Gellatly Resham, Boustani Maya, Nair Pooja, Mahajan Rujuta, Jambhale Abhijeet, Sahu Rooplata, Chodankar Bindiya, Krishna Madhuri, Malik Kanika, Mathur Sonal, Becker Kimberly, Michelson Daniel, Patel Vikram, Chorpita Bruce
Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA.
Loma Linda University, Loma Linda, CA USA.
Discov Psychol. 2024;4(1):43. doi: 10.1007/s44202-024-00154-1. Epub 2024 Apr 17.
Given the relationship between poor engagement and worse treatment outcomes, improving engagement has been the focus of attention in recent years. Engagement is a particular challenge among minoritized and otherwise challenged youth, such as those from socioeconomically disadvantaged groups, including youth in low- and middle-income countries (LMICs), where they face lower levels of access to resources, including mental health treatment. The present study describes engagement challenges that arose in an uncontrolled pre-post evaluation of a school-based, modular, multi-problem, stepped-care intervention delivered in urban Indian communities. Specifically, the study aimed to (1) characterize barriers and facilitators of youth treatment engagement; and (2) evaluate treatment acceptability and fit of treatment from the youth perspective. Youth participants completed semi-structured interviews, which were transcribed and coded using thematic analysis. Participants described numerous facilitators to engagement (e.g., positive therapeutic relationship) and reported high overall satisfaction with the intervention, while also identifying barriers to engagement (e.g., concerns about confidentiality) and offering suggestions to increase fit and acceptability (e.g., more visually appealing treatment materials). Findings highlight ways in which engagement can be enhanced and implementation supports improved to maximize treatment effectiveness among minoritized and disadvantaged youth in LMICs.
The online version contains supplementary material available at 10.1007/s44202-024-00154-1.
鉴于参与度低与治疗效果较差之间的关系，近年来提高参与度一直是关注的焦点。在少数族裔及其他面临挑战的青少年中，参与度是一个特别的挑战，比如那些来自社会经济弱势群体的青少年，包括低收入和中等收入国家（LMICs）的青少年，他们获得资源（包括心理健康治疗）的机会较少。本研究描述了在印度城市社区开展的一项基于学校的、模块化的、多问题的、逐步护理干预措施的无对照前后评估中出现的参与度挑战。具体而言，该研究旨在：（1）描述青少年治疗参与度的障碍和促进因素；（2）从青少年的角度评估治疗的可接受性和适配性。青少年参与者完成了半结构化访谈，访谈内容经转录后使用主题分析法进行编码。参与者描述了许多参与度的促进因素（如积极的治疗关系），并报告对干预措施总体满意度较高，同时也指出了参与度的障碍（如对保密性的担忧），并提出了提高适配性和可接受性的建议（如更具视觉吸引力的治疗材料）。研究结果突出了在低收入和中等收入国家提高少数族裔和弱势青少年参与度以及改善实施支持以最大化治疗效果的方法。
在线版本包含可在10.1007/s44202-024-00154-1获取的补充材料。
