School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom.
School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom; NHS Lothian, Edinburgh, United Kingdom.
Child Abuse Negl. 2024 Aug;154:106883. doi: 10.1016/j.chiabu.2024.106883. Epub 2024 Jun 12.
BACKGROUND: The internet has become a place of increased risk of abuse, including sexual abuse, for young people (YP). One potential risk factor to online abuse and exploitation is the ability to mentalise. We developed the i-Minds app, a mentalisation-based digital health intervention (DHI) for YP who have experienced technology assisted sexual abuse (TASA), which we tested in a clinical feasibility trial. Nested within the trial was a qualitative implementation study with clinicians who referred to the trial. OBJECTIVE: To explore the barriers and enablers to the future integration of i-Minds into clinical practice. PARTICIPANTS AND SETTING: Twelve HCPs were recruited from across two trial recruitment sites (Manchester and Edinburgh). METHODS: Semi-structured interviews were informed by Normalisation Process Theory (NPT). Framework analysis was used; transcripts were coded deductively to NPT constructs. RESULTS: Practitioners were positive about the need for, and added value of, the i-Minds app over existing interventions, including other DHIs. While they felt confident with the app, concerns remained around the safety of using the app without practitioner support. i-Minds promoted changes in practitioners' work and impacted online behaviour of YP. There was an identified need for further training and organisational support. CONCLUSIONS: Practitioners are aware of TASA but have limited knowledge, skills and tools to work with TASA in clinical practice with YP. There is a need for awareness raising and education about TASA and DHI. i-Minds offers a theory-informed DHI for working with YP exposed to TASA that is acceptable to practitioners and YP.
背景:互联网已经成为年轻人(YP)遭受虐待的高风险场所,包括性虐待。易受网络虐待和剥削的一个潜在风险因素是心理化能力。我们开发了 i-Minds 应用程序,这是一种针对经历过技术辅助性虐待(TASA)的 YP 的基于心理化的数字健康干预(DHI),我们在一项临床可行性试验中对其进行了测试。该试验嵌套了一项与转诊到试验的临床医生进行的定性实施研究。
目的:探讨未来将 i-Minds 整合到临床实践中的障碍和促进因素。
参与者和设置:从两个试验招募地点(曼彻斯特和爱丁堡)招募了 12 名 HCP。
方法:半结构化访谈受正常化进程理论(NPT)的启发。使用框架分析;根据 NPT 结构对转录本进行了演绎编码。
结果:从业者对 i-Minds 应用程序的需求和附加值持积极态度,包括其他 DHI 在内。虽然他们对该应用程序有信心,但仍担心在没有从业者支持的情况下使用该应用程序的安全性。i-Minds 促进了从业者工作的变化,并影响了 YP 的在线行为。需要进一步的培训和组织支持。
结论:从业者意识到 TASA 的存在,但在临床实践中处理 YP 遭受的 TASA 时,他们的知识、技能和工具有限。需要提高对 TASA 和 DHI 的认识和教育。i-Minds 为处理接触过 TASA 的 YP 提供了一种基于理论的 DHI,它受到从业者和 YP 的认可。
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