Web-Based Decision Aid to Assist Help-Seeking Choices for Young People Who Self-Harm: Outcomes From a Randomized Controlled Feasibility Trial

Rowe, Sarah L.; Patel, Krisna; French, Rebecca S.; Henderson, Claire; Ougrin, Dennis; Slade, Mike; Moran, Paul

Abstract

Background: Adolescents who self-harm are often unsure how or where to get help. We developed a web-based personalised decision aid (DA), designed to support young people in decision-making about seeking help for their self-harm.
Objective: Our aim was to evaluate the feasibility and acceptability of the DA intervention and the randomised controlled trial (RCT) in a school setting.
Methods: We conducted a 2-group, single blind, randomised controlled feasibility trial in a school setting. Participants aged 12-18 years who reported self-harm in the past 12 months were randomised to either a web-based DA or to general information about mood and feelings. Feasibility of recruitment, randomisation and follow-up rates were assessed, as was acceptability of the intervention and study procedures. Descriptive data were collected on outcome measures examining decision-making and help-seeking behaviour. Qualitative interviews were conducted with young people, parents/carers and staff, and subjected to thematic analysis to explore their views of the DA and study processes.
Results: Parental consent was a significant barrier to young people participating in the trial, with only 208 (18%) of the 1,164 parent/guardians contacted for consent responding to study invitations. Where parental consent was obtained, we were able to recruit 82% (n=170) of young people into the study. Of those young people screened, 14% (n=23) had self-harmed in the past year. Ten participants were randomised to receiving the DA and 13 were randomised to the control group. Four-week follow-up assessments were completed with all participants. The DA had good acceptability but qualitative interviews suggested that a DA that addressed broader mental health problems such as depression, anxiety and self-harm may be more beneficial.
Conclusions: A broad-based mental health DA addressing a wide range of psychosocial problems may be useful for young people. The requirement for parental consent is a key barrier to intervention research on self-harm in the school setting. Adaptations to the research design and/or the intervention are needed before generalisable research about DAs can be successfully conducted in a school setting.

Citation

Rowe, S. L., Patel, K., French, R. S., Henderson, C., Ougrin, D., Slade, M., & Moran, P. (2018). Web-Based Decision Aid to Assist Help-Seeking Choices for Young People Who Self-Harm: Outcomes From a Randomized Controlled Feasibility Trial. JMIR Mental Health, 5(1), Article e10. https://doi.org/10.2196/mental.8098

• Journal Article Type: Article
• Acceptance Date: Nov 16, 2017
• Online Publication Date: Jan 30, 2018
• Publication Date: Jan 30, 2018
• Deposit Date: Nov 20, 2017
• Publicly Available Date: Jan 30, 2018
• Journal: JMIR Mental Health
• Electronic ISSN: 2368-7959
• Publisher: JMIR Publications
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 1
• Article Number: e10
• DOI: https://doi.org/10.2196/mental.8098
• Keywords: Adolescents, self-harm, decision aid, intervention, school, feasibility, RCT, ethics
• Public URL: https://nottingham-repository.worktribe.com/output/908215
• Publisher URL: http://mental.jmir.org/2018/1/e10/
• Contract Date: Nov 20, 2017