Background Parenting programmes are widely implemented to help alleviate conduct problems in children. This qualitative study was undertaken as part of the Personalised Programmes for Children Randomised Controlled Trial (PPC RCT) which evaluated a personalised parenting programme for those who had either declined or not responded to previous standard group-based parenting interventions. The narratives of parents or carers taking part in the RCT were explored to understand their experiences of personalisation. Methods Twenty-five parents took part in semi-structured interviews either in person or online. Verbatim transcripts were analysed using a thematic codebook approach. Results Three main themes were identified from the parents’ narratives: (1) the importance of choice, (2) the importance of the relationship with the practitioner, and (3) the importance of going beyond the usual. Conclusions Our findings demonstrate that offering parents choices within an intervention (such as location or time) is essential in creating an appropriate personalised approach that was valued by the study participants. Parents also highly valued the inclusion of their children. To engage parents who have previously not engaged or responded to prior group interventions, a more personalised approach utilising the element of choice and parent-led approaches should be considered.

Background Despite young British Bangladeshis experiencing a higher prevalence of mental health problems than the White British population, they are comparatively underrepresented in mental health research and fewer access services. Aims This study aimed to identify priorities and preferences for mental health support among young British Bangladeshis, as well as strategies to enhance the cultural appropriateness and accessibility of services. Method A qualitative study was conducted in London and Leicester, with participants recruited through voluntary and community organisations. In-depth interviews were held with young people with lived experience of mental health problems (n = 12), their family members (n = 7) and Bangladeshi community workers from voluntary sector organisations (n = 7). Data were analysed using thematic framework analysis. Results Participants’ priorities for mental health support included reducing stigma, raising awareness, and addressing intergenerational and identity-related stressors. Preferences centred on culturally and linguistically appropriate care delivered by therapists familiar with Bangladeshi values in trusted community settings. Suggested strategies for improving existing services included enhancing access by providing support in trusted community spaces, building trust through the involvement of culturally aware professionals, and involving families and community leaders to reduce stigma and promote open discussion around youth mental health. Conclusions This study identifies a need for culturally tailored, linguistically accessible and community-rooted mental health support for British Bangladeshi youth. Representatives from these communities should be actively involved in the development of future programmes and policies, ensuring that support is both relevant and sustainable.

Objectives Few studies have examined sleep health among African adolescents. We aimed to understand sleep health among Ugandan secondary school students. Methods We collected quantitative data in two schools through a survey with items on sleep health and insomnia (using the Cleveland Adolescent Sleepiness Questionnaire, Munich Chronotype Questionnaire and Insomnia Severity Index [ISI]) and mental health with the UNICEF Measuring Mental Health Among Adolescents and Young People at the Population Level (MMAPP) tool. We used regression models to assess characteristics associated with ISI score, and of sleep health with depression and anxiety. We conducted focus group discussions and in-depth interviews with students, parents, teachers, and officials. Quantitative and qualitative analyses were guided by the social ecological model of sleep health. Results The 358 participants generally reported poor sleep health (assessed by satisfaction, alertness, timing, efficiency and duration), especially among boarding students. The median sleep duration was 5.1 hours (interquartile range 4.2-6.2). Overall, 36 (10.1%) participants screened positive for moderate/severe insomnia (ISI ≥15), with higher prevalence among females than males (12.7% vs. 6.2%; p = .05). Qualitative interviews highlighted that individual (knowledge and attitudes), social-cultural (religious beliefs, family dynamics, academic demands, peer pressure), environmental (school and home conditions, technological influences), and societal factors (national school schedule guidelines) influenced sleep patterns. Depression and anxiety were associated with multiple dimensions of poor sleep health. Conclusions Ugandan adolescents face substantial sleep challenges, which are associated with poor mental health. Evidence-based interventions should be adapted for specific social-ecological contexts to improve sleep and mental health in this population.

