The Research problem
Adolescent mental health (MH) is a pressing public health issue globally. The highest prevalence of mental disorders is during adolescence. Adolescent MH problems can persist over the lifespan, leading to impaired education, development, personality formation, and years lived with disability. Early prevention of adolescent MH problems to mitigate associated consequences is warranted.
Currently, there is still a gap between the population needing MH preventive interventions and those who can access the services. This gap was seen as particularly pronounced in low- and middle-income countries (LMICs). Digital preventive MH interventions (e.g. interventions delivered via websites and smartphone apps) for adolescents are proven to be convenient, cost-effective, and potentially reduce stigma. Culturally adapting an evidence-based digital preventive MH intervention to countries with different cultures and economic statuses may have opportunities to easily reach diverse youths in moments of need, narrow the need-to-access gap, and achieve equity in MH for all adolescents worldwide. However, most digital preventive MH interventions are developed in HICs or English-speaking countries; the effectiveness of cultural adaptations in adolescents has not been thoroughly reviewed.
Furthermore, a deep understanding of the diverse needs of various groups is critical to developing a culturally relevant and feasible digital MH intervention. No comparative study has been identified to explore differences in cultural preferences and barriers among different countries. A wide range of factors, such as preferences on language, image, delivery, gamification, peer interaction, help-seeking values, stigma, religious concerns, and school climate, are important factors that should be investigated.
Research Design
Methodology:
A systematic review (SR) and meta-analysis will be conducted to examine the effectiveness of culturally adapted digital interventions in preventing mental disorders among adolescents and to compare the effectiveness across cultures and LMICs/ HICs.
A comparative study will be conducted to examine cultural preferences and digital exclusion factors among adolescents across three continents in China, Japan, South Africa, Ghana, and the UK. A total of 1,000 adolescents (aged 10-19), 200 from each country, will be invited to complete an online survey. To increase representativeness, we will sample participants from various socioeconomic statuses.
Project Objectives
- To explore the effectiveness of culturally adapted digital MH interventions in adolescents in HICs and LMICs.
- To identify the cultural preference/digital exclusion factors affecting the use of the interventions.
