背景:75%的精神疾病患者在12-24岁之间发病。这个年龄段的许多人报告说,在接受以青年为中心的优质精神保健服务方面存在重大障碍。随着科技的飞速发展,以及最近的COVID-19大流行,移动健康(mHealth)为青年心理健康研究提供了新的机会,实践,和政策。
目的:研究目标是:1)综合当前证据,支持针对经历心理健康挑战的青年的mHealth干预措施;2)确定mHealth领域与青年心理健康服务获取和健康结果相关的当前差距。
方法:以Arksey和O\'Malley的方法为指导,我们对使用mHealth工具改善青少年心理健康的同行评审研究进行了范围审查(2016年1月-2022年2月).使用MEDLINE,PubMed,PsycINFO,和Embase数据库,我们使用以下关键术语进行搜索:1)mHealth;2)青年和年轻人;3)心理健康。使用内容分析法分析了当前的差距。
结果:搜索产生了4270条记录,其中151人符合纳入标准。纳入的文章强调了青年mHealth干预资源分配的全面方面,m健康交付方法,测量工具,mHealth干预评估,青年参与所有研究参与者的平均年龄为17岁(Q1:14;Q3:21)。只有三项研究(2%)涉及在二元期权之外报告自己的性别或性别的参与者。许多研究(n=68,45%)是在COVID-19爆发后发表的。研究类型和设计多种多样,其中60项(40%)被确定为随机对照试验(RCTs)。值得注意的是,151项研究中有143项(95%)来自发达国家,这表明在资源较低的环境中实施移动医疗服务的可行性存在证据不足。此外,结果突出了与薄弱的研究设计有关的担忧,专家参与以及为捕捉影响或随时间变化而选择的成果衡量标准类型。还缺乏为青年研究mHealth技术以及使用非青年为中心的方法来实施成果的标准化法规和准则。
结论:这项研究可用于指导未来的工作,以及开发以青年为中心的移动健康工具,这些工具可以随着时间的推移为不同类型的青年实施和维持。需要优先考虑青年参与的实施科学研究,以增进对mHealth实施的当前理解。同样,核心成果集可能支持以青年为中心的衡量战略,以系统的方式捕捉成果,优先考虑公平,多样性,inclusion,和强大的测量科学。最后,这项研究表明,需要未来的实践和政策研究,以确保mHealth的风险最小化,并且这种创新的医疗保健服务随着时间的推移正在满足年轻人的新需求。
背景:
A total of 75% of people with mental health disorders have an onset of
illness between the ages of 12 and 24 years. Many in this age group report substantial obstacles to receiving quality youth-centered mental health care services. With the rapid development of technology and the recent COVID-19 pandemic, mobile health (mHealth) has presented new opportunities for youth mental health research, practice, and policy.
The research objectives were to (1) synthesize the current evidence supporting mHealth interventions for youths who experience mental health challenges and (2) identify current gaps in the mHealth field related to youth\'s access to mental health services and health outcomes.
Guided by the methods of Arksey and O\'Malley, we conducted a scoping
review of peer-reviewed studies that used mHealth tools to improve youth mental health (January 2016-February 2022). We searched MEDLINE, PubMed, PsycINFO, and Embase databases using the following key terms: (1) mHealth; (2) youth and young adults; and (3) mental health. The current gaps were analyzed using content analysis.
The search produced 4270 records, of which 151 met inclusion criteria. Included articles highlight the comprehensive aspects of youth mHealth intervention resource allocation for targeted conditions, mHealth delivery methods, measurement tools, evaluation of mHealth intervention, and youth engagement. The median age for participants in all studies is 17 (IQR 14-21) years. Only 3 (2%) studies involved participants who reported their sex or gender outside of the binary option. Many studies (68/151, 45%) were published after the onset of the COVID-19 outbreak. Study types and designs varied, with 60 (40%) identified as randomized controlled trials. Notably, 143 out of 151 (95%) studies came from developed countries, suggesting an evidence shortfall on the feasibility of implementing mHealth services in lower-resourced settings. Additionally, the results highlight concerns related to inadequate resources devoted to self-harm and substance uses, weak study design, expert engagement, and the variety of outcome measures selected to capture impact or changes over time. There is also a lack of standardized regulations and guidelines for researching mHealth technologies for youths and the use of non-youth-centered approaches to implementing results.
This study may be used to inform future work as well as the development of youth-centered mHealth tools that can be implemented and sustained over time for diverse types of youths. Implementation science research that prioritizes youths\' engagement is needed to advance the current understanding of mHealth implementation. Moreover, core outcome sets may support a youth-centered measurement strategy to capture outcomes in a systematic way that prioritizes equity, diversity, inclusion, and robust measurement science. Finally, this study suggests that future practice and policy research are needed to ensure the risk of mHealth is minimized and that this innovative health care service is meeting the emerging needs of youths over time.