Effectiveness and cost‐effectiveness of online recorded recovery narratives in improving quality of life for people with non‐psychotic mental health problems: a pragmatic randomized controlled trial

World Psychiatry, Journal Year: 2024, Volume and Issue: 23(1), P. 101 - 112

Published: Jan. 12, 2024

Narratives describing first‐hand experiences of recovery from mental health problems are widely available. Emerging evidence suggests that engaging with narratives can benefit people experiencing problems, but no randomized controlled trial has been conducted as yet. We developed the Narrative Experiences Online (NEON) Intervention, a web application providing self‐guided and recommender systems access to collection recorded (n=659). investigated whether NEON Intervention benefited adults non‐psychotic by conducting pragmatic parallel‐group trial, usual care control condition. The primary endpoint was quality life at week 52 assessed Manchester Short Assessment (MANSA). Secondary outcomes were psychological distress, hope, self‐efficacy, meaning in 52. Between March 9, 2020 26, 2021, we recruited 1,023 participants across England (the target based on power analysis 994), whom 827 (80.8%) identified White British, 811 (79.3%) female, 586 (57.3%) employed, 272 (26.6%) unemployed. Their mean age 38.4±13.6 years. Mood and/or anxiety disorders (N=626, 61.2%) stress‐related (N=152, 14.9%) most common problems. At 52, our intention‐to‐treat found significant baseline‐adjusted difference 0.13 (95% CI: 0.01‐0.26, p=0.041) MANSA score between intervention groups, corresponding change 1.56 scale points per participant, which indicates increased life. also detected 0.22 0.05‐0.40, p=0.014) groups “presence meaning” subscale Meaning Life Questionnaire, 1.1 participant. an incremental gain 0.0142 quality‐adjusted years (QALYs) credible interval: 0.0059 0.0226) £178 increase cost –£154 £455) generating cost‐effectiveness ratio £12,526 QALY compared care. This lower than £20,000 threshold used National Health Service England, indicating would be cost‐effective use service resources. In subgroup including who had specialist services baseline, both reduced (–£98, 95% –£606 £309) improved QALYs (0.0165, 0.0057 0.0273) participant conclude is effective new for

Language: Английский

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Self-Compassion during COVID-19 in Non-WEIRD Countries: A Narrative Review

Healthcare, Journal Year: 2023, Volume and Issue: 11(14), P. 2016 - 2016

Published: July 13, 2023

The coronavirus disease 2019 (COVID-19) pandemic impacted people's mental health negatively worldwide, including in non-WEIRD (Western, Educated, Industrialised, Rich and Democratic) countries. Self-compassion, kindness understanding towards oneself difficult times have received increasing attention the field of health. Self-compassion is strongly associated with good various populations. This narrative review aimed to synthesise evidence on self-compassion countries during COVID-19 pandemic. MEDLINE PsycINFO were searched for empirical studies. was consistently positive too. However, how, what degree, each component impacts remains be evaluated across different cultures. Future research such as multi-national intervention studies, or network meta-analysis, needed advance our how improves

Language: Английский

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Implementation of a Mental Health Literacy e-Curriculum (MHLeC) in Malawi Universities: a feasibility cluster randomised trial protocol

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: March 24, 2025

Background Mental health literacy (MHL) in Malawi is low. illness often attributed to substance abuse or spirit possession, resulting stigma, maltreatment, and discrimination towards people with mental problems. Inadequacies Malawi's services workforce increase limited treatment access, knowledge, negative attitudes, causing an epidemic of use suicides. MHL foundational for promotion, prevention illness, stigma reduction. Educational settings are ideal implementing promotion activities. We want deliver a e-curriculum (MHLeC) first year university students improve their MHL. The project aims assess the feasibility MHLeC four Malawian universities within cluster randomised trial. Methods In this pragmatic, trial, we will approach eight public private tertiary institutions about study participation. Clusters be participating allocated mandatory voluntary group using stratified randomisation on 1:1 ratio. University characteristics (e.g., private, number first-year enrolled, information technology (IT) infrastructure) used stratify randomisation. Specific objectives include 1) estimating likely participation rates 2) establishing potential attendance /retention during delivery 3) assessing acceptability through qualitative feedback after intervention 4) appropriateness chosen questionnaires measuring student outcomes. Data analysed descriptively. Outcomes from data collected inform future main trial including design recruitment strategies, sample size power calculations full-scale Discussion This give us insights how best conduct definitive can rolled out nationally tested similar cohorts across Africa if positive results obtained. More broadly, research has significantly awareness among young Malawi. Trial registration: This registered Pan African Clinical Trials Registry (PACTR) website https://pactr.samrc.ac.za/ (PACTR202308849574524). Registered 31st August 2023.