Abstract Background A large number of young women are not in education, employment, or training (NEET) in England. This group experiences poorer mental health and social outcomes than young women who work and study, and NEET young men. Gender disparities are compounded in deprived and coastal areas, where young women especially lack self-agency and aspirations. Research suggests that greater hope lowers risks of staying NEET and developing mental health problems. We co-developed a hope-focused intervention (HOPEFUL) for this group. HOPEFUL is a flexible modular programme, designed to help develop a more hopeful mindset that facilitates setting and pursuing personally meaningful goals. It is designed to be supported by a mentor, if possible selected by the participant from their existing social network. We aim to understand the feasibility of involving NEET young women and mentors in a trial of HOPEFUL conducted in coastal and adjacent local authority areas in Sussex, Kent and Medway, and East Anglia. Methods This protocol describes the feasibility stage of an adaptive assessor-blind pragmatic randomised controlled trial (RCT) with 1:1 allocation (stratified by age group and local authority area) to (1) mentor-supported HOPEFUL plus usual support versus (2) usual support with waitlist access to HOPEFUL materials. NEET young women (aged 16–25 years) are recruited from local authority, charity and voluntary, and primary care services, as well as directly from the community using outreach, local advertising, social media, and peer networks. Our adaptive trial design incorporates a preliminary feasibility trial ( N = 70) with progression to a definitive RCT ( N = 248), as warranted. Feasibility outcomes (corresponding to the recruitment and retention of young women and mentors) will be assessed post-intervention (16 weeks) against pre-specified progression criteria. Discussion Feasibility trial results will inform decisions about progression to a definitive RCT of the HOPEFUL intervention. If warranted, the latter will test whether HOPEFUL improves hope (primary outcome) and secondary outcomes (including mental health symptoms and social outcomes) compared to usual support services at 16 weeks (primary endpoint) and 12-month follow-up. We will disseminate feasibility results using tailored outputs. In the longer term, we anticipate practice impacts through scaled-up access to HOPEFUL.

Youth mental health services are struggling to meet demand, highlighting the need for changes aligned with young people’s needs. The CATALYST project (Co-designing and testing an Asset-based TAsk-sharing modeL for Youth mental health Services in deprived communiTies) uses place-based approaches to inform improvements to mental health support for 16–25-year-olds. In addition to improving access to care, there is an urgent need to prevent escalation of mental health issues through earlier, community-based interventions. This paper presents a situational analysis of Brighton and Hove, UK, a coastal area with high levels of socioeconomic inequality, to explore why young people are not being reached by existing services, and what could improve access. We conducted a desk-based review of 21 policy, strategy, and research documents, and a series of interviews and focus groups. Participants (N = 34) included young people, community members, and professional stakeholders. Data were analysed using a framework analysis guided by the research questions. We identified eight barriers and five facilitators to accessing support across system-, service-, and individual-levels. Participants described a system under strain, characterised by a lack of funding, workforce capacity, siloed referrals, and high access thresholds. Young people described low levels of trust in the system and experiences of exclusion and isolation. However, a strong voluntary sector, and community-based models like Single Points of Access (SPOAs) were seen as promising facilitators for accessible mental health support. The findings align with other areas with high levels of deprivation, but Brighton and Hove’s vibrant voluntary sector offers unique opportunities. Mobilising these assets through increased community partnership and use of task-sharing could enhance access to timely and appropriate mental health support. These approaches have implications for prevention practice by facilitating earlier identification of emerging mental health difficulties and providing ongoing, community-based support to prevent escalation.

