Selinske MJ, Shanahan D, Adams VM. Messaging matters: a systematic review of the conservation messaging literature. Biol Conserv. 2019;236:92–9.CrossRef
4.
Firestone M, Smylie J, Maracle S, McKnight C, Spiller M, O’Campo P. Mental health and substance use in an urban First Nations population in Hamilton. Ontario C J Public Health. 2015;106(6):e375–81.CrossRef
5.
Friesen E. The landscape of mental health services in rural Canada. Univ Toronto Med J. 2019;96(2):47–52.
6.
7.
8.
Barwick M, Urajnik D, Sumner L, Cohen S, Reid G, Engel K, Moore JE. Profiles and service utilization for children accessing a mental health walk-in clinic vs usual care. J Evid Based Soc Work. 2013;10(4):338–52.CrossRefPubMed
9.
Kowalewski K, McLennan JD, McGrath PJ. A preliminary investigation of wait times for child and adolescent mental health services in Canada. J Can Acad Child Adolesc Psychiatry. 2011;20(2):112.PubMedPubMedCentral
10.
Vallerand IA, McLennan JD. Child and adolescent mental health service management strategies that may influence wait times. J Can Acad Child Adolesc Psychiatry. 2013;22(2):159 (2003).PubMedPubMedCentral
11.
Westin AM, Barksdale CL, Stephan SH. The effect of waiting time on youth engagement to evidence based treatments. Community Ment Hlt J. 2013;50:221–8.CrossRef
12.
Schraeder KE, Reid GJ. Why wait? The effect of wait-times on subsequent help-seeking among families looking for children’s mental health services. J Abnorm Child Psychol. 2015;43(3):553–65.CrossRefPubMed
13.
14.
15.
Nahum-Shani I, Smith SN, Spring BJ, Collins LM, Witkiewitz K, Tewari A, Murphy SA. Just-in-Time Adaptive Interventions (JITAIs) in mobile health: key components and design principles for ongoing health behavior support. Ann Behav Med. 2018;52(6):446–62.CrossRefPubMed
16.
17.
Clough BA, Casey LM. The smart therapist: a look to the future of smartphones and mHealth technologies in psychotherapy. Prof Psychol Res Pr. 2015;46(3):147–53.CrossRef
18.
Gibson K, Coulson H, Miles R, Kakekakekung C, Daniels E, O’Donnell S. Conversations on telemental health: listening to remote and rural First Nations communities. Rural Remote Health. 2011;11(2):1656–75.PubMed
19.
Donker T, Petrie K, Proudfoot J, Clarke J, Birch MR, Christensen H. Smartphones for smarter delivery of mental health programs: a systematic review. J Med Internet Res. 2013;15(11):e247.CrossRefPubMedPubMedCentral
20.
Marshall JM, Dunstan DA, Bartik W. The digital psychiatrist: in search of evidence-based apps for anxiety and depression. Front Psychiatry. 2019;10(831):1–7.
21.
Chib A, Lin SH. Theoretical advancement in mHealth: a systematic review of mobile apps. J Health Commun. 2018;23(10–11):909–55.CrossRefPubMed
22.
Berking M, Ebert D, Cuijpers P, Hofmann SG. Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychother Psychosom. 2013;82(4):234–45.CrossRefPubMed
23.
Fehlinger T, Stumpenhorst M, Stenzel N, Rief W. Emotion regulation is the essential skill for improving depressive symptoms. J Affect Disord. 2013;144(1–2):116–22.CrossRefPubMed
24.
25.
MacIsaac A, Mushquash AR, Mohammed S, Grassia E, Smith S, Wekerle C. Adverse childhood experiences and building resilience with the Joypop app: evaluation study. JMIR Mhealth Uhealth. 2021;9(1):e25087.CrossRefPubMedPubMedCentral
26.
Barlow DH, Farchione TJ, Sauer-Zavala S, Murray-Latin H, Ellard KK, Bullis JR, Bentley KH, Boettcher HT, Cassiello-Robbins C. Unified protocol for transdiagnostic treatment of emotional disorders: Workbook. 2nd ed. New York: Oxford University Press; 2010.
27.
Kowatch KR. Analysis of the child and adolescent needs and strengths assessment in a First Nation population [dissertation]. Thunder Bay (CAN): Lakehead University; 2017.
28.
