Knapp Ashley A, Hersch Emily, Wijaya Clarisa, Herrera Miguel A, Kruzan Kaylee P, Carroll Allison J, Lee Sydney, Baker Alex, Gray Alanna, Harris Vann, Simmons Robert, Kour Sodhi Deepika, Hannah Nanette, Reddy Madhu, Karnik Niranjan S, Smith Justin D, Brown C Hendricks, Mohr David C
Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Department of Psychology, University of Massachusetts Boston, Boston, MA, United States.
Front Digit Health. 2023 Jul 25;5:1183319. doi: 10.3389/fdgth.2023.1183319. eCollection 2023.
Adolescence is a vulnerable developmental period, characterized by high rates of mental health concerns, yet few adolescents receive treatment. Public libraries support adolescents by providing them with access to teen programming, technological resources, and have recently been providing mental health services. Digital mental health (DMH) services may help libraries provide scalable mental health solutions for their adolescent patrons and could be well positioned to address the mental health needs of historically underrepresented racial and ethnic (HURE) adolescents; however, little research has been conducted on the compatibility of DMH services with adolescent patron mental health needs or resource needs of library workers supporting them.
The research team formed a partnership with a public library, which serves a large HURE adolescent population. We conducted needs assessment and implementation readiness interviews with 17 library workers, including leadership, librarians, and workers with specialized areas of practice. Interview questions focused on library infrastructure, as well as library needs and preferences around the design and implementation of DMH services for adolescents. We used the Consolidated Framework for Implementation Research as guiding implementation determinant framework to code and analyze the interview transcripts.
Our findings revealed library workers play an important role in guiding patrons to desired resources and share a goal of implementing adolescent DMH resources into the library and elevating marginalized adolescents' voices. Existing library resources, such as the library's role as a safe space for adolescents in the community, close relationships with external and community organizations, and availability of no-cost technological resources, could help facilitate the implementation of DMH services. Barriers related to community buy-in, mental health stigma, and library worker confidence in supporting adolescent mental health could affect service implementation.
Our findings suggest public libraries are highly promising settings to deploy DMH services for adolescents. We identified important determinants that may impact the implementation of DMH services in public library settings. Special considerations are needed to design services to meet the mental health needs of HURE adolescent populations and those adolescents' most experiencing health inequities.
青春期是一个易受影响的发育阶段，心理健康问题发生率很高，但很少有青少年接受治疗。公共图书馆通过为青少年提供青少年节目、技术资源来支持他们，并且最近一直在提供心理健康服务。数字心理健康（DMH）服务可能有助于图书馆为其青少年读者提供可扩展的心理健康解决方案，并且可能处于有利地位来满足历史上代表性不足的种族和族裔（HURE）青少年的心理健康需求；然而，关于DMH服务与青少年读者心理健康需求或支持他们的图书馆工作人员资源需求的兼容性，几乎没有进行过研究。
研究团队与一家为大量HURE青少年群体服务的公共图书馆建立了合作关系。我们对17名图书馆工作人员进行了需求评估和实施准备情况访谈，包括领导层、图书馆员以及具有专业实践领域的工作人员。访谈问题集中在图书馆基础设施，以及图书馆在为青少年设计和实施DMH服务方面的需求和偏好。我们使用实施研究综合框架作为指导实施决定因素框架，对访谈记录进行编码和分析。
我们的研究结果表明，图书馆工作人员在引导读者获取所需资源方面发挥着重要作用，并共同致力于将青少年DMH资源引入图书馆并提升边缘化青少年的声音。现有的图书馆资源，例如图书馆作为社区中青少年安全空间的角色、与外部和社区组织的密切关系以及免费技术资源的可用性，有助于促进DMH服务的实施。与社区认同、心理健康污名以及图书馆工作人员支持青少年心理健康的信心相关的障碍可能会影响服务的实施。
我们的研究结果表明，公共图书馆是为青少年部署DMH服务的极具前景的场所。我们确定了可能影响公共图书馆环境中DMH服务实施的重要决定因素。需要特别考虑设计服务，以满足HURE青少年群体以及那些最易遭受健康不平等的青少年的心理健康需求。