Study Objectives:There is little research on sleep health interventions in Africa. We assessed the feasibility and acceptability of a tiered sleep health intervention among Ugandan adolescents. The intervention, delivered in two secondary schools, comprised universal components (sleep education sessions, structural changes to light, temperature and school-timings) plus targeted psychologist-delivered group cognitive behaviour therapy for insomnia (CBT-I) for students with moderate/severe insomnia (Insomnia Severity Index ≥15). Methods:Feasibility and acceptability were assessed through semi-structured interviews immediately after the intervention (T1) and 3 months later (T2) among students with baseline (T0) insomnia, teachers and dormitory matrons, along with structured implementation trackers. We conducted a quantitative survey at baseline to assess prevalence of dimensions of sleep and mental health, and for those with insomnia only, repeated this at T1 and T2. Results:The intervention was feasible and acceptable. High fidelity, dose and reach were achieved through integration of sleep education to the school schedule, structural changes to light, temperature and wake-up time for boarding students, effective small group delivery of CBT-I sessions and good retention despite fatigue due to extended sessions. Acceptability was reflected in high student engagement and positive feedback on the relevance of both universal and targeted components. Among 36 students with baseline insomnia, prevalence of moderate/severe insomnia decreased to 19.4% (7/36) post-intervention and further to 3.6% (1/28) at three months, indicating strong potential for impact. Conclusions:Multi-level, school-based sleep interventions can be successful in low-income settings. Large-scale cluster-randomized controlled trials are needed to estimate impact and cost-effectiveness.

This systematic review examined two questions regarding youth mental health intervention research: (1) how is co-design practiced? (2) what clinical and implementation-related outcomes are reported? Eligible studies were primary research published from 2008 involving youth aged 15-24 years co-designing mental health interventions. Studies were excluded if they were descriptive only, focused on prevention/screening, involved only adult perspectives, or were grey literature, conference proceedings, dissertations, or protocols. We searched seven databases (Medline, PsycINFO, CINAHL, Scopus, Global Health, EMBASE, Cochrane) using terms mapped to youth, co-design, mental health, and interventions, and conducted a narrative synthesis. Study quality was independently assessed by two reviewers with discrepancies resolved through consultation. Fifty-eight studies were included, predominantly from high-income, English-speaking settings, with a majority of qualitative (57%) and mixed-methods (36%) designs. Co-design typically involved small-group workshops with youth in consultative roles focused on adapting content or design. Over half of the studies did not report an explicit theoretical framework, and few examined relational dynamics within co-design. Only 12 studies evaluated mental health outcomes, with most reporting moderate-to-large improvements. Implementation outcomes were reported in 38% of studies, with generally high usability, engagement and improved alignment with user needs. Co-design evidence remains limited by inconsistent reporting and lack of rigorous outcome evaluation.

Objective This study aimed to coproduce a culturally adaptive storytelling video intervention to support the psychosocial well-being of Nepalese migrant workers.Design A multimethods participatory study was conducted involving three different but interconnected phases: (1) formative research involving a systematic review, pilot survey and stakeholder consultations; (2) exploration and analysis of Nepalese literature relevant to contemporary migration; and (3) coproduction of a storytelling video intervention, using participatory workshops.Participants and settings Convenience sample of outgoing and returnee migrant workers from the Gulf Cooperation Council (GCC) countries, their families and other relevant stakeholders in Dhading District of Bagmati Province, Nepal.Results The systematic review of 33 included studies identified five key health issues: mental health; occupational hazards; sexual health; healthcare access; and infectious diseases. In the survey (n=60), workers reported various health problems including fever/common cold (42%); mental health problems (25%); and verbal abuse (35%). Twenty interviewees identified issues related to physical health (eg, pneumonia, kidney disease) as well as mental health (eg, anxiety, depression). Nepalese literary resources primarily portrayed themes of: separation; hopelessness and helplessness; and poor workplace environments. Drawing on these findings and iterative workshops with stakeholders, a culturally sensitive storytelling video intervention was coproduced to support the psychosocial well-being of Nepalese migrant workers in GCC countries. The intervention used an animated video format with audio narration and subtitles, presenting a story centred around the struggles of an archetypal male migrant worker and their use of coping strategies for dealing with adversities.Conclusions This is a feasibility study conducted in a single district of Nepal; as such, the findings should be generalised cautiously. Despite these limitations, the project is testament to the value of participatory methods in the development of culturally sensitive public health interventions for marginalised groups, and points to the utility of coproduced storytelling formats in migrant health contexts. Future research is needed to evaluate feasibility and acceptability of the intervention as well as the outcomes and experiences of migrant workers who engaged with the video.

