Stakeholder perspectives on a patient-centred intervention (DIALOG+) for adolescents with common mental disorders in Colombia: A qualitative study.

BACKGROUND: Patient and stakeholders' involvement in the development of mental health interventions is a central part of the research process as end-user's input can improve the design of patient-centered interventions. This is particularly important when developing interventions directed towards improving the mental health of children and adolescents. The rising prevalence of mental health disorders in this population requires special attention and the development of interventions that include them as active participants is crucial. OBJECTIVE: Our aim is to explore the perspectives and opinions of adolescents, parents, educators/youth workers, and clinicians regarding the appeal and usability of an existing patient-centered digital intervention (DIALOG+), which aims to improve quality of life. METHODS: As part of a broader study aiming to adapt and test DIALOG+, we conducted Online Focus Groups (OFGs) with adults and adolescents in two cities in Colombia. The existing DIALOG+ intervention was introduced to participants, followed by a structured discussion regarding the opinions and views of stakeholders. A framework approach was used to identify the main themes followed by content analysis to aid adaptation. RESULTS: We conducted 10 OFGs with a total of 45 participants. A positive feature highlighted by all groups was the innovation of including a digital intervention in a traditional medical visit. Additionally, participants considered that the active role that adolescents have when using the intervention empowers them. Barriers identified included concerns from clinicians related to the time required during consultations and confusion with terminology. Furthermore, additional domains that are particularly relevant for the adolescent population were suggested. CONCLUSIONS: Data obtained suggest that overall, the DIALOG+ intervention and supporting app are seen as innovative and appealing to adolescents as well as adult stakeholders. However, concerns raised about the availability of time to apply the intervention, the app interface and the language and terminology require modification.

Adapting a Mental Health Intervention for Adolescents During the COVID-19 Pandemic: Web-Based Synchronous Focus Group Study.

BACKGROUND: Although focus groups are a valuable qualitative research tool, face-to-face meetings may be difficult to arrange and time consuming. This challenge has been further compounded by the global COVID-19 pandemic and the subsequent lockdown and physical distancing measures implemented, which caused exceptional challenges to human activities. Online focus groups (OFGs) are an example of an alternative strategy and require further study. At present, OFGs have mostly been studied and used in high-income countries, with little information relating to their implementation in low- and middle-income countries (LMICs). OBJECTIVE: The aim of this study is to share our experiences of conducting OFGs through a web conferencing service and provide recommendations for future research. METHODS: As part of a broader study, OFGs were developed with adults and adolescents in Colombia during the COVID-19 pandemic. Through a convenience sampling method, we invited eligible participants via email in two different cities of Colombia to participate in OFGs conducted via Microsoft Teams. Researcher notes and discussion were used to capture participant and facilitator experiences, as well as practical considerations. RESULTS: Technical issues were encountered, but various measures were taken to minimize them, such as using a web conferencing service that was familiar to participants, sending written instructions, and performing a trial meeting prior to the OFG. Adolescent participants, unlike their adult counterparts, were fluent in using web conferencing platforms and did not encounter technical challenges. CONCLUSIONS: OFGs have great potential in research settings, especially during the current and any future public health emergencies. It is important to keep in mind that even with the advantages that they offer, technical issues (ie, internet speed and access to technology) are major obstacles in LMICs. Further research is required and should carefully consider the appropriateness of OFGs in different settings.