JMIR Publications

ABSTRACT

Background:

Psychosocial problems such as depression, anxiety, and substance abuse are common and burdensome in young people. In New Zealand, “screening” for such problems is undertaken routinely only with Year 9 students in low-decile schools and opportunistically in pediatric settings using a non-validated and time-consuming clinician-administered Home, Education/employment, Eating, Activity, Drugs, Sexuality, Suicide/depression, Safety (HEEADSSS) interview. The Youth version, Case-finding and Help Assessment Tool (YouthCHAT) is a relatively new, locally developed, eTablet-based composite screener for identifying similar psychosocial issues to HEEADSSS. Based on individually validated screening instruments, it is self-administered within minutes.

Objective:

To compare the performance and acceptability of YouthCHAT, an electronic psychosocial screen, with face-to-face HEEADSSS assessment among 13-year old high-school students.

Methods:

A counter-balanced randomised trial of YouthCHAT either before or after face-to-face HEEADSSS assessment was undertaken with 129 New Zealand 13-year old high school students of predominantly Maori and Pacific Island ethnicity. Main outcome measures included comparability of YouthCHAT and HEEADSSS time to complete, detection rates and acceptability to students and clinic nurses.

Results:

On average, YouthCHAT assessments were more than twice as fast as HEEADSSS assessments (median 7.1 versus 17 minutes; t(92)=-7.197, p<0.001), and YouthCHAT detected more issues overall; however, not all domains of assessment were comparable. For substance misuse and problems at home, the two assessments were roughly comparable, and YouthCHAT detected significantly more issues around problems with eating or body image perception, sexual health, safety, and physical inactivity. In terms of mental health, HEEADSSS had a greater detection rate; however, its inclusion criteria was much broader than that of YouthCHAT, which only assessed depression and anxiety. The order of assessment made no difference to the duration of either assessment, or rates of positive screens for anxiety and depression in YouthCHAT.

Conclusions:

This study provides preliminary evidence regarding the administration time, detection rates and acceptability of YouthCHAT as a school-based psychosocial screener for young people. Although further research is needed to confirm its effectiveness in other age and ethnic groups, YouthCHAT shows great promise for aiding earlier identification and treatment of common psychosocial problems in young people with possible utility as an annual ‘health check’. Clinical Trial: This study was registered with the Australian New Zealand Clinical Trials Network Registry ACTRN12616001243404p. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371422 (Archived by WebCite at http://www.webcitation.org/ 6rmlEiM1L)