BACKGROUND:This study aimed to gain insights into stakeholders' priorities and preferences for a scalable intervention for common mental problems among perinatal adolescents in Malawi. METHODS:Participatory stakeholder workshops (n=9) were conducted iteratively according to the principles of the Person-Based Approach. Three stakeholder groups were recruited from one urban and one rural primary health centre in Zomba district, Malawi: perinatal adolescents (n=10), their family members (n=8) and healthcare workers (n=10). Framework analysis was conducted using intervention descriptors from the Template for Intervention Description and Replication checklist. RESULTS:Participants emphasized the need for information on causes and symptoms of common mental problems and for developing coping strategies: a) those focused on external stressors-problem-solving, financial literacy and interpersonal skills-and b) emotion-focused approach behaviours-behavioural activation, relaxation and anger management. There was a strong preference for healthcare workers as intervention providers. Participants agreed on a brief antenatal intervention delivered weekly using both group and individual formats. There were positive views on both self-help and guided formats. All stakeholder groups felt there was a need for follow-up to ensure that adolescents correctly engaged with the intervention material. CONCLUSIONS:Findings informed the design of a brief multicomponent guided intervention for adolescents in the antenatal period.

Wise interventions (WIs) use theory-driven approaches to reshape individuals’ interpretations of their experiences. In these pre-registered meta-analyses, we conducted random-effects, fixed-effects, moderation, and subgroup meta-analyses across different time points to evaluate the effects of WIs on depressive or anxiety symptoms. We also conducted quality assessments and evaluated publication bias and heterogeneity. Sixteen RCTs were included, revealing small but significant effects of WIs on depressive symptoms post-intervention (g = 0.22; p = 0.00) and anxiety symptoms at post-intervention (g = 0.20; p = 0.00) and 3-month follow-up (g = 0.09; p = 0.02). The strongest post-intervention effects on depressive symptoms were found for gratitude interventions (g = 0.29; p = 0.04) and online delivery (g = 0.35; p = 0.03). Moderation analyses for other endpoints yielded equivocal results. These findings highlight new opportunities to support youth by reframing their identities as sources of strength and fostering gratitude.

BACKGROUND:Codesign of mental health interventions entails the active involvement of end users and other stakeholders in various stages of the developmental process. This has emerged as a promising approach for developing evidence-based mental health interventions aligned with minoritised populations' needs and preferences. However, key questions remain about the methods and outcomes of codesign studies focused on young people from racially minoritised groups. The current review aimed to explore the codesign approaches and phases used in developing mental health interventions with young people from racially minoritised populations, analyse the codesign outcomes for participants and examine the contextual enablers and barriers impacting the codesign process. METHODS:A systematic search was conducted across MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science and Scopus. Citations and references of included studies were also checked. Study quality and reporting of codesign were assessed using the Mixed Method Appraisal Tools and the Guidance for Reporting Involvement of Patients and the Public-2 checklist. Data were synthesised using narrative synthesis, content analysis and meta-synthesis. RESULTS:Eighteen eligible studies reported various codesign and participatory approaches, including community-based participatory research, co-production, human-centred design, youth and family codesign model, community engagement research, community development model, participatory evaluation model, participatory research design approach and community participatory research partnership. The most common codesign stages followed were exploring problems and solutions, ideating and creating, and refining. In terms of outcomes, the reported benefits of codesign for young people included personal development and well-being, enhanced knowledge and career skills, and better mental health outcomes. Codesigning with youth and other stakeholders (e.g., family members, other caregivers, community members and practitioners) also improved the research projects by identifying specific problems, increasing participant recruitment and enhancing data collection. Additionally, other stakeholders gained a platform to share their expertise, understand youth mental health and build capacity through codesign. Regarding enablers and barriers, reducing power differentials, fostering community engagement and collaboration with other stakeholders facilitated the codesign process, whereas barriers included lack of resources, power imbalances, lack of rapport building and selection bias. CONCLUSIONS:This review outlines the potential benefits of codesign for developing mental health interventions for racially minoritised youth. These benefits include continuous stakeholder engagement to understand community needs better, reducing power differentials and building trust through culturally tailored activities and communication strategies. PATIENT AND PUBLIC CONTRIBUTION:Patients and the public did not contribute directly to this review though the reviewed literature was specifically concerned with participatory research activities.