Language: Английский

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Statistical analysis plans for two randomised controlled trials of the Narrative Experiences Online (NEON) Intervention: impact of receiving recorded mental health recovery narratives on quality of life in people experiencing psychosis (NEON) and people experiencing non-psychosis mental health problems (NEON-O)

Trials, Journal Year: 2023, Volume and Issue: 24(1)

Published: May 20, 2023

Abstract Background Mental health recovery narratives are a first-hand account of an individual’s from mental distress, access to can aid recovery. The NEON Intervention is web-application providing managed collection narratives. We present the statistical analysis plan for assessing effectiveness in improving quality life at 1-year post-randomisation. pay particular focus on challenges encountered due online nature this trial. Methods and design assessed two trial populations, one people with experience psychosis last 5 years, distress six months (NEON Trial) non-psychosis problems (NEON-O Trial). Both trials two-arm randomised controlled superiority comparing usual care. target sample size 684 participants 994 NEON-O. Participants were centrally 1:1 ratio. Results primary outcome mean score subjective items Manchester Short Assessment Quality-of-Life questionnaire (MANSA) 52 weeks. Secondary outcomes scores Herth Hope Index, Health Confidence Scale, Meaning Life questionnaire, CORE-10 Euroqol 5-Dimension 5-Level (EQ-5D-5L). Conclusion This manuscript (SAP) trials. Any post hoc analysis, such as those requested by journal reviewers will be clearly labelled final reporting. Trial registration prospectively registered. Trial: ISRCTN11152837, registered 13 August 2018. NEON-O ISRCTN63197153, 9 January 2020.

Language: Английский

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The Implementation of Recommender Systems for Mental Health Recovery Narratives: Evaluation of Usage and Performance (Preprint)

JMIR Mental Health, Journal Year: 2024, Volume and Issue: 11, P. e45754 - e45754

Published: Feb. 15, 2024

Background Recommender systems help narrow down a large range of items to smaller, personalized set. NarraGive is first-in-field hybrid recommender system for mental health recovery narratives, recommending narratives based on their content and narrator characteristics (using content-based filtering) beneficially impacting other similar users collaborative filtering). integrated into the Narrative Experiences Online (NEON) intervention, web application providing access NEON Collection narratives. Objective This study aims analyze 3 algorithms used in inform future interventions using lived experience Methods Using recently published framework evaluating structure analysis, we compared filtering algorithm by accuracy (how close predicted ratings are true ratings), precision (the proportion recommended that relevant), diversity diverse are), coverage all available can be recommended), unfairness (whether produce less accurate predictions disadvantaged participants) across gender ethnicity. We data from participants 2 parallel-group, waitlist control clinical trials intervention (NEON trial: N=739; [eg, nonpsychosis] problems [NEON-O] N=1023). Both included people with self-reported who had not statutory services. In addition, trial experienced psychosis previous 5 years. Our evaluation database Likert-scale narrative provided response validated feedback questions. Results Participants NEON-O 2288 1896 ratings, respectively. Each rated median For trial, performed better coverage; accuracy, diversity, both ethnicity; neither precision. did perform any metric; precision, or coverage. Conclusions Clinical population may associated performance. susceptible wide undesirable biases. Approaches mitigating these include enough initial (to prevent overfitting), ensuring accessed outside loop between items), encouraging provide every they interact only when have strong opinions).

