Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium.
University Psychiatric Center (UPC) KU Leuven, Leuven, Belgium.
Health Expect. 2023 Dec;26(6):2532-2548. doi: 10.1111/hex.13832. Epub 2023 Aug 22.
Although youth-friendly service characteristics have been previously identified, consensus among a representative group of stakeholders about which of these characteristics are truly relevant to the youth-friendliness of services is currently lacking. In our study, young adults, parents and professionals were consulted on this topic to reveal existing (dis)agreement. In addition, (dis)agreement on feasibility for implementation in clinical practice was also assessed.
A mixed-method Delphi approach was used with three online questionnaire rounds and a physical meeting. Young adults (18-26 years) and parents were part of a public panel and professionals were allocated to the professional panel. In the rounds, participants were asked to rate the importance and feasibility of each item. Subsequently, the percentage agreement (% of participants giving a score of 7 or above on a 9-point Likert scale) within and across panels was calculated. Consensus was assumed to have been reached when at least 70% agreement was achieved. A thematic analysis of the qualitative data, obtained in the rounds and the physical meeting, was performed to identify overarching themes and characteristics of relevance to the youth-friendliness of services.
For 65% of the items included in the Delphi questionnaire, consensus on importance was reached within both panels. Participants showed more insecurity about the feasibility of these items, however. Our thematic analysis revealed reasons for disagreement between and within the panels.
Our study revealed substantial between- and within-panel agreement on youth-friendly service characteristics. We recommend that the items for which consensus was reached should be used as a checklist in terms of youth mental health service development, design and delivery. The characteristics for which there was disagreement between and within the panels should inspire an ongoing trialogue between young adults, parents and professionals both on the individual level and the service level.
In this study, (parents of) young adults with lived experience were included as experts, including one of the coauthors. This coauthor contributed to the manuscript by having a final say about the included quotes.
尽管之前已经确定了青年友好服务的特征,但目前缺乏代表利益相关者群体的共识,即这些特征中哪些真正与服务的青年友好性相关。在我们的研究中,青年、家长和专业人士就这一主题进行了咨询,以揭示现有的(不)一致意见。此外,还评估了在临床实践中实施的(不)可行性。
采用混合方法 Delphi 法,进行了三轮在线问卷调查和一次现场会议。18-26 岁的年轻人和家长是公众小组的一部分,专业人士被分配到专业小组。在轮次中,参与者被要求对每个项目的重要性和可行性进行评分。随后,计算了组内和组间的百分比协议(在 9 分 Likert 量表上得分为 7 或以上的参与者比例)。当达到至少 70%的协议时,即达成共识。对轮次和现场会议中获得的定性数据进行了主题分析,以确定与服务的青年友好性相关的总体主题和特征。
德尔菲问卷中包含的 65%的项目在两个小组内都达成了重要性的共识。然而,参与者对这些项目的可行性表示更为不确定。我们的主题分析揭示了小组之间和小组内部存在分歧的原因。
我们的研究表明,青年友好服务特征在小组之间和小组内部都存在很大的一致性。我们建议,对于达成共识的项目,应将其作为青年心理健康服务发展、设计和提供的检查表。在小组之间和小组内部存在分歧的特征应激发青年、家长和专业人士之间持续的三方对话,既在个人层面,也在服务层面。
在这项研究中,有生活经验的(家长的)年轻人作为专家被纳入其中,其中一位合著者也是如此。这位合著者对纳入的引语有最终决定权,并为手稿做出了贡献。