Introduction Young people (YP) whose parents have depression are at elevated risk for developing depression themselves and could benefit from preventive interventions. However, when parents are in a depressive episode, this reduces the effects of psychological interventions for depression in YP. Moreover, parental depression is often managed suboptimally in usual care. There is, therefore, a case for identifying and optimising parental depression treatment to enhance the effectiveness of psychological preventive interventions for depression in YP.Methods and analysis This is a randomised controlled trial (Skills for adolescent WELLbeing) to determine the effectiveness of a cognitive behavioural therapy (CBT) intervention compared with usual care in increasing the time to a major depressive episode in YP by 9-month follow-up (primary outcome). The intervention offers a 12-week treatment-optimisation phase for parents depressed at study entry, followed by randomisation of the young person to a small group manualised online CBT programme facilitated by a therapist. YP allocated to the intervention will receive eight weekly sessions plus three monthly continuation sessions. Secondary outcomes include the number of depression-free weeks, mental health symptoms and functioning. Mechanisms of intervention action will be assessed with mediation analysis of quantitative data and thematic analysis of qualitative interviews. Participants (parents/carers with depression and their children aged 13–19 years) will be identified through existing cohorts of adults with depression, from primary care through health boards in Wales and England, UK, schools and advertising including via social media.Ethics and dissemination The trial has received ethical approval from Wales NHS Research Ethics Committee (REC) 5, the Health Research Authority and Health and Care Research Wales (IRAS 305331; REC 22/WA/0254). This manuscript is based on V.5.7 of the protocol (17 January 2025). Findings will be disseminated in peer-reviewed journals and conferences. Reports and social media messages will be used to disseminate findings to the wider public.Trial registration number ISRCTN13924193 (date registered: 15 March 2023).

