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Article ; Online: Increasing digital mental health reach and uptake via youth partnerships.

Stiles-Shields, Colleen / Ramos, Giovanni / Ortega, Adrian / Psihogios, Alexandra M

Npj mental health research

2023 Volume 2

Abstract: Youth in the United States are facing an unprecedented mental health crisis. Yet, brick-and-mortar mental healthcare, such as face-to-face therapy, is overwhelmingly inaccessible to youth despite research advances in youth mental health. Digital Mental ... ...

Abstract	Youth in the United States are facing an unprecedented mental health crisis. Yet, brick-and-mortar mental healthcare, such as face-to-face therapy, is overwhelmingly inaccessible to youth despite research advances in youth mental health. Digital Mental Health tools (DMH), the use of technologies to deliver mental health assessments and interventions, may help to increase mental healthcare accessibility. However, for a variety of reasons, evidence-based DMH have not been successful in reaching youth in real-world settings, particularly those who are most encumbered with access barriers to mental healthcare. This Comment therefore focuses on increasing DMH reach and uptake by young people, particularly among minoritized youth, by engaging in community-based youth partnerships. This idea recognizes and grows from decades' worth of community-based participatory research and youth partnerships successfully conducted by other disciplines (e.g., social work, public health, urban planning, education). Increasing uptake and engagement is an issue that is unlikely to be solved by adult-driven theory and design. As such, we emphasize the necessity of reframing youth input into DMH design and deployment from one-time participants to integral community-based partners. Indeed, recognizing and valuing their expertise to equitably address DMH implementation challenges, youth should help to pose the very questions that they will help to answer throughout the design and implementation planning for DMH moving forward.
Language	English
Publishing date	2023-06-27
Publishing country	England
Document type	Journal Article
ISSN	2731-4251
ISSN (online)	2731-4251
DOI	10.1038/s44184-023-00030-1
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Article ; Online: An overview of and recommendations for more accessible digital mental health services.

Lattie, Emily G / Stiles-Shields, Colleen / Graham, Andrea K

Nature reviews psychology

2022 Volume 1, Issue 2, Page(s) 87–100

Abstract: Mental health concerns are common, and various evidence-based interventions for mental health conditions have been developed. However, many people have difficulty accessing appropriate mental health care and this has been exacerbated by the COVID-19 ... ...

Abstract	Mental health concerns are common, and various evidence-based interventions for mental health conditions have been developed. However, many people have difficulty accessing appropriate mental health care and this has been exacerbated by the COVID-19 pandemic. Digital mental health services, such as those delivered by mobile phone or web-based platforms, offer the possibility of expanding the reach and accessibility of mental health care. To achieve this goal, digital mental health interventions and plans for their implementation must be designed with the end users in mind. In this Review, we describe the evidence base for digital mental health interventions across various diagnoses and treatment targets. Then, we explain the different formats for digital mental health intervention delivery, and offer considerations for their use across key age groups. We discuss the role that the COVID-19 pandemic has played in emphasizing the value of these interventions, and offer considerations for ensuring equity in access to digital mental health interventions among diverse populations. As healthcare providers continue to embrace the role that technology can play in broadening access to care, the design and implementation of digital mental healthcare solutions must be carefully considered to maximize their effectiveness and accessibility.
Language	English
Publishing date	2022-01-26
Publishing country	England
Document type	Journal Article
ISSN	2731-0574
ISSN (online)	2731-0574
DOI	10.1038/s44159-021-00003-1
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Article: Median arcuate ligament syndrome: a cost analysis to determine the economic burden of a rarely diagnosed disease.

Skelly, Christopher L / Stiles-Shields, Colleen / Goldenthal, Hayley / Bohr, Nicole / Feldman, Estee / Mak, Grace Zee / Drossos, Tina

Frontiers in psychology

2024 Volume 14, Page(s) 1166744

Abstract: Background: Chronic abdominal pain (CAP) is a medical condition resulting in enormous economic burden and healthcare utilization costs. One understudied source of CAP is the median arcuate ligament syndrome (MALS). MALS is often not diagnosed and ... ...

