Why Parents Do Not Use Digital Health Interventions for Their Child's Mental Health?

There are free, evidence-based Digital Health Interventions (DHIs) that can help children's mental health, but few parents use them. We sought to understand what influenced uptake of DHIs by parents of children aged 2-12 years old with a mental health problem. We interviewed parents and analysed data using inductive content analysis. Four factors emerged: i) personal capacity; ii) awareness of DHIs and where to find one; iii) credibility, including trust and endorsement from experts; and iv) the suitability of a DHI to their child's specific problem and level of need. Incorporating these themes into the design of future DHIs may improve uptake.

A co-designed website (FindWays) to improve mental health literacy of parents of children with mental health problems: Protocol for a pilot randomised controlled trial.

BACKGROUND: Mental health problems, such as behavioural and emotional problems, are prevalent in children. These problems can have long lasting, detrimental effects on the child, their parents and society. Most children with a mental health problem do not receive professional help. Those that do get help can face long wait times. While waiting, parents want to learn how they can help their child. To address this need, we co-designed a new website to help parents find ways of helping their child's mental health problem while waiting to get specialist help. OBJECTIVES: To assess the acceptability and feasibility of a new co-designed website, FindWays, through a pilot randomised controlled trial. The protocol is registered with ISRCTN (ISRCTN64605513). METHODS: This study will recruit up to 60 parents of children aged two-twelve years old referred to a paediatrician for behavioural and/or emotional problems. Participants will be randomly allocated by computer generated number sequence to either the intervention or control group. Intervention group participants will receive access to the FindWays website to help them manage their child's mental health problem while they wait to see the paediatrician. Acceptability and feasibility will be assessed over the 4-month intervention through mixed methods including: recruitment, adherence, retention, net promoter score (quantitative measures) and semi-structured interviews to gain an in-depth understanding of parents' experience and potential adverse effects (qualitative measure). Secondary outcomes measured by parent survey at 4-months post randomisation include child mental health, parent mental health, impact of the child's mental health problem on their functioning and family, and health service use and associated costs. RESULTS: Recruitment commenced June 2022 with publication expected in October 2023. CONCLUSION: This study will provide novel data on the acceptability and feasibility of a new website co-designed with parents to help them find ways of managing their child's behaviour and emotions.

The Effect of Digital Health Interventions on Parents' Mental Health Literacy and Help Seeking for Their Child's Mental Health Problem: Systematic Review.

BACKGROUND: Many children with mental health problems do not receive professional help. Despite the frequent use of digital health interventions (DHIs) such as websites or web-based service navigation platforms, their effects on parents' mental health literacy, help seeking, or uptake of professional services are unclear. OBJECTIVE: This study aims to provide a systematic review and narrative synthesis to describe whether DHIs improve the aforementioned parental outcomes. METHODS: Databases, including CINAHL, Embase, MEDLINE OVID, PsycINFO, and PubMed (2000-2020), were accessed. Studies were included if they evaluated quantitative changes in mental health literacy, help seeking, or the uptake of services by parents of children with mental health problems. Theoretical frameworks, sample sizes, participant demographics, recruitment, interventions, DHI use, results, and health economic measures were used for data extraction. RESULTS: Of the 11,379 search results, 5 (0.04%) studies met the inclusion criteria. One randomized controlled trial found the reduced uptake of services after using a DHI coupled with a telephone coach for a child's behavioral problem. Of 3 studies, 2 (66.7%) found statistically significant improvement in mental health literacy for attention-deficit/hyperactivity disorder but had no control group. One study found nonsignificant improvement in mental health literacy and help-seeking attitudes toward anxiety and depression compared with those in active controls. All studies were rated as having a high or serious risk of bias. Search results were affected because of a single reviewer screening articles, overall low-quality studies, and a lack of consistent nomenclature. CONCLUSIONS: There is no high-quality evidence that DHIs can improve parents' mental health literacy, help seeking, or uptake of services. More research is needed to evaluate DHIs by using rigorous study designs and consistent measures. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020130074; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020130074.

Patients presenting for hospital-based screening for the coronavirus disease 2019: Risk of disease, and healthcare access preferences.

OBJECTIVE: Early during the coronavirus disease 2019 (COVID-19) pandemic, Australian EDs experienced an unprecedented surge in patients seeking screening. Understanding what proportion of these patients require testing and who can be safely screened in community-based models of care is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns. METHODS: In this cross-sectional survey, we screened patients presenting to a COVID-19 screening clinic in a tertiary ED. We assessed the proportion of patients who met testing criteria; self-reported symptom severity; reasons why they came to the ED for screening and views on community-based care. RESULTS: We include findings from 1846 patients. Most patients (55.3%) did not meet contemporaneous criteria for testing and most (57.6%) had mild or no (13.4%) symptoms. The main reason for coming to the ED was being referred by a telephone health service (31.3%) and 136 (7.4%) said they tried to contact their general practitioner but could not get an appointment. Only 47 (2.6%) said they thought the disease was too specialised for their general practitioner to manage. CONCLUSIONS: While capacity building in acute care facilities is an important part of pandemic planning, it is also important that patients not needing hospital level of care can be assessed and treated elsewhere. We have identified a significant proportion of people at this early stage in the pandemic who have sought healthcare at hospital but who might have been assisted in the community had services been available and public health messaging structured to guide them there.

Do Digital Health Interventions Improve Mental Health Literacy or Help-seeking Among Parents of Children Aged 2-12 Years? A Scoping Review.

BACKGROUND: Digital Health Interventions (DHIs) can improve mental health literacy (MHL) and help-seeking behaviour in teens and adults. However, it is unclear whether DHIs improve parental MHL, help-seeking behaviour or access to mental health services for their children. OBJECTIVE: To perform a scoping review of DHIs aiming to improve MHL, help-seeking behaviour or access to mental health services among parents of 2-12-year-olds with behavioural and emotional problems (BEP). METHOD: A search of Ovid MEDLINE found four original articles meeting inclusion criteria. RESULTS: One of the four articles was a randomised controlled trial, which showed a significant improvement in some measures of MHL, but no change in help-seeking attitudes. The other three studies evaluated interventions, in uncontrolled pre-test and post-test evaluations, on attention-deficit/hyperactivity disorder knowledge. Two of these studies showed a significant change in ADHD knowledge. There was no consistency in MHL measures between studies. CONCLUSIONS: There is preliminary evidence that DHIs may improve MHL in parents of children with BEP. How this translates to help seeking, access to mental health services or improved outcomes is unknown.