Schoolvermijding wegens emotionele problemen (ook in Nederland bekend als EBSA, het acroniem van ‘emotionally-based school avoidance’, red.) is een belangrijke oorzaak van langdurig schoolverzuim en mogelijk verergerd in de periode van COVID-19. Dit artikel beschrijft een kortdurende psychosociale interventie voor ouders, ontwikkeld om iets te doen aan de slechte toegankelijkheid van tijdige interventies voor EBSA. Het ontwikkelingsproces bestond uit een persoonsgerichte benadering met twee fasen. Tijdens fase 1 werden in een reeks co-designworkshops kwalitatieve data verzameld over de wensen en prioriteiten op het vlak van interventie van N = 10 ouders en N = 7 hulpverleners. In fase 2 werd, na herhaalde consultaties met N = 4 ouders en N = 3 hulpverleners, een blauwdruk van de interventie uitgewerkt. Met behulp van framework-analyse werden de bevindingen over belangrijke interventieparameters geordend; die parameters waren de relevante mechanismen, de inhoud en de methoden van aanbieden die nodig waren voor het geven van effectieve, aanvaardbare en uitvoerbare hulp aan gezinnen met een kind met EBSA. De resulterende blauwdruk bevat drie online modules, aangeboden gedurende een periode van drie weken, elk bestaand uit video’s met psycho-educatie, zelfstandig uit te voeren leertaken en elk met een eigen coachingsessie. De inhoud van de respectievelijke modules bestond uit: (i) zelfzorgstrategieën voor een beter welzijn en betere zelfeffectiviteit van de ouders; (ii) opvoedstrategieën voor het veranderen van gedragspatronen die de klachten van kinderen en de schoolvermijding in stand houden; en (iii) strategische communicatiestrategieën voor een betere kwaliteit van de relaties tussen thuis en school. Deze blauwdruk is inmiddels uitgewerkt tot een volledig prototype waarnaar binnenkort een haalbaarheidsonderzoek wordt gedaan. Samenvatting in gewone taal Sinds het begin van de COVID-19-pandemie is het aantal kinderen dat niet naar school gaat flink toegenomen. Dat hogere schoolverzuim heeft voor een groot deel te maken met ‘schoolvermijding door emotionele problemen’, een probleem dat ook wel EBSA wordt genoemd, een afkorting van de Engelse term ‘emotionally-based school avoidance’. Met ‘schoolvermijding door emotionele problemen’ wordt bedoeld dat een kind thuisblijft van school omdat het last heeft van angstgevoelens bij de gedachte aan naar school gaan, en daar erg tegenop ziet. Door de lange wachtlijsten voor hulp bij psychische problemen van kinderen en pubers kan het lastig zijn om op tijd hulp te krijgen voor een kind met EBSA. Dit artikel beschrijft de ontwikkeling van een nieuwe, kortdurende psychosociale interventie (dat wil zeggen een methode om psychische of sociale problemen te verhelpen) voor ouders om hun kind met schoolvermijding door emotionele problemen te kunnen ondersteunen. De ontwikkeling van de nieuwe interventie verliep in twee fasen. Tijdens de eerste fase voerden we gesprekken met tien ouders en zeven hulpverleners. Die gesprekken waren bedoeld om ideeën te verzamelen over wat voor soort hulp gezinnen nodig hebben, over de wensen voor de inhoud van de interventie en over de beste manier om ervoor te zorgen dat de interventie praktisch bruikbaar was voor gezinnen. Op basis van deze gesprekken maakten we een plan voor de nieuwe interventie. Tijdens de tweede fase werd dit plan verder uitgewerkt om de interventie echt geschikt te maken voor gezinnen. De naam van de interventie is ISAAC, de afkorting van de Engelse naam ‘Intervention for School Anxiety and Absenteeism in Children’, oftewel ‘interventie voor schoolangst en schoolverzuim bij kinderen’. ISAAC bestaat uit drie online modules of onderdelen die ouders in een periode van drie weken kunnen afronden. Elke module bestaat uit video’s, activiteiten om ouders actief te laten meedenken en huiswerkopdrachten. De huiswerkopdrachten helpen ouders met het leren van een nieuwe vaardigheid of het uitproberen van een nieuwe manier van reageren op de angst van hun kind om naar school te gaan. Ook krijgen de ouders ondersteuning van een coach. In de eerste module krijgen ouders tips om goed voor hun eigen welzijn te zorgen en met stress om te gaan. De tweede module helpt ouders met het aanleren van nieuwe manieren van omgaan met de problemen van hun kind rondom het naar school gaan. De derde module geeft advies over een goed werkende manier van communiceren met de school van het kind. De volgende stap voor deze interventie is dat we gaan uitzoeken of ouders er prettig mee kunnen werken en of de interventie in het echte dagelijks leven praktisch uitvoerbaar is om te geven en te volgen.

Background International students account for a growing proportion of university students and can experience mental health challenges. While the Social Identity Model of Identity Change (SIMIC) highlights the mental health-promoting benefits of preserving and building group memberships, it overlooks the effects of identifying with a particularly salient group such as fellow international students. Aims This study aimed to explore how SIMIC and international student identification contribute to understanding the protective factors that predict students’ mental health. Method A cross-sectional survey of 343 international students employed path analyses to examine the associations among identification with fellow international students, social identity maintenance, new group memberships and psychological distress, with social support and resilience as potential mediators. Indirect effects were evaluated using 95% confidence intervals. Results New group memberships (β = −0.01; P = 0.05; 95% CI = −0.03, −0) and identification with international students (β = −0.02; P = 0.05; 95% CI = −0.02, −0) predicted psychological distress, both mediated by social support and resilience. While the maintenance of previous groups did not indirectly predict psychological distress through these mechanisms (β = −0.01; P = 0.13; 95% CI = −0.02, 0), a significant indirect effect (β = −0.04; P = 0.03; 95% CI = −0.09, −0) was observed through social support when accounting for covariates. Conclusions Shared international student identity and new group memberships offer a sense of social support and resilience which, in turn, alleviates psychological distress. Interventions could reframe this identity as a source of strength for international students.