Mushquash AR, Pearson ES, Waddington K, MacIsaac A, Mohammed S, Grassia E, Smith S, Wekerle C. User perspectives on the resilience-building JoyPop app: qualitative study. JMIR Mhealth Uhealth. 2021;9(7):e28677.CrossRefPubMedPubMedCentral
29.
30.
Malik I, Perez A, Toombs E, Schmidt F, Olthuis JV, Charlton J, Grassia E, Squier C, Stasiuk K, Bobinski T, Mushquash AR. Female youth and Mental Health Service Providers’ perspectives on the JoyPopTM app: A qualitative study. Front Digit Health. 2023;5:1–20.CrossRef
31.
32.
33.
34.
Mushquash AR, Toombs E, Charlton J, Malik I, Schmidt F, Squier C, Stasiuk K, Bobinski T, Olthuis J. Recruitment and retention patterns among Indigenous and non-Indigenous youth during a pilot evaluation of the JoyPopTM app. In A. R. Mushquash (Chair), Implementing and evaluating the JoyPopTM app as a tool to support Indigenous and non-Indigenous youth in Northwestern Ontario. Paper presented at: Symposium for the. Canadian Psychological Association 84th Annual Convention; 2023 June. Toronto: Canada; 2023.
35.
Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004;26(1):41–54.CrossRef
36.
Kaufman EA, Xia M, Fosco G, Yaptangco M, Skidmore CR, Crowell SE. The difficulties in emotion regulation scale short form (DERS-SF): validation and replication in adolescent and adult samples. J Psychopathol Behav Assess. 2016;38:443–55.CrossRef
37.
Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–43.CrossRefPubMed
38.
Goodman A, Goodman R. Strengths and difficulties questionnaire as a dimensional measure of child mental health. J Am Acad Child Adolesc Psychiatry. 2009;48(4):400–3.CrossRefPubMed
39.
Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581–6.CrossRefPubMed
40.
Breda CS, Riemer M. Motivation for Youth’s Treatment Scale (MYTS): a new tool for measuring motivation among youths and their caregivers. Adm Policy Ment Health. 2012;39(1–2):118–32.CrossRefPubMedPubMedCentral
41.
Stoyanov SR, Hides L, Kavanagh DJ, Wilson H. Development and validation of the User Version of the Mobile Application Rating Scale (uMARS). JMIR Mhealth Uhealth. 2016;4(2):e72.CrossRefPubMedPubMedCentral
42.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington: American Psychiatric Publishing, Inc; 2013.
43.
Kring AM, Sloan DM, editors. Emotion regulation and psychopathology: a transdiagnostic approach to etiology and treatment. New York: Guilford Press; 2009.
44.
45.
46.
Brueton VC, Tierney JF, Stenning S, Meredith S, Harding S, Nazareth I, Rait G. Strategies to improve retention in randomized trials: a Cochrane systematic review and meta-analysis. BMJ Open. 2014;4:e003821.CrossRefPubMedPubMedCentral
47.
Elfeky A, Gillies K, Gardner H, Fraser C, Ishaku T, Treweek S. Non-randomised evaluations of strategies to increase participant retention in randomised controlled trials: a systematic review. Syst Rev. 2020;9(1):224.CrossRefPubMedPubMedCentral
48.
Tull MT, Barrett HM, McMillan ES, Roemer L. A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behav Ther. 2007;38(3):303–13.CrossRefPubMed
49.
50.
51.
Feingold A. Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis. Psychol Methods. 2009;14:43–53.CrossRefPubMedPubMedCentral
52.
53.
Dong Y, Peng C-Y. Principled missing data methods for researchers. Springerplus. 2023;2:222.CrossRef
54.
Jelicić H, Phelps E, Lerner RM. Use of missing data methods in longitudinal studies: the persistence of bad practices in developmental psychology. Dev Psychol. 2009;45(4):1195–9.CrossRefPubMed
Metadata
Title
Increasing access to mental health supports for 12–17-year-old Indigenous youth with the JoyPop mobile mental health app: study protocol for a randomized controlled trial
Authors
Aislin R. Mushquash
Teagan Neufeld
Ishaq Malik
Elaine Toombs
Janine V. Olthuis
Fred Schmidt
Crystal Dunning
Kristine Stasiuk
Tina Bobinski
Arto Ohinmaa
Amanda Newton
Sherry H. Stewart
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Trials / Issue 1/2024
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-024-08076-y

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