Development of the Strengths, Skills, and Goals Matrix: a tool for facilitating strengths-based adolescent and young adult engagement in research.

BACKGROUND: The involvement of adolescents and young adults (AYAs) with lived experience of health and mental health conditions as partners in research is increasing given the prominence of participatory approaches to research, including patient-oriented research (POR). Much of the relevant research is conducted by graduate students. While guiding AYA engagement frameworks and models exist, the processes of partnering with AYAs in patient-oriented graduate-level research projects have not been well established. Co-developed tools and practices are required to support strengths-based, developmentally appropriate AYA-graduate student partnerships. OBJECTIVES: The objectives of this commentary are: (1) to share the processes of partnership between a graduate student and five Young Adult Research Partners (YARP), (2) to describe the co-design and implementation of the Strengths, Skills, and Goals Matrix (SSGM), a tool for facilitating strengths-based AYA engagement in research, and (3) to outline considerations for applying this tool across a variety of research contexts with patient partners. MAIN BODY: Within the YARP-graduate student partnership, the SSGM offered extensive benefits, including tangible skill development, peer mentorship, and rapport building among all members. This tool offers strategies for strengths-based engagement practices which emphasize AYAs' preferences and goals throughout POR projects. Practical recommendations and considerations for applying the SSGM within graduate-level research and beyond are described, including the importance of connecting AYAs' current (and desired) skills to specific tasks within the research project and resulting outputs. CONCLUSIONS: The SSGM has possible relevance in a variety of settings given its broadly applicable structure. Future research could explore the adaptation, application, and evaluation of the SSGM across research contexts to determine its feasibility and ease of implementation. PATIENT OR PUBLIC CONTRIBUTION: This article was conceived of and co-authored by five young adult research partners. The YARP co-designed the SSGM presented in this article, the figures, and substantially contributed to the preparation of the article.

The involvement of adolescents and young adults (AYAs) with lived experience of health and mental health conditions as partners in research is becoming more common in student research projects. Though guidelines for engaging AYAs as partners in research exist, the steps for developing meaningful AYA-student partnerships are not clearly defined. These partnerships require tools and practices that are co-developed by AYAs and students to be successful. In this commentary, we share the details of a partnership between a graduate student and five AYA research partners. Next, we describe how we developed the Strengths, Skills, and Goals Matrix (SSGM), a tool for supporting AYA engagement in research which emphasizes the capabilities and goals of each AYA partner. Finally, we outline suggestions for patient partners and research teams interested in using this tool in different settings. Within our research partnership, the SSGM helped all members build relationships, develop skills, and share their skills with one another. The SSGM focuses on the strengths of each person and allows patient partners to determine their own goals for engaging in research. Future research should explore how the SSGM works for different types of research teams or projects.

Transition readiness of youth with co-occurring chronic health and mental health conditions: A mixed methods study.

BACKGROUND: A large proportion of youth with chronic conditions have mental health comorbidities. However, the effect of these comorbidities on paediatric-adult transition readiness, and the relevance of widely used tools for measuring transition readiness, are unknown. OBJECTIVE: The objectives of this study were to describe and explore the transition readiness of youth with co-occurring chronic health and mental health conditions using a combination of quantitative data obtained from participants completing the Transition Readiness Assessment Questionnaire (TRAQ) and qualitative data. DESIGN AND PARTICIPANTS: A three-phase sequential explanatory mixed methods design was employed, with the qualitative strand taking priority. First, the TRAQ scores (range 1-5) of youth with co-occurring conditions (n = 61) enroled in a multisite randomized controlled trial were measured, followed by qualitative interviews with a sample of youth (n = 9) to explain the quantitative results. Results from both strands were then integrated, yielding comprehensive insights. RESULTS: Median TRAQ scores ranged from 2.86 on the appointment keeping subscale to 5.00 on the talking with providers subscale. The qualitative results uncovered the complexities faced by this group concerning the impact of a mental health comorbidity on transition readiness and self-management skills across TRAQ domains. The integrated findings identified a diverse and highly individualized set of strengths and challenges amongst this group that did not align with overarching patterns as measured by the TRAQ. CONCLUSIONS: This mixed methods study generated novel understandings about how youth with co-occurring conditions develop competencies related to self-care, self-advocacy and self-management in preparation for paediatric-adult service transitions. Results demonstrated the assessment of transition readiness using a generic scale does not address the nuanced and complex needs of youth with co-occurring chronic health and mental health conditions. Our findings suggest tailoring transition readiness practices for this group based on youths' own goals, symptoms, coping mechanisms and resources. PATIENT OR PUBLIC INVOLVEMENT: This study was conducted in collaboration with five young adult research partners (YARP) with lived experience transitioning from paediatric to adult health/mental health services. The YARP's contributions across study phases ensured the perspectives of young people were centred throughout data collection, analysis, interpretation and presentation of findings. All five YARP co-authored this manuscript.