Language: Английский

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Pragmatic, feasibility randomized controlled trial of a recorded mental health recovery narrative intervention: narrative experiences online intervention for informal carers (NEON-C)

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 14

Published: Jan. 23, 2024

Introduction Informal carers of people with mental health problems often have unmet support needs. Mental recovery narratives are increasingly accessible, but their relevance to and effect on informal been minimally investigated. The Narrative Experiences Online (NEON) Intervention is a first-in-field intervention that provides access diverse collection recorded narratives. This trial aimed examine the feasibility acceptability NEON for carers. Methods study involved two-arm randomized controlled trial. Carers were randomly assigned receiving versus not Intervention. aspects investigated included randomization, processes, engagement rates, recruitment procedures, attrition, sample size estimation, identification candidate primary secondary outcomes, conducting definitive A qualitative process evaluation was conducted. Findings total 121 eligible, whom 54 (intervention: 27, control: 27). Twelve-month follow-up data available 36 accessed mean 25 over 12-month period, group, compared control reported small hope moderate presence meaning in life. Five modifications recommended improve user experience, applicability, processes. Discussion feasible acceptable. Significant refinement processes required personalize ensure applicability Further testing prior

Language: Английский

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Differences Between Online Trial Participants Who Have Used Statutory Mental Health Services and Those Who Have Not: Analysis of Baseline Data From 2 Pragmatic Trials of a Digital Health Intervention

Journal of Medical Internet Research, Journal Year: 2023, Volume and Issue: 25, P. e44687 - e44687

Published: Feb. 27, 2023

Background Digital health interventions (DHIs) are an established element of mental service provision internationally. Regulators have positioned the best practice standard evidence as interventional study with a comparator reflective care, often operationalized pragmatic trial. DHIs can extend to those not currently using services. Hence, for external validity, trials might openly recruit mixture people who used services and not. Prior research has demonstrated phenomenological differences in experience between these groups. Some users nonservice influence change created by DHIs; hence, should systematically examine inform intervention development evaluation work. This paper analyzes baseline data collected NEON (Narrative Experiences Online; ie, psychosis) NEON-O (NEON other [eg, nonpsychosis] problems) trials. These were DHI that recruited had specialist All participants experiencing distress. Trial experienced psychosis previous 5 years. Objective aims identify sociodemographic clinical characteristics associated use participants. Methods For both trials, hypothesis testing was compare intention-to-treat sample Bonferroni correction applied significance thresholds account multiple testing. Results Significant identified Compared (124/739, 16.8%), (609/739, 82.4%) more likely be female (P<.001), older White British lower quality life (P<.001) status (P=.002). There geographical distribution employment (P<.001; unemployment), current problems personality disorders), recovery recovered). Current than prior users. (399/1023, 39%), (614/1023, 60.02%) unemployment) distress less hope empowerment meaning (P<.001). Conclusions Mental history numerous characteristics. Investigators work develop evaluate populations mixed histories. International Registered Report Identifier (IRRID) RR2-10.1186/s13063-020-04428-6

Language: Английский

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Perception and appropriation of a web-based recovery narratives intervention: qualitative interview study