Abstract	Background: Chronic abdominal pain (CAP) is a medical condition resulting in enormous economic burden and healthcare utilization costs. One understudied source of CAP is the median arcuate ligament syndrome (MALS). MALS is often not diagnosed and treated for a variety of reasons, including the fact that MALS is highly comorbid with psychological symptoms and psychiatric disorders similar to CAP. To better inform future work on the study of MALS, we undertook a pilot study to estimate the economic impact and public health burden of this condition. We hypothesized that MALS imposes a significant public health burden. Methods: Pediatric and adult patients enrolled in a prospective study undergoing multidisciplinary evaluation and treatment for MALS at a tertiary care facility were invited to participate in a brief self-report survey, the Direct and Indirect Medical Care Impact of MALS Form, to capture health care resources including procedures, surgeries, health care visits, and absenteeism (school and work). To estimate costs from the Direct and Indirect Medical Care Impact of MALS Form, the medical care usage data self-reported by patients were converted to dollar value utilizing FSC-93 billing data and corresponding current procedural terminology (CPT) codes for procedures and provider visits one year prior to surgery and then following surgery. Descriptive analyses were conducted to characterize the sample in terms of demographics and reported absences from school and work. Results: One hundred and nineteen patients (mean age = 30.9 ± 13.0) completed the questionnaires, yielding a 57% response rate. 82.4% ( Conclusion: Median arcuate ligament syndrome imposes a large economic burden on patients and the healthcare system. The current findings, although reflective of a homogenous population, are adding to a growing body of literature suggesting that healthcare disparities play a role in the low rates of diagnosis and treatment of MALS.
Language	English
Publishing date	2024-01-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2023.1166744
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Article ; Online: The Needle in the Haystack: Identifying Credible Mobile Health Apps for Pediatric Populations during a Pandemic and beyond.

Psihogios, Alexandra M / Stiles-Shields, Colleen / Neary, Martha

Journal of pediatric psychology

2020 Volume 45, Issue 10, Page(s) 1106–1113

Abstract: Background: The COVID-19 pandemic has ignited wider clinical adoption of digital health tools, including mobile health apps (mHealth apps), to address mental and behavioral health concerns at a distance. While mHealth apps offer many compelling benefits, ...

Abstract	Background: The COVID-19 pandemic has ignited wider clinical adoption of digital health tools, including mobile health apps (mHealth apps), to address mental and behavioral health concerns at a distance. While mHealth apps offer many compelling benefits, identifying effective apps in the crowded and largely unregulated marketplace is laborious. Consumer demand and industry productivity are increasing, although research is slower, making it challenging for providers to determine the most credible and safe apps for patients in need. Objectives/methods: This commentary offers a practical, empirically guided framework and associated resources for selecting appropriate mHealth apps for pediatric populations during the pandemic and beyond. Results: In the first stage, Narrow the target problem, end user, and contender apps. Beginning the search with continuously updated websites that contain expert app ratings can help expedite this process (e.g., Psyberguide). Second, Explore each contender app's: (a) scientific and theoretical support (e.g., are app components consistent with health behavior change theories?), (b) privacy policies, and (c) user experience (e.g., through crowdsourcing feedback about app usability and appeal via social media). Third, use clinical expertise and stakeholder feedback to Contextualize whether the selected app is a good fit for a particular patient and/or caregiver (e.g., by considering age, race/ethnicity, ability, gender, sexual orientation, technology access), including conducting a brief self-pilot of the app. Conclusion: Youth are increasingly turning to technology for support, especially during the pandemic, and pediatric psychologists must be primed to recommend the most credible tools. We offer additional recommendations for rapidly disseminating evidence-based apps to the public.
MeSH term(s)	Adolescent ; Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections/complications ; Coronavirus Infections/prevention & control ; Coronavirus Infections/psychology ; Humans ; Longitudinal Studies ; Male ; Mental Disorders/complications ; Mental Disorders/psychology ; Mental Disorders/therapy ; Mobile Applications/standards ; Pandemics/prevention & control ; Pneumonia, Viral/complications ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/psychology ; Quarantine/psychology ; SARS-CoV-2 ; Telemedicine/methods
Keywords	covid19
Language	English
Publishing date	2020-11-07
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	625329-5
ISSN	1465-735X ; 0146-8693
ISSN (online)	1465-735X
ISSN	0146-8693
DOI	10.1093/jpepsy/jsaa094
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Article ; Online: Traditional and Nontraditional Mental Healthcare Services: Usage and Preferences Among Adolescents and Younger Adults.

Cohen, Katherine A / Stiles-Shields, Colleen / Winquist, Nathan / Lattie, Emily G

The journal of behavioral health services & research

2021 Volume 48, Issue 4, Page(s) 537–553

Abstract: In recent years, nontraditional mental healthcare services and tools (e.g., mobile apps, peer counselors, online support groups) have been developed to increase access to and utilization of behavioral health services. This study investigates how ... ...

