Indigenous Adolescents’ Perception of an eMental Health Program (SPARX): Exploratory Qualitative Assessment

Abstract

BackgroundDepression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Māori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Māori. ObjectiveThe aim was to conduct an exploratory qualitative study of Māori adolescents’ opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program.MethodsTaitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes.ResultsTaitamariki participating in the interviews found SPARX to be helpful. The Māori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Māori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whānau (Māori word for family) members with reported beneficial effect.ConclusionsOverall, this small group of Māori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.

Use and uptake of web-based therapeutic interventions amongst Indigenous populations in Australia, New Zealand, the United States of America and Canada: a scoping review

“…As shown in Table 3, 11 (34%) sources were from the USA [15][16][17][18][19][20][21][22][23][24][25] and nine (28%) sources were from New Zealand [26][27][28][29][30][31][32][33][34], with the remainder from Australia (12, 38%) [35][36][37][38][39][40][41][42][43][44][45]. As there were no studies from Canada, the findings reported from here on pertain to New Zealand, the USA and Australia.…”

“…There was an increasing number of publications over time. As shown in Table 4, health topics addressed in the reported studies were varied; however, mental health (32%) [24,27,31,32,36,37,39,[41][42][43] and substance use (19%) [16,18,21,22,28] were the two prominent issues targeted. Most sources reported studies that focused on interventions with consumers (82%), although four (18%) [24,34,36,37,39,43] sources reported the use of WBTI to support healthcare workers.…”

“…The types of WBTI described in the source publications are presented in Tables 4 and 5. The majority of the interventions used in these studies were interactive websites (n = 21, of 25 interventions in the 32 studies, 84%), providing education modules and tutorials [15, 16, 19, 22, 25-27, 29, 36], screening and assessment tools [18,21], management and monitoring tools [20,23,28,34,38], gamified avatar-based cognitive behaviour therapy (CBT) [31,32] and decision support tools [24,30]. Seven sources reported the use of mobile "apps" [17,33,39,[41][42][43]45], two sources incorporated the use of text or multimedia messaging service [35,40] and two sources studied an intervention that used a mixture of intervention tools [37,44].…”

SPARX-R computerized therapy among adolescents in youth offenders' program: Step-wise cohort study

“…Further, as the study was carried out with young people in one specific program for youth offenders in one location, generalisability is limited. However, as our research group and others have reported positive or promising findings for SPARX and SPARX-R with various populations (Fleming et al, 2012a;Lucassen et al, 2015;Merry et al, 2012;Perry et al, 2017;Shepherd et al, 2018) we consider it important to present the current results, despite having limited information as to why SPARX-R was not appealing.…”

“…In a trial of young people seeking help from primary care, school health, or school counselling, adherence to SPARX was good and satisfaction was high (Merry et al, 2012). There was high uptake of and engagement with SPARX by youth attending alternative education, including among those without symptoms of depression (Fleming et al, 2016), and high interest was reported among Māori and sexual minority youth (Shepherd et al, 2018;Lucassen et al, 2015). The program used in this study was the first iteration of revised version, SPARX-R 1.0.…”