Gonsalves Pattie P, Hodgson Eleanor S, Kumar Avinash, Aurora Tiara, Chandak Yash, Sharma Rhea, Michelson Daniel, Patel Vikram
Sangath, New Delhi, India.
Quicksand Design Studio, New Delhi, India.
Front Public Health. 2019 Aug 23;7:238. doi: 10.3389/fpubh.2019.00238. eCollection 2019.
Digital technology platforms offer unparalleled opportunities to reach vulnerable adolescents at scale and overcome many barriers that exist around conventional service provision. This paper describes the design and development of , a blended problem-solving game-based intervention for adolescents with or at risk of anxiety, depression and conduct difficulties in India. This intervention was developed as part of the PRemIum for ADolEscents (PRIDE) research programme, which aims to establish a suite of transdiagnostic psychological interventions organized around a stepped care system in Indian secondary schools. Intervention development followed a person-centered approach consisting of four iterative activities: (i) review of recent context-specific evidence on mental health needs and preferences for the target population of school-going Indian adolescents, including a multiple stakeholder analysis of school counseling priorities and pilot studies of a brief problem-solving intervention; (ii) new focus group discussions with = 46 student participants and = 8 service providers; (iii) co-design workshops with = 22 student participants and = 8 service providers; and (iv) user-testing with = 50 student participants. Participants were aged 12-17 years and recruited from local schools in New Delhi and Goa, including a subgroup with self-identified mental health needs ( = 6). Formative data from existing primary sources, new focus groups and co-design workshops supported a blended format for delivering a brief problem-solving intervention, with counselors supporting use of a game-based app on "offline" smartphones. User-testing with prototypes identified a need for simplification of language, use of concrete examples of concepts and practice elements to enhance engagement. There were also indications that participants most valued relatability and interactivity within real-world stories with judicious support from an in-app guide. The final prototype comprised a set of interactive and gamified vignettes and a structured set of problem-solving questions to consolidate and generalize learning while encouraging real-world application. Findings shaped the design of and its delivery as an open-access blended intervention for secondary school students with a felt need for psychological support, consistent with an early intervention paradigm. A randomized controlled trial is planned to evaluate processes and impacts of when delivered for help-seeking students in low-resource school settings.
数字技术平台提供了前所未有的机会，可以大规模地接触弱势青少年，并克服传统服务提供过程中存在的许多障碍。本文描述了一款针对印度焦虑、抑郁和行为困难的青少年或有此类风险的青少年的、基于问题解决游戏的混合式干预措施的设计与开发。该干预措施是作为青少年优质项目（PRIDE）研究计划的一部分而开发的，该计划旨在围绕印度中学的阶梯式护理系统建立一套跨诊断心理干预措施。干预措施的开发遵循以人为主的方法，包括四项迭代活动：（i）回顾近期关于印度在校青少年目标人群心理健康需求和偏好的特定背景证据，包括对学校咨询优先事项的多利益相关方分析以及简短问题解决干预措施的试点研究；（ii）与46名学生参与者和8名服务提供者进行新的焦点小组讨论；（iii）与22名学生参与者和8名服务提供者共同设计工作坊；以及（iv）对50名学生参与者进行用户测试。参与者年龄在12至17岁之间，从新德里和果阿的当地学校招募，包括一个自我认定有心理健康需求的亚组（6人）。来自现有主要来源、新焦点小组和共同设计工作坊的形成性数据支持了一种混合形式，用于提供简短的问题解决干预措施，由辅导员在“离线”智能手机上支持使用基于游戏的应用程序。对原型进行的用户测试表明，需要简化语言，使用概念和实践元素的具体示例以提高参与度。还有迹象表明，参与者最看重真实世界故事中的相关性和互动性，并在应用内指南的明智支持下进行。最终原型包括一组交互式和游戏化的小插曲以及一组结构化的问题解决问题，以巩固和概括学习内容，同时鼓励在现实世界中的应用。研究结果塑造了该干预措施的设计及其作为一种开放获取的混合式干预措施的实施方式，面向那些感觉需要心理支持的中学生，这与早期干预范式一致。计划进行一项随机对照试验，以评估该干预措施在资源匮乏的学校环境中为寻求帮助的学生提供服务时的过程和影响。