Abstract	In recent years, nontraditional mental healthcare services and tools (e.g., mobile apps, peer counselors, online support groups) have been developed to increase access to and utilization of behavioral health services. This study investigates how adolescents and younger adults use and perceive various nontraditional mental healthcare services in comparison to traditional services and in comparison to each other. A questionnaire-based study was conducted that included 203 participants between the ages of 17 and 37 (M = 25.01, SD = 5.04). Results showed that while usage rates of nontraditional mental health services were considerably high, the highest rates were reported for traditional services. Similarly, participants reported high levels of willingness to use nontraditional services, yet the highest levels of willingness were reported for traditional services. These findings suggest that the integration of nontraditional services with traditional services may be particularly impactful for young people.
MeSH term(s)	Adolescent ; Adult ; Humans ; Mental Health Services ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2021-01-20
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1419909-9
ISSN	1556-3308 ; 1094-3412
ISSN (online)	1556-3308
ISSN	1094-3412
DOI	10.1007/s11414-020-09746-w
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Zs.A 3947: Show issues

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Article ; Online: Caregiver Expressed Emotion in Families of Youth With Spina Bifida: Demographic, Medical, and Family Correlates.

Stiles-Shields, Colleen / Kritikos, Tessa K / Winning, Adrien M / Starnes, Meredith / Holmbeck, Grayson N

Journal of pediatric psychology

2022 Volume 48, Issue 2, Page(s) 144–155

Abstract: Objective: Caregiver expressed emotion (EE), an interview-based measure of emotional valence within an interpersonal relationship, is associated with psychosocial outcomes across multiple conditions. Guided by a model implicating a bidirectional role of ...

Abstract	Objective: Caregiver expressed emotion (EE), an interview-based measure of emotional valence within an interpersonal relationship, is associated with psychosocial outcomes across multiple conditions. Guided by a model implicating a bidirectional role of "Chronic Family Stress" in the unfolding of EE in family environments, the current study examined demographic, medical, and family-level variables in association with EE in caregivers of children with spina bifida (SB). Methods: Data were combined from 2 distinct studies of families with a child with SB, resulting in a sample of 174 (ages 8-17). Linear regressions examined the family stressors and child variables in association with maternal and paternal warmth and criticism, as coded from EE interviews. Results: Higher levels of family stress were associated with paternal criticism (p = .03), while having non-Hispanic White children was associated with both maternal and paternal criticism (ps < .005). Having children younger in age (ps < .01) and without a shunt (ps < .01) was associated with higher warmth. Conclusions: Family stressors, absence of the negative impacts of systemic racism, shunt status, and age appear to be associated with the expression of EE in caregivers of a child with SB. Findings highlight multiple assessment considerations, including assessing EE when children are younger to engage caregivers with children with SB when they are more likely to be expressing more warmth. Pinpointing factors associated with caregiver EE in SB will help to better identify families at risk for high levels of criticism and also aid in the development of targeted prevention and intervention programs.
MeSH term(s)	Child ; Humans ; Adolescent ; Expressed Emotion ; Caregivers/psychology ; Family/psychology ; Spinal Dysraphism/psychology ; Demography
Language	English
Publishing date	2022-09-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	625329-5
ISSN	1465-735X ; 0146-8693
ISSN (online)	1465-735X
ISSN	0146-8693
DOI	10.1093/jpepsy/jsac073
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Article ; Online: Ethical considerations for developing pediatric mhealth interventions for teens with socially complex needs.

Bounds, Dawn T / Stiles-Shields, Colleen / Schueller, Stephen M / Odgers, Candice L / Karnik, Niranjan S

Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc

2022 Volume 36, Issue 1, Page(s) 7–16

Abstract: Topic: Mobile Health (mHealth) stands as a potential means to better reach, assess, and intervene with teens with socially complex needs. These youth often face overlapping adversities including medical illness and a history of experiencing adverse ... ...

Abstract	Topic: Mobile Health (mHealth) stands as a potential means to better reach, assess, and intervene with teens with socially complex needs. These youth often face overlapping adversities including medical illness and a history of experiencing adverse childhood experiences (ACEs). Clinicians are faced with navigating ethical decisions when developing mHealth tools for teens who have socially complex needs. Many tools have been developed for adults from the general population. However, despite the development of thousands of mHealth interventions, developers tend to focus on designing for usability, engagement, and efficacy, with less attention on the ethical considerations of making such tools. Purpose: To safely move mHealth interventions from research into clinical practice, ethical standards must be met during the design phase. In this paper we adapt the Four Box Model (i.e., medical indications, preferences of patients, quality of life, and contextual features) to guide mHealth developers through ethical considerations when designing mHealth interventions for teens who present with a medical diagnosis and a history of ACEs. Sources: A review of language, inclusive features, data sharing, and usability is presented using both the Four Box Model and potential scenarios to guide each consideration. Conclusions: To better support designers of mHealth tools we present a framework for evaluating applications to determine overlap with ethical design and are well suited for use in clinical practice with underserved pediatric patients.
MeSH term(s)	Adult ; Humans ; Child ; Adolescent ; Quality of Life ; Telemedicine
Language	English
Publishing date	2022-09-22
Publishing country	England
Document type	Review ; Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1018093-x
ISSN	1744-6171 ; 1073-6077 ; 0897-9685
ISSN (online)	1744-6171
ISSN	1073-6077 ; 0897-9685
DOI	10.1111/jcap.12396
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Article ; Online: Community Teens' COVID-19 Experience: Implications for Engagement Moving Forward.

