Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 31, 2023
Open Peer Review Period: Aug 31, 2023 - Sep 11, 2023
Date Accepted: Sep 19, 2023
(closed for review but you can still tweet)
Investigating the feasibility, acceptability, and appropriation of a socially assistive robot among minority youth at-risk of self-harm: pilot studies
ABSTRACT
Background:
Minority youth are at increased risk of experiencing self-harmful thoughts and behaviours. However, there is limited evidence of successful interventions to support young people in the moment of their distress. Digital interventions are considered a potential solution to provide in-the-moment support for those at-risk of adverse mental health and self-harm.
Objective:
The aim of these pilot studies is to investigate the feasibility and acceptability of a new, in-situ intervention tool, Purrble, among two broad groups of minority youth; i) LGBTQ+ and ii) racial and ethnic minorities. Purrble was designed to support in-situ emotion regulation support when individuals are facing emotionally challenging situations.
Methods:
This study consists of two mixed-method pilot trials. The pilots follow the same mixed-method design, including 3-weeks of daily and weekly surveys, as well as optional follow-up interviews. Participants were recruited who were i) aged between 16-25 years; ii) part of a minority group; iii) had experiences of self-harmful thoughts or behaviours, or elevated symptoms of depression or anxiety; and iv) living in the UK at the time of the study. The primary outcomes were i) the feasibility of Purrble as an intervention among pilot sample (analysed by consent rate, retention rate, adherence to surveys, and engagement with the device) and ii) acceptability and appropriation of Purrble across pilots as a tool to support emotion regulation in-situ (thematically analysed qualitative open-ended questions and interview data). Secondary outcomes were descriptive pilot data concerning mental health outcomes in each sample.
Results:
A total of 21 LGBTQ+ young people took part in pilot 1, with 86.4% completing baseline and 3-weeks of daily surveys. These young people maintained engagement with Purrble across deployment, across which period there was a decrease in self-harmful thoughts and anxiety symptoms. Nineteen ethnic and racial minority youth took part in pilot 2, of whom 84.2% completed the study. While pilot 2 participants also maintained engagement with Purrble across deployment, this was to a lesser degree than participants of pilot 1 and perceived mental health outcomes did not indicate potential change associated with the device. Thematic analysis indicated three superordinate themes; i) Stopping the self-harm cycle; ii) Adopting emotion regulation strategies; and iii) Stages of change.
Conclusions:
These were the first pilots of a novel intervention that aims to provide in-situ emotion regulation support for young people at-risk of self-harm. Both quantitative and qualitative findings suggest that Purrble is an acceptable and feasible intervention, particularly among LGBTQ+ youth. The intervention has been described as interrupting the cycle of self-harmful ideation and behaviour, by supporting emotion regulation practices.
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