Jenkins Emily, Haines-Saah Rebecca, McGuinness Liza, Hirani Saima, Boakye-Yiadom Noah, Halsall Tanya, Rivers Robert, Morris Jonathan
School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5 Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4N1 Canada.
Int J Ment Health Syst. 2020 Jul 31;14:58. doi: 10.1186/s13033-020-00390-7. eCollection 2020.
Mental health challenges are a leading health concern for youth globally, requiring a comprehensive approach incorporating promotion, prevention and treatment within a healthy public policy framework. However, the broad enactment of this vision has yet to be realized. Further, mental health evidence specific to youth is still emerging and has not yet focused at a policy level. This is a critical gap, as policy is a key mental health promotion lever that can alter the social and structural conditions that contribute to shaping youth mental health outcomes for youth, across the full spectrum of need. Responsive to this research and intervention priority, our prototype study intervention-the Agenda Gap-is comprised of an innovative, multi-media engagement intervention, developed in collaboration with youth. This intervention aims to equip youth and build capacity for them to lead meaningful policy change reflective of the mental health needs of diverse communities of youth, including those who experience structural vulnerability and who would not typically have had their voice represented in policymaking processes.
This study will use a multiple case study design and mixed methods grounded in a realist approach and will be conducted in three sites across two Canadian provinces (British Columbia and Alberta). In an earlier phase of this research, we collaboratively designed the prototype intervention with youth, community and policy partners. In this phase of the study, the intervention will be implemented and further tested with new groups of youth collaborators (n = 10-15/site). Outcome data will be collected through realist qualitative interviews, validated questionnaires [i.e., Child and Youth Resilience Measure (CYRM-12), General Self-Efficacy (GSE) Scale, and the Critical Consiousness Scale (CCS)] and additional survey items developed by our study team. Analysis will focus on identification of key context-mechanism-outcome configurations to provide comprehensive insights into how this intervention works, for whom, and in what context.
This study is unique in its "upstream" focus on youth-engaged policymaking as a tool for improving the social and structural conditions that influence youth mental health across socioecological levels. Through the implementation and testing of the Agenda Gap intervention with diverse youth, this study will contribute to the evidence base on youth-engaged policymaking as a novel and innovative, mental health promotion strategy.
心理健康挑战是全球青少年面临的主要健康问题，需要在健康的公共政策框架内采取综合方法，包括促进、预防和治疗。然而，这一愿景的广泛实施尚未实现。此外，针对青少年的心理健康证据仍在不断涌现，尚未聚焦于政策层面。这是一个关键差距，因为政策是促进心理健康的关键杠杆，能够改变有助于塑造青少年心理健康结果的社会和结构条件，涵盖所有需求领域。为响应这一研究和干预重点，我们的原型研究干预措施——议程差距，由与青少年合作开发的创新多媒体参与式干预组成。该干预旨在使青少年具备能力并增强其能力，引领反映不同青少年群体心理健康需求的有意义的政策变革，包括那些经历结构性脆弱性且通常在决策过程中没有发言权的群体。
本研究将采用多案例研究设计，并基于现实主义方法运用混合方法，在加拿大两个省份（不列颠哥伦比亚省和艾伯塔省）的三个地点进行。在本研究的早期阶段，我们与青少年、社区和政策伙伴共同设计了原型干预措施。在研究的这个阶段，将对新的青少年合作群体（每个地点n = 10 - 15）实施该干预并进行进一步测试。结果数据将通过现实主义定性访谈、经过验证的问卷[即儿童和青少年复原力量表（CYRM - 12）、一般自我效能感量表（GSE）以及批判性意识量表（CCS）]以及我们研究团队开发的其他调查项目收集。分析将聚焦于识别关键的背景 - 机制 - 结果配置，以全面深入了解该干预如何发挥作用、对谁起作用以及在何种背景下起作用。
本研究的独特之处在于其“上游”重点，即把青少年参与政策制定作为一种工具，以改善影响社会生态层面青少年心理健康的社会和结构条件。通过对不同青少年群体实施和测试议程差距干预措施，本研究将为青少年参与政策制定作为一种新颖且创新的心理健康促进策略提供证据基础。