"They go hand in hand": a patient-oriented, qualitative descriptive study on the interconnectedness between chronic health and mental health conditions in transition-age youth.

BACKGROUND: Transition-age youth (TAY) with chronic health conditions frequently experience co-occurring mental health conditions. However, little is known about the perspectives of TAY with co-occurring diagnoses preparing to exit pediatric health and mental health services. Research is needed to understand the impact of a mental health condition on transition readiness and self-management in TAY with chronic health conditions. METHODS: TAY (aged 16-20 years) with co-occurring chronic health and mental health conditions were recruited in Alberta, Canada. Nine semi-structured individual interviews were completed by phone or videoconference, and transcribed verbatim. Guided by qualitative description, we analyzed the data using thematic analysis in partnership with five young adults with lived experience in the health/mental health systems. RESULTS: Participants shared their experiences living with simultaneous physical and mental health concerns and preparing for transition to adult care. Our analysis revealed three overarching themes: 1) "they're intertwined": connections between chronic health and mental health conditions in TAY, 2) impact of mental health on transition readiness and self-management, and 3) recommendations for service provision from the perspectives of TAY. CONCLUSIONS: Our findings highlighted the myriad ways in which physical and mental health are connected as TAY prepare for service transitions using specific examples and powerful metaphors. TAY endorsed the importance of providers discussing these connections in routine clinical care. Future research should involve co-designing and evaluating educational material addressing this topic with diverse TAY, caregivers, and service providers.

Recommendations for youth engagement in Canadian mental health research in the context of COVID-19.

The COVID-19 pandemic has resulted in reduced access to in-person mental health services, and a shift to virtual platforms. Youth may be uniquely impacted by physical distancing requirements during the pandemic, including limited socialization opportunities, closures of educational institutions, a lack of meaningful extracurricular activities and adverse implications on key developmental milestones. Due to the potential impact of COVID-19 on youth well-being, the need to rapidly transform services to be accessible, and the potential risks associated with this rapid transformation, it is imperative that youth continue to be engaged in research and service development. Young people's perspectives, strengths and skills need to be considered to effectively adapt the delivery of mental health services. Continuing to center youth engagement in mental health research throughout the pandemic can ensure research questions, programs, and services align with the needs and preferences of youth. In this commentary, we pose three recommendations for conducting youth-engaged mental health research during the pandemic, including adapting youth engagement strategies when rapid decisions must be made, the use of tools for virtual engagement, and suggestions for evaluating youth engagement practices. These strategies and principles may be applicable to other scenarios where rapid research or system transformation would benefit from youth engagement, such as time-limited child research by trainees (e.g., dissertations) or natural disasters.

La pandémie de la COVID-19 a entraîné un accès réduit aux services de santé mentale en personne, et une transition aux plateformes virtuelles. Les jeunes peuvent être particulièrement touchés par les consignes de distanciation physique durant la pandémie, notamment par les occasions limitées de socialisation, la fermeture des institutions éducatives, le manque d'activités parascolaires et les implications néfastes sur les principales étapes du développement. Étant donné l'impact potentiel de la COVID-19 sur le bien-être des jeunes, le besoin de transformer rapidement les services pour les rendre accessibles, et les risques potentiels associés à cette transformation rapide, il est impératif que les jeunes continuent de participer à la recherche et au développement des services. Les perspectives, les forces et les talents des jeunes gens doivent être pris en considération afin d'adapter efficacement la prestation des services de santé mentale. Continuer d'axer la participation des jeunes dans la recherche en santé mentale durant la pandémie peut faire en sorte que les questions, les programmes et les services de la recherche correspondent aux besoins et aux préférences des jeunes. Dans le présent commentaire, nous énonçons trois recommandations pour mener une recherche en santé mentale avec la participation des jeunes durant la pandémie, notamment adapter les stratégies de participation des jeunes lorsqu'il faut prendre des décisions rapidement, l'utilisation des outils de participation virtuelle, et des suggestions pour évaluer les pratiques de participation des jeunes. Ces stratégies et principes peuvent s'appliquer à d'autres scénarios quand la recherche rapide ou la transformation du système bénéficierait de la participation des jeunes, comme la recherche sur les enfants en temps limité par les stagiaires (p. ex., dissertation) ou des catastrophes naturelles.