Browsing by Author "Merry S"

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    A better start national science challenge: supporting the future wellbeing of our tamariki E tipu, e rea, mō ngā rā o tō ao: grow tender shoot for the days destined for you
    (Taylor and Francis Group, 2023-02-22) Maessen SE; Taylor BJ; Gillon G; Moewaka Barnes H; Firestone R; Taylor RW; Milne B; Hetrick S; Cargo T; McNeill B; Cutfield W; Moton TM; King PT; Dalziel S; Merry S; Robertson S; Day A
    The majority of children and young people in Aotearoa New Zealand (NZ) experience good health and wellbeing, but there are key areas where they compare unfavourably to those in other rich countries. However, current measures of wellbeing are critically limited in their suitability to reflect the dynamic, culture-bound, and subjective nature of the concept of ‘wellbeing’. In particular, there is a lack of measurement in primary school-aged children and in ways that incorporate Māori perspectives on wellbeing. A Better Start National Science Challenge work in the areas of Big Data, Healthy Weight, Resilient Teens, and Successful learning demonstrates how research is increasing our understanding of, and our ability to enhance, wellbeing for NZ children. As we look ahead to the future, opportunities to support the wellbeing of NZ young people will be shaped by how we embrace and mitigate against potential harms of new technologies, and our ability to respond to new challenges that arise due to climate change. In order to avoid increasing inequity in who experiences wellbeing in NZ, wellbeing must be monitored in ways that are culturally acceptable, universal, and recognise what makes children flourish.
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    A Nunavut community-directed Inuit youth mental wellness initiative: making I-SPARX fly
    (Taylor & Francis Group, 2024-10-10) Bohr Y; Hankey J; Thomas A; Abdelmaseh M; Armour L; McCague H; Barnhardt J; Oskalns M; Garvey N; Singh Y; Danz C; Singoorie C; Qaunaq R; Oshoweetok I; Lucassen M; Merry S; Shepherd M; Bornstein MH; Ahmad F; Shulman S; Weiss J
    Inuit youth in Nunavut (NU) are resilient but face a protracted suicide crisis. The SPARX serious game and e-intervention, developed originally in New Zealand, teaches youth cognitive behavioural therapy (CBT) skills to ameliorate stress and depression. Inuit youth in NU reviewed and culturally adapted SPARX and an existing wellness outcome measure for Inuit. One hundred and twenty-one youth, aged 13 to 24, across NU then tested, played, and evaluated I(nuit)-SPARX, showing improvement in several areas of wellbeing post-play. Youth completed a CBT skills survey, engaged in sharing circles to assess CBT skill retention, and shared their thoughts about the usefulness and cultural fit of I-SPARX with Inuit Qaujimajatuqangit (IQ). Communication Skills, Listening Skills, and Problem Solving emerged as the most helpful learned CBT skills, and NU youth provided real-world examples of using I-SPARX skills to support their mental wellness. Several principles of IQ were exemplified and upheld in the content of the adapted SPARX tool and the process of the project as a whole. Empirically grounded, asynchronous e-tools, developed in collaboration with Inuit communities to ensure cultural specificity, may support psychological wellness in communities where mental health resources are scarce.
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    Nationwide Implementation of Unguided Cognitive Behavioral Therapy for Adolescent Depression: Observational Study of SPARX
    (JMIR Publications, 2024-09-03) Fleming T; Lucassen M; Frampton C; Parag V; Bullen C; Merry S; Shepherd M; Stasiak K
    Background: Internet-based cognitive behavioral therapy (iCBT) interventions are effective in clinical trials; however, iCBT implementation data are seldom reported. Objective: The objective of this study is to evaluate uptake, adherence, and changes in symptoms of depression for 12-to 19-year-olds using an unguided pure self-help iCBT intervention (SPARX; Smart, Positive, Active, Realistic, X-factor thoughts) during the first 7 years of it being publicly available without referral in Aotearoa New Zealand. Methods: SPARX is a 7-module, self-help intervention designed for adolescents with mild to moderate depression. It is freely accessible to anyone with a New Zealand Internet Protocol address, without the need for a referral, and is delivered in an unguided “serious game” format. The New Zealand implementation of SPARX includes 1 symptom measure—the Patient Health Questionnaire adapted for Adolescents (PHQ-A)—which is embedded at the start of modules 1, 4, and 7. We report on uptake, the number of modules completed, and changes in depressive symptoms as measured by the PHQ-A. Results: In total, 21,320 adolescents aged 12 to 19 years (approximately 2% of New Zealand 12‐ to 19-year-olds) registered to use SPARX. Of these, 63.6% (n=13,564; comprising n=8499, 62.7% female, n=4265, 31.4% male, and n=800, 5.9% another gender identity or gender not specified; n=8741, 64.4% New Zealand European, n=1941, 14.3% Māori, n=1202, 8.9% Asian, n=538, 4.0% Pacific, and n=1142, 8.4% another ethnic identity; mean age 14.9, SD 1.9 years) started SPARX. The mean PHQ-A at baseline was 13.6 (SD 7.7) with 16.1% (n=1980) reporting no or minimal symptoms, 37.4% (n=4609) reporting mild to moderate symptoms (ie, the target group) and 46.7% (n=5742) reporting moderately severe or severe symptoms. Among those who started, 51.1% (n=6927) completed module 1, 7.4% (n=997) completed at least 4 modules, and 3.1% (n=416) completed all 7 modules. The severity of symptoms reduced from baseline to modules 4 and 7. Mean PHQ-A scores for baseline, module 4, and module 7 for those who completed 2 or more assessments were 14.0 (SD 7.0), 11.8 (SD 7.9), and 10.5 (SD 8.5), respectively; mean difference for modules 1-4 was 2.2 (SD 5.7; P<.001) and for modules 1-7 was 3.6 (SD 7.0; P<.001). Corresponding effect sizes were 0.38 (modules 1-4) and 0.51 (modules 1-7). Conclusions: SPARX reached a meaningful proportion of the adolescent population. The effect size for those who engaged with it was comparable to trial results. However, completion was low. Key challenges included logistical barriers such as slow download speeds and compatibility with some devices. Ongoing attention to rapidly evolving technologies and engagement with them are required. Real-world implementation analyses offer important insights for understanding and improving the impact of evidence-based digital tools and should be routinely reported.