Browsing by Author "Wong S"

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    Enabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study
    (JMIR Publications, 2022-11-04) Hunter I; Lockhart C; Rao V; Tootell B; Wong S
    Background: Telehealth is often suggested to improve access to health care and has had significant publicity worldwide during the COVID-19 pandemic. However, limited studies have examined the telehealth needs of underserved populations such as rural communities. Objective: This study aims to investigate enablers for telehealth use in underserved rural populations to improve access to health care for rural older adults. Methods: In total, 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. A total of 98 adults aged ≥55 years participated. The participants were asked whether they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and how they perceived barriers to and enablers of telehealth for older adults in rural communities. Focus group transcripts were thematically analyzed. Results: The term telehealth was not initially understood by many participants and required an explanation. Those who had used telehealth reported positive experiences (time and cost savings) and were likely to use telehealth again. A total of 2 main themes were identified through an equity lens. The first theme was trust, with 3 subthemes—trust in the telehealth technology, trust in the user (consumer and health provider), and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent and unreliable internet connectivity. Another key enabler is easy access to user support. Trust in the health system focused on waiting times, lack of and/or delayed communication and coordination, and cost. The second theme was choice, with 3 subthemes—health service access, consultation type, and telehealth deployment. Access to health services through telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care through telehealth was extremely popular, although some participants preferred to be seen in person. A major enabler for telehealth was telehealth deployment by a fixed community hub or on a mobile bus, with support available, particularly when combined with non–health-related services such as internet banking. Conclusions: Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified, particularly trust and choice. The term telehealth is not well understood. The unreliable and expensive connectivity options available to rural communities have limited telehealth experience to phone or patient portal use for those with connectivity. Having the opportunity to try telehealth, particularly by using video, would increase the understanding and acceptance of telehealth. This study highlights that local rural communities need to be involved in designing telehealth services within their communities.
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    The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative
    (Cambridge University Press, 2025-09-25) Hasking P; Kiekens G; Petukhova MV; Albor Y; Al-Hadi A; Alonso J; Al-Saud N; Altwaijri Y; Andersson C; Atwoli L; Muaka CA; Báez-Mansur P; Ballester L; Bantjes J; Baumeister H; Bendtsen M; Benjet C; Berman A; Bruffaerts R; Carrasco P; Chan S; Cohut I; Couder MCD; Cristóbal-Narvaez P; Cuijpers P; David O; Dong D; Ebert D; Gaete J; Forero CG; Gutiérrez-García R; Haro J; Hunt X; Hurks P; Husky M; Jaguga F; Jansen L; Jiménez-Pérez A; Kählke F; Klinkenberg E; Langer Á; Lee S; Lima RA; Liu Y; Lochner C; Mac-Ginty S; Martínez V; Mason A; McLafferty M; Mori T; Murray E; Musyoka C; Nedelcea C; Núñez D; O’Neill S; Piqueras J; Popescu C; Rapsey C; Robinson K; Roca M; Rodriguez-Jimenez T; Salemink E; Sampson N; Scarf D; Siu O-L; Stein D; Struijs SY; Tomoiaga C; Valdés-García K; van der Heijde C; Vigo D; Voorspoels W; Wang A; Wong S; Nock M; Kessler R; World Mental Health - International College Student collaborators
    Background. Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. Methods. We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to DSM-5 mood, anxiety, and externalizing disorders. Results. We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time–order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Conclusions. Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.