JMIR Publications

ABSTRACT

Background:

Despite many factors which promote resilience, First Nations young people continue to face adversity and disadvantage. Differing worldviews regarding illness and treatment practices, language differences, culturally inappropriate service models, geographical remoteness and stigma can inhibit access to appropriate mental health support. Mental health treatments delivered digitally (dMH), offer flexible access to evidence-based, non-stigmatising, low-cost treatment and early intervention on a broad scale. There is rapidly growing utilisation and acceptance of these technologies among young First Nations people.

Objective:

The objective was to assess feasibility, acceptability, user engagement and safety of the newly developed AIMhi for Youth (AIMhi-Y) app, and to trial the study tools in preparation for future assessment of effectiveness.

Methods:

This was a non-randomised pre-post study, utilising mixed methods. First Nations young people aged 12-25 years who provided consent and possessed the ability to navigate a simple app with basic English literacy were included. Researchers conducted one face-to-face 20-minute session with participants to introduce and orientate participants to the AIMhi-Y app. The app integrates culturally adapted low intensity cognitive behavioural therapy (CBT), psychoeducation and mindfulness-based activities. Participants received supportive text messages weekly throughout the 4-week intervention period and completed assessments of psychological distress, depression, anxiety, substance misuse, help-seeking, service use, and parent-rated strengths and difficulties at baseline and 4 weeks. Qualitative interviews and rating scales were completed after 4 weeks to gain feedback on subjective experience, look and style, content, overall rating, check-ins, and involvement in the study. App usage data were collected.

Results:

Thirty young people (17 Male; 13 Female) aged between 12-18 years (M = 14.0; SD =1.55) were assessed twice over 4 weeks. Repeated measures t-tests showed improvements in wellbeing measures which were statistically and clinically significant for psychological distress (K10) and depressive symptoms (PHQ-2). Participants spent on average 37 minutes in the app. The app was rated positively with mean ratings of 4 out of 5 points. Participants reported that they found the app easy to use, culturally relevant, and useful.

Conclusions:

This study supports earlier research suggesting that dMH apps that are appropriately designed with and for the target populations are a feasible and acceptable means of lowering symptoms for mental health disorders among First Nations youth.