Frontiers in Digital Health, Journal Year: 2024, Volume and Issue: 6

Published: Feb. 14, 2024

Introduction Mental health recovery narratives are widely available to the public, and can benefit people affected by mental problems. The NEON Intervention is a novel web-based digital intervention providing access Collection of narratives. was found be effective cost-effective in NEON-O Trial for with nonpsychosis problems (ISRCTN63197153), has also been evaluated psychosis experience (ISRCTN11152837). We aimed document experiences, through an integrated process evaluation. Methods Analysis interviews purposive sample arm participants who had completed trial participation. Results interviewed 34 20 (mean age 40.4 years). Some users accessed almost daily, whilst others used it infrequently or not at all. Motivations participation included: exploring as alternative addition existing provision; searching answers about experiences; developing their practice professional (for subset were professionals); claiming payment vouchers. High (10 + narrative accesses) described three forms appropriation: distracting from difficult emotional boost; sustaining sense having social support network. Most valued scale ( n = 659 narratives), but some overwhelming. Many felt they could describe characteristics desired that would health. Finding meeting desires enhanced engagement, finding one reduced engagement. Narratives perceived authentic if acknowledged reality appeared real world experiences similar those participant. Discussion present recommendations interventions incorporating collections narratives: (1) make diversity collection visible; (2) provide delivery mechanisms afford appropriation; (3) enable contributors produce narratives; (4) learning healthcare professionals; (5) consider use address loneliness.

Language: Английский

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Development and delivery cost of digital health technologies for mental health: Application to the Narrative Experiences Online Intervention

Frontiers in Psychiatry, Journal Year: 2022, Volume and Issue: 13

Published: Nov. 7, 2022

Background The increasing development and use of digital health interventions requires good quality costing information to inform commissioning choices about resource allocation decisions. Narrative Experiences Online (NEON) Intervention is a web-application that delivers recorded mental recovery narratives its users. Two randomized controlled trials are testing the NEON in people with experience psychosis experiencing non-psychosis problems (NEON-O). Aim This study describes estimates cost components total developing delivering Intervention. Materials methods Total costs for Trial (739 participants) NEON-O (1,024 were estimated by: identifying categories involved intervention delivery; accurate measurement or estimation use; valuation generate overall costs, using relevant unit costs. Resource identified through consultation literature, reporting standards iterative researchers delivery. Sensitivity analysis was used test assumptions made. Results £182,851. largest software (27%); Lived Experience Advisory Panel workshops (23%); coding (9%); researchers' time source (9%). delivery during £118,663 (£349 per user). In Trial, £123,444 (£241 include updating narrative collection (50%); advertising (19%); administration (14%); maintenance (11%). Uncertainty had effect on estimates. Conclusion Our work shows expertise commitment from range personnel. Teams need allocate substantial resources curating collections. Implications practice identifies promote consistent informs future decision-making at scale. registration Trial: ISRCTN11152837, registered 13 August 2018, http://www.isrctn.com/ISRCTN11152837 . ISRCTN63197153, 9 January 2020, http://www.isrctn.com/ISRCTN63197153

Language: Английский

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The Implementation of Recommender Systems for Mental Health Recovery Narratives: Evaluation of Use and Performance (Preprint)

Published: Jan. 16, 2023

Recommender systems help narrow down a large range of items to smaller, personalized set. NarraGive is first-in-field hybrid recommender system for mental health recovery narratives, recommending narratives based on their content and narrator characteristics (using content-based filtering) beneficially impacting other similar users collaborative filtering). integrated into the Narrative Experiences Online (NEON) intervention, web application providing access NEON Collection narratives. This study aims analyze 3 algorithms used in inform future interventions using lived experience Using recently published framework evaluating structure analysis, we compared filtering algorithm by accuracy (how close predicted ratings are true ratings), precision (the proportion recommended that relevant), diversity diverse are), coverage all available can be recommended), unfairness (whether produce less accurate predictions disadvantaged participants) across gender ethnicity. We data from participants 2 parallel-group, waitlist control clinical trials intervention (NEON trial: N=739; [eg, nonpsychosis] problems [NEON-O] N=1023). Both included people with self-reported who had not statutory services. In addition, trial experienced psychosis previous 5 years. Our evaluation database Likert-scale narrative provided response validated feedback questions. Participants NEON-O 2288 1896 ratings, respectively. Each rated median For trial, performed better coverage; accuracy, diversity, both ethnicity; neither precision. did perform any metric; precision, or coverage. Clinical population may associated performance. susceptible wide undesirable biases. Approaches mitigating these include enough initial (to prevent overfitting), ensuring accessed outside loop between items), encouraging provide every they interact only when have strong opinions).

Language: Английский

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