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      A Web-Based Psychoeducational Intervention for Adolescent Depression: Design and Development of MoodHwb

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          Abstract

          Background

          Depression is common in adolescence and leads to distress and impairment in individuals, families and carers. Treatment and prevention guidelines highlight the key role of information and evidence-based psychosocial interventions not only for individuals but also for their families and carers. Engaging young people in prevention and early intervention programs is a challenge, and early treatment and prevention of adolescent depression is a major public health concern. There has been growing interest in psychoeducational interventions to provide accurate information about health issues and to enhance and develop self-management skills. However, for adolescents with, or at high risk of depression, there is a lack of engaging Web-based psychoeducation programs that have been developed with user input and in line with research guidelines and targeted at both the individual and their family or carer. There are also few studies published on the process of development of Web-based psychoeducational interventions.

          Objective

          The aim of this study was to describe the process underlying the design and development of MoodHwb ( HwbHwyliau in Welsh): a Web-based psychoeducation multimedia program for young people with, or at high risk of, depression and their families, carers, friends, and professionals.

          Methods

          The initial prototype was informed by (1) a systematic review of psychoeducational interventions for adolescent depression; (2) findings from semistructured interviews and focus groups conducted with adolescents (with depressive symptoms or at high risk), parents or carers, and professionals working with young people; and (3) workshops and discussions with a multimedia company and experts (in clinical, research, and multimedia work). Twelve interviews were completed (four each with young people, parents or carers, and professionals) and six focus groups (three with young people, one with parents and carers, one with professionals, and one with academics).

          Results

          Key themes from the interviews and focus groups were: aims of the program, design and content issues, and integration and context of the program. The prototype was designed to be person-centered, multiplatform, engaging, interactive, and bilingual. It included mood-monitoring and goal-setting components and was available as a Web-based program and an app for mobile technologies.

          Conclusions

          MoodHwb is a Web-based psychoeducational intervention developed for young people with, or at high risk of, depression and their families and carers. It was developed with user input using qualitative methods as well as user-centered design and educational and psychological theory. Further research is needed to evaluate the effectiveness of the program in a randomized controlled trial. If found to be effective, it could be implemented in health, education, youth and social services, and charities, to not only help young people but also families, carers, friends, and professionals involved in their care.

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          Most cited references41

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          Using thematic analysis in psychology

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            Developing and evaluating complex interventions: the new Medical Research Council guidance

            Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance
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              Depression in adolescence.

              Unipolar depressive disorder in adolescence is common worldwide but often unrecognised. The incidence, notably in girls, rises sharply after puberty and, by the end of adolescence, the 1 year prevalence rate exceeds 4%. The burden is highest in low-income and middle-income countries. Depression is associated with substantial present and future morbidity, and heightens suicide risk. The strongest risk factors for depression in adolescents are a family history of depression and exposure to psychosocial stress. Inherited risks, developmental factors, sex hormones, and psychosocial adversity interact to increase risk through hormonal factors and associated perturbed neural pathways. Although many similarities between depression in adolescence and depression in adulthood exist, in adolescents the use of antidepressants is of concern and opinions about clinical management are divided. Effective treatments are available, but choices are dependent on depression severity and available resources. Prevention strategies targeted at high-risk groups are promising. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                JMIR Ment Health
                JMIR Ment Health
                JMH
                JMIR Mental Health
                JMIR Publications (Toronto, Canada )
                2368-7959
                Jan-Mar 2018
                15 February 2018
                : 5
                : 1
                : e13
                Affiliations
                [1] 1 Division of Psychological Medicine and Clinical Neurosciences Medical Research Council Centre for Neuropsychiatric Genetics and Genomics Cardiff University Cardiff, Wales United Kingdom
                [2] 2 National Centre for Mental Health Cardiff University Cardiff, Wales United Kingdom
                [3] 3 Population Health Sciences University of Bristol Bristol, England United Kingdom
                [4] 4 Institute of Health and Wellbeing University of Glasgow Glasgow, Scotland United Kingdom
                [5] 5 Faculty of Medical and Health Sciences School of Medicine University of Auckland Auckland New Zealand
                [6] 6 Department for Health University of Bath Bath, England United Kingdom
                [7] 7 Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit Institute of Health and Wellbeing University of Glasgow Glasgow, Scotland United Kingdom
                Author notes
                Corresponding Author: Rhys Bevan Jones bevanjonesr1@ 123456cardiff.ac.uk
                Author information
                http://orcid.org/0000-0001-8976-9825
                http://orcid.org/0000-0002-3689-737X
                http://orcid.org/0000-0002-9484-1729
                http://orcid.org/0000-0002-0377-818X
                http://orcid.org/0000-0001-6154-9011
                http://orcid.org/0000-0002-8132-6920
                http://orcid.org/0000-0002-2267-1951
                http://orcid.org/0000-0002-8281-1573
                http://orcid.org/0000-0001-8046-0784
                http://orcid.org/0000-0001-5821-5889
                http://orcid.org/0000-0002-4589-8833
                http://orcid.org/0000-0002-6219-1768
                Article
                v5i1e13
                10.2196/mental.8894
                5832901
                29449202
                b7aa4213-4c2e-4d4f-aa8f-0021f29328ec
                ©Rhys Bevan Jones, Anita Thapar, Frances Rice, Harriet Beeching, Rachel Cichosz, Becky Mars, Daniel J Smith, Sally Merry, Paul Stallard, Ian Jones, Ajay K Thapar, Sharon A Simpson. Originally published in JMIR Mental Health (http://mental.jmir.org), 15.02.2018.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

                History
                : 3 October 2017
                : 26 October 2017
                : 21 November 2017
                : 22 November 2017
                Categories
                Original Paper
                Original Paper

                adolescent,depression,internet,education,preventive psychiatry,early medical intervention

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