The Design and Relevance of a Computerized Gamified Depression Therapy Program for Indigenous Māori Adolescents

Abstract

BackgroundDepression is a major health issue among Māori indigenous adolescents, yet there has been little investigation into the relevance or effectiveness of psychological treatments for them. Further, consumer views are critical for engagement and adherence to therapy. However, there is little research regarding indigenous communities’ opinions about psychological interventions for depression.ObjectiveThe objective of this study was to conduct semistructured interviews with Māori (indigenous New Zealand) young people (taitamariki) and their families to find out their opinions of a prototype computerized cognitive behavioral therapy (cCBT) program called Smart, Positive, Active, Realistic, X-factor thoughts (SPARX), a free online computer game intended to help young persons with mild to moderate depression, feeling down, stress or anxiety. The program will teach them how to resolve their issues on their own using Cognitive Behavioural Therapy as psychotherapeutic approach. MethodsThere were seven focus groups on the subject of the design and cultural relevance of SPARX that were held, with a total of 26 participants (19 taitamarki, 7 parents/caregivers, all Māori). There were five of the groups that were with whānau (family groups) (n=14), one group was with Māori teenage mothers (n=4), and one group was with taitamariki (n=8). The general inductive approach was used to analyze focus group data.ResultsSPARX computerized therapy has good face validity and is seen as potentially effective and appealing for Māori people. Cultural relevance was viewed as being important for the engagement of Māori young people with SPARX. Whānau are important for young peoples’ well-being. Participants generated ideas for improving SPARX for Māori and for the inclusion of whānau in its delivery.ConclusionsSPARX computerized therapy had good face validity for indigenous young people and families. In general, Māori participants were positive about the SPARX prototype and considered it both appealing and applicable to them. The results of this study were used to refine SPARX prior to it being delivered to taitamariki and non-Māori young people.Trial RegistrationThe New Zealand Northern Y Regional Ethics Committee; http://ethics.health.govt.nz/home; NTY/09/003; (Archived by WebCite at http://www.webcitation/6VYgHXKaR).

Computer-Based and Online Therapy for Depression and Anxiety in Children and Adolescents

“…effective and acceptable to M aori young people and was acceptable to the families, although the families would have preferred a less individually focused approach, and emphasized the need to consider families in interventions for indigenous cultures (Shepherd et al 2015). SPARX has also been adapted for sexual minority youth (Rainbow SPARX) (Lucassen et al 2013(Lucassen et al , 2015a and has shown some evidence of effectiveness and acceptability in a small open trial (Lucassen et al 2015b).…”

Game for health: How eHealth approaches might address the psychological needs of children and young people with long‐term physical conditions

“…To our knowledge, this is the first study to investigate the eHealth-related needs of children, young people, families and clinicians living or working with long-term physical conditions. It adds to the existing viewpoints on eHealth interventions of subgroups of young people, including those with depression, [29][30][31][32] those from indigenous communities 33 and those of sexual minority. 34,35 The multiple perspectives collected during this study offer a rich dataset from which commonly and disparately relevant issues can be identified for the benefit of developers of future eHealth interventions for children and young people with long-term physical conditions.…”

Evaluation of existing experimental evidence for treatment of depression in indigenous populations: A systematic review

“…Furthermore, while some trials used psycho-educational components, no trials used narrative or interpersonal psychotherapy. Our systematic search identified a qualitative study (Shepherd et al, 2015) looking at the potential of using a computerised gamified depression therapy for Maori adolescents. Incorporating validated screening tools, or cultural adaptations of psychometric tools (Brown et al, 2013) to determine reductions in depressive symptoms should be a common practice in studies focusing on mental health of Indigenous people, to allow results of trials to be compared to trials focusing on depression in general population.…”

“…Incorporating validated screening tools, or cultural adaptations of psychometric tools (Brown et al, 2013) to determine reductions in depressive symptoms should be a common practice in studies focusing on mental health of Indigenous people, to allow results of trials to be compared to trials focusing on depression in general population. Our systematic search identified a qualitative study (Shepherd et al, 2015) looking at the potential of using a computerised gamified depression therapy for Maori adolescents. This innovative study targets depression using CBT and may provide new ways to prevent depression in Indigenous youth.…”