Objectives: Existing youth mental health services are unable to meet a rising demand for care. Changes are required to align care with young people's needs and priorities. In this paper, we present a case study examining the developmental stages of a community-based participatory research project in which young people and professional stakeholders co-designed a youth mental health service blueprint in Southern England.Methods: We took a reflexive approach to critique, appraise and evaluate how our subjectivity - as embedded researchers - influenced the research process.Findings: In this paper, we reflect on (1) the impact of an immersive approach on the development of trust with stakeholders and participants; (2) our methodology for developing and implementing community-based research and (3) the ways in which the complexity and the fragmentation of youth mental health services affected the research process.Conclusion: A participatory approach can be complex and challenging; however, we argue that by engaging with communities and building relationships and trust, researchers can develop a deeper and more nuanced understanding of how to create and shape services that better reflect local needs and priorities.

Young women who are not in education, employment, or training (NEET) experience poorer health and social outcomes compared to non-NEET young women and to NEET young men, especially in deprived areas with intersecting inequalities. The evidence on effective public health approaches is scarce. Interventions that target hope, which NEET young women notably lack, offer a promising theory-driven and intuitive means to prevent mental health problems and improve social outcomes. Hope can be defined as a goal-focused mindset comprising self-agency (motivation and self-belief) and pathways (identifying routes to achieving goals). Hope is implicated in a variety of evidence-based psychosocial interventions for young people, but is not directly targeted by existing prevention programmes for NEET populations. The current study used a phased qualitative research design and participatory methods to model a hope-focused intervention for NEET young women. Phase 1 investigated population needs and intervention parameters through semi-structured interviews with 28 key informants living or working in disadvantaged coastal communities in South-East England. The sample comprised eight NEET young women, four family members, and 16 practitioners from relevant support organisations. Phase 2 refined intervention parameters and outcomes through co-design sessions with four NEET young women, followed by a theory of change workshop with 10 practitioners. The resulting intervention model is articulated as a mentor-supported, in-person psychosocial intervention that builds hope by enhancing positive sense of self and time spent in meaningful activities, before explicitly teaching the skills needed to identify, set, and pursue personally meaningful goals.

This study aimed to assess feasibility, acceptability, and potential for impact of FOotpaths foR Adolescent Maternal Mental Health (FOR MAMA), a co-designed intervention for pregnant adolescents in Malawi. We used a mixed-methods interventional pre-post cohort design. We recruited pregnant adolescents from a rural health centre in Zomba district, Malawi, all of whom were offered a five-session psychosocial intervention delivered by community healthcare workers. Quantitative feasibility indicators related to participant enrolment, session attendance and intervention completion. Feasibility of intervention delivery was explored using in-depth semi-structured interviews with healthcare workers. Acceptability was investigated through in-depth semi-structured interviews with intervention participants and a service user satisfaction questionnaire. Intervention outcomes were assessed using standardised measures of common mental disorders, financial distress and poor mental health, and perceived social support. 19 adolescents aged 15-19 years (mean=17.21, SD=1.18) started the intervention, with 18 (94.7%) completing the programme. Significant improvements (p<0.05) were reported across all outcome measures, with moderate to high pre-post effect sizes. Intervention participants reported high levels of service satisfaction, although healthcare workers (n = 6) reported that some feasibility challenges emerged during recruitment and delivery. The FOR MAMA intervention proved to be an acceptable and feasible psychosocial intervention for pregnant adolescents in Malawi.

