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      Participatory Research as One Piece of the Puzzle: A Systematic Review of Consumer Involvement in Design of Technology-Based Youth Mental Health and Well-Being Interventions

      research-article
      , BSc,BEd,GDipPsych(Hons) 1 , 2 , , , BA,Dip Ed,MSW,PhD 1 , , PhD,MPsych(Clinical),B Soc Sci,B Health Sc Hons 1 , , BSc 1 , 2 , , BHlthSc 3 , 4 , , BPsych (Hons) 1 , , BA,GDipInfoStud 5 , , BPsych (Hons) 1 , 2 , , PhD,MBBS,FRANZCP 1 , , PhD,BSC,MAppStats 1 , , PhD,B.A. (Hons) 2 , 6 , , PhD,BEng (Hons) 1 , 2
      (Reviewer)
      JMIR Human Factors
      Gunther Eysenbach
      mental health, young people, technology, intervention, participatory, design

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          Abstract

          Background

          Despite the potential of technology-based mental health interventions for young people, limited uptake and/or adherence is a significant challenge. It is thought that involving young people in the development and delivery of services designed for them leads to better engagement. Further research is required to understand the role of participatory approaches in design of technology-based mental health and well-being interventions for youth.

          Objective

          To investigate consumer involvement processes and associated outcomes from studies using participatory methods in development of technology-based mental health and well-being interventions for youth.

          Methods

          Fifteen electronic databases, using both resource-specific subject headings and text words, were searched describing 2 broad concepts-participatory research and mental health/illness. Grey literature was accessed via Google Advanced search, and relevant conference Web sites and reference lists were also searched. A first screening of titles/abstracts eliminated irrelevant citations and documents. The remaining citations were screened by a second reviewer. Full text articles were double screened. All projects employing participatory research processes in development and/or design of (ICT/digital) technology-based youth mental health and well-being interventions were included. No date restrictions were applied; English language only. Data on consumer involvement, research and design process, and outcomes were extracted via framework analysis.

          Results

          A total of 6210 studies were reviewed, 38 full articles retrieved, and 17 included in this study. It was found that consumer participation was predominantly consultative and consumerist in nature and involved design specification and intervention development, and usability/pilot testing. Sustainable participation was difficult to achieve. Projects reported clear dichotomies around designer/researcher and consumer assumptions of effective and acceptable interventions. It was not possible to determine the impact of participatory research on intervention effectiveness due to lack of outcome data. Planning for or having pre-existing implementation sites assisted implementation. The review also revealed a lack of theory-based design and process evaluation.

          Conclusions

          Consumer consultations helped shape intervention design. However, with little evidence of outcomes and a lack of implementation following piloting, the value of participatory research remains unclear.

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          Most cited references66

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          Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

          Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Conclusions Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.
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            The value and challenges of participatory research: strengthening its practice.

            The increasing use of participatory research (PR) approaches to address pressing public health issues reflects PR's potential for bridging gaps between research and practice, addressing social and environmental justice and enabling people to gain control over determinants of their health. Our critical review of the PR literature culminates in the development of an integrative practice framework that features five essential domains and provides a structured process for developing and maintaining PR partnerships, designing and implementing PR efforts, and evaluating the intermediate and long-term outcomes of descriptive, etiological, and intervention PR studies. We review the empirical and nonempirical literature in the context of this practice framework to distill the key challenges and added value of PR. Advances to the practice of PR over the next decade will require establishing the effectiveness of PR in achieving health outcomes and linking PR practices, processes, and core elements to health outcomes.
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              Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals.

              This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices.
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                Author and article information

                Contributors
                Journal
                JMIR Hum Factors
                JMIR Hum Factors
                JMIR Human Factors
                JMIR Human Factors
                Gunther Eysenbach (JMIR Publications Inc., Toronto, Canada )
                2292-9495
                Jul-Dec 2015
                09 July 2015
                : 2
                : 2
                : e12
                Affiliations
                [1] 1Flinders Human Behaviour & Health Research Unit Department of Psychiatry Flinders University Bedford ParkAustralia
                [2] 2Young and Well Cooperative Research Centre Abbotsford, VictoriaAustralia
                [3] 3Mental Health Informatics Research Unit Country Health SA LHN Inc AdelaideAustralia
                [4] 4School of Medicine University of Adelaide AdelaideAustralia
                [5] 5Gus Fraenkel Medical Library Flinders University Bedford ParkAustralia
                [6] 6Institute for Culture and Society University of Western Sydney PenrithAustralia
                Author notes
                Corresponding Author: Simone Kate Orlowski simone.orlowski@ 123456flinders.edu.au
                Author information
                http://orcid.org/0000-0001-8395-1087
                http://orcid.org/0000-0002-5464-8887
                http://orcid.org/0000-0003-1885-2423
                http://orcid.org/0000-0001-5696-0578
                http://orcid.org/0000-0003-3102-1771
                http://orcid.org/0000-0001-5153-1272
                http://orcid.org/0000-0002-6737-7537
                http://orcid.org/0000-0002-4257-0779
                http://orcid.org/0000-0002-2504-8102
                http://orcid.org/0000-0002-9835-3474
                http://orcid.org/0000-0003-0015-4213
                http://orcid.org/0000-0003-2868-9260
                Article
                v2i2e12
                10.2196/humanfactors.4361
                4797690
                27025279
                9b086f79-c20e-4fcf-b71f-3e9c216514b1
                ©Simone Kate Orlowski, Sharon Lawn, Anthony Venning, Megan Winsall, Gabrielle M Jones, Kaisha Wyld, Raechel A Damarell, Gaston Antezana, Geoffrey Schrader, David Smith, Philippa Collin, Niranjan Bidargaddi. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 09.07.2015.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on http://humanfactors.jmir.org, as well as this copyright and license information must be included.

                History
                : 20 February 2015
                : 29 April 2015
                : 25 May 2015
                : 27 May 2015
                Categories
                Original Paper
                Original Paper

                mental health,young people,technology,intervention,participatory,design

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