Stiles-Shields, Colleen / Reyes, Karen M / Lennan, Nia / Zhang, Jim / Archer, Joseph / Julion, Wrenetha A / Shalowitz, Madeleine U

Journal of clinical psychology in medical settings

2023 Volume 31, Issue 1, Page(s) 143–152

Abstract: Data collected from pediatric primary care settings during the pandemic suggest an increase in internalizing symptoms and disparities in care based upon minoritized identity status(es). To inform care moving forward, the current study characterized the ... ...

Abstract	Data collected from pediatric primary care settings during the pandemic suggest an increase in internalizing symptoms and disparities in care based upon minoritized identity status(es). To inform care moving forward, the current study characterized the pandemic and related technology usage experiences of teenaged pediatric patients from communities with high hardship indexes. As part of a larger mixed-methods study, 17 teens (Mean age = 15.99 ± .99) and 10 caregivers independently voiced experiences related to the pandemic during remote focus group and interview sessions. Thematic analyses were used to assess qualitative data; descriptive analyses were used to characterize qualitative data. Despite no direct queries about the pandemic, 41% of teens and 40% of caregivers described their lived experiences during the pandemic. Two subthemes emerged within the primary theme of COVID-19: (1) Wellness/Mental Health and (2) Smartphone Use and Utility. Although distress and negative effects were voiced, questionnaire data indicated normative psychosocial functioning for both teen self-report and caregiver proxy report. Informed by the voiced experiences of teens and their caregivers from communities with high hardship indexes, methods for better assessing and managing internalizing symptoms in teen patients are presented. A multi-modal and multi-informant approach that leverages technology to garner information about teens' experiences and deliver care may help improve the well-being of teens in communities systemically burdened with disparities.
MeSH term(s)	Humans ; Child ; Adolescent ; COVID-19 ; Focus Groups ; Surveys and Questionnaires ; Self Report
Language	English
Publishing date	2023-10-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1235893-9
ISSN	1573-3572 ; 1068-9583
ISSN (online)	1573-3572
ISSN	1068-9583
DOI	10.1007/s10880-023-09975-z
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Zs.A 4286: Show issues

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Article ; Online: Health behaviors and disordered eating in adolescents and young adults with spina bifida: results from a national survey.

Stiles-Shields, Colleen / Holmbeck, Grayson N

Disability and rehabilitation

2019 Volume 42, Issue 20, Page(s) 2910–2916

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Adolescent ; Body Image ; Body Weight ; Feeding and Eating Disorders/epidemiology ; Female ; Health Behavior ; Humans ; Male ; Spinal Dysraphism/complications ; Spinal Dysraphism/epidemiology ; Young Adult
Language	English
Publishing date	2019-04-12
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1104775-6
ISSN	1464-5165 ; 0963-8288
ISSN (online)	1464-5165
ISSN	0963-8288
DOI	10.1080/09638288.2019.1575483
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Article ; Online: Benefit-finding among young adults with spina bifida.

Kritikos, Tessa K / Stiles-Shields, Colleen / Shapiro, Jenna B / Holmbeck, Grayson N

Journal of health psychology

2021 Volume 27, Issue 5, Page(s) 1176–1186

Abstract: The purpose of the current study was to examine benefit-finding in a sample of young adults with SB and assess relationships between demographic and medical variables and benefit-finding. Young adults with SB ( ...

Abstract	The purpose of the current study was to examine benefit-finding in a sample of young adults with SB and assess relationships between demographic and medical variables and benefit-finding. Young adults with SB (
MeSH term(s)	Employment ; Humans ; Interpersonal Relations ; Self Report ; Spinal Dysraphism/complications ; Spinal Dysraphism/psychology ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2021-02-04
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2021897-7
ISSN	1461-7277 ; 1359-1053
ISSN (online)	1461-7277
ISSN	1359-1053
DOI	10.1177/1359105321990804
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