Background: Youth-focused co-design, involving active collaboration between researchers, designers, clinicians and end users, is essential for enhancing the acceptability, feasibility and effectiveness of digital mental health interventions (DMHIs). However, most literature on co-design comes from high-income countries and offers limited contextually relevant guidance to programme and intervention developers in low- and middle-income countries (LMICs).Aims: This paper presents 10 recommendations drawn from the co-authors' experiences of co-designing youth-focused DMHIs as researchers, public engagement specialists and youth advisors.Methods: The recommendations emphasise key aspects of the co-design process including the use of conceptual frameworks, the involvement of diverse youth groups, contextual considerations, and the promotion of young people's safety and well-being.Results: The recommendations highlight strategies and examples for involving young people, the importance of acknowledging young people's contributions and evaluating experiences of co-design to improve the overall effectiveness and relevance of DMHIs in LMICs.Conclusion: By implementing these recommendations, DMHI developers can foster more effective and inclusive co-design processes that better meet the needs of young people in LMIC contexts.

BackgroundAdolescents in LMICs face heightened risks for perinatal mental health problems due to an abundance of psychosocial adversities and a lack of service capacity. Efforts to develop scalable selective prevention programmes for this group require active involvement from key stakeholders. AimThis study aimed to gain insights into stakeholders’ priorities and preferences for a scalable intervention for common mental problems among perinatal adolescents in Malawi. MethodsParticipatory stakeholder workshops (n=9) were conducted iteratively according to the principles of the Person-Based Approach. Three stakeholder groups were recruited from one urban and one rural primary health centre in Zomba district, Malawi: perinatal adolescents (n=10), their family members (n=8), and healthcare workers (n=10). Framework analysis was conducted using intervention descriptors from the TIDieR checklist Results Participants emphasised the need for information on causes and symptoms of common mental problems, and for developing coping strategies: a) those focused on external stressors – problem-solving, financial literacy and interpersonal skills, and b) emotion-focused approach behaviours – behavioural activation, relaxation, and anger management. There was a strong preference for healthcare workers as intervention providers. Participants agreed on a brief antenatal intervention to be delivered weekly using both group and individual formats. There were positive views on both self-help and guided formats. Importantly, all stakeholder groups felt there was need for follow-up to ensure that adolescents correctly engaged with the intervention material. Hence, a guided self-help format was agreed upon.ConclusionFindings informed the design of a brief multi-component guided intervention for adolescents in the antenatal period.

Objective:This review will i) describe methods used to involve children in the development and/or evaluation of parent-focused interventions to prevent or treat child mental health problems; ii) summarize the perspectives of children or adults about these methods; iii) highlight any reported enablers and barriers; and iv) identify guidance and make recommendations for further research.Introduction:Parent-focused interventions (where children are not primarily involved or are excluded) have been implemented to address various child mental health outcomes. However, it is unclear to what extent, and to what end, children have been involved in developing and evaluating such interventions. Engaging children in formative research activities, with or without their parents, has the potential to improve quality and implementation of the interventions.Inclusion criteria:Eligible studies will involve children (5-12 years) in the development and/or evaluation of parent-focused interventions aimed at preventing or treating common child mental health problems (eg, anxiety, depression, ADHD, disruptive behavior) delivered in any setting (eg, school, community, home, health facility). Eligible interventions may include one or more psychosocial practice elements targeting behavioral, cognitive, emotional, interpersonal, social, and/or environmental factors implicated in the onset and maintenance of child mental health problems.Methods:Comprehensive searches will be conducted in 5 electronic databases (PsycINFO, MEDLINE, CINAHL, Embase, and Scopus). Gray literature will be sourced using Google as well as through searches of key organization websites and via notifications on social media. Only English-language primary studies will be considered. Findings across a range of methodologies will be charted and combined into a narrative synthesis.Review registration:Open Science Framework https://osf.io/x9376/