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  1. Article: Editorial: Control alt delete - technology and children's mental health.

    Thabrew, Hiran / Gega, Lina

    Child and adolescent mental health

    2023  Volume 28, Issue 1, Page(s) 1–3

    Abstract: With international contributions from Denmark, Peru, Italy, Turkey, Estonia, Russia, Canada, the USA, Australia and the UK, this special issue offers insights and evidence about the technology's ability to act as a force of good and a source of harm for ... ...

    Abstract With international contributions from Denmark, Peru, Italy, Turkey, Estonia, Russia, Canada, the USA, Australia and the UK, this special issue offers insights and evidence about the technology's ability to act as a force of good and a source of harm for young people's mental health. As we better understand the complex and bidirectional relationship between technology and mental health, we need to move beyond dichotomous narratives about it being good or bad; it is both, depending on how it is used. Collective responsibility across technology companies, researchers, public services and community organisations, parents and the young people themselves can make a difference in the way technology is used to protect and improve mental health.
    MeSH term(s) Humans ; Child ; Adolescent ; Mental Health ; Child Health ; Parents ; Italy ; Estonia
    Language English
    Publishing date 2023-01-13
    Publishing country England
    Document type Editorial
    ZDB-ID 2073663-0
    ISSN 1475-3588 ; 1475-357X
    ISSN (online) 1475-3588
    ISSN 1475-357X
    DOI 10.1111/camh.12631
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Family Systems Training for Medical Students.

    Thabrew, Hiran

    Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists

    2018  Volume 26, Issue 5, Page(s) 541–544

    Abstract: Objectives: To evaluate whether a workshop on family systems delivered to medical students could improve participants' understanding of families from a systemic point of view and help them recognise and address systemic issues that may be affecting ... ...

    Abstract Objectives: To evaluate whether a workshop on family systems delivered to medical students could improve participants' understanding of families from a systemic point of view and help them recognise and address systemic issues that may be affecting their patients.
    Method: Fifth year (senior) medical students ( n = 36) from the University of Auckland participated in a 90-min workshop about family systems. Pre- and post-workshop, self-reported measures of knowledge and confidence were completed and qualitative feedback was also obtained from participants.
    Results: The workshop was well received and its interactive and role-play based nature were particularly appreciated. Participants reported gains in all explored areas of knowledge and understanding, suggesting that the workshop met its desired aims.
    Conclusions: This workshop is an educationally effective and expedient way to equip medical students with some knowledge and understanding about family systems. It may benefit their future work with individual patients and families.
    MeSH term(s) Adult ; Curriculum ; Education/methods ; Education, Medical, Undergraduate/methods ; Family ; Female ; Humans ; Male ; Students, Medical ; Systems Theory ; Young Adult
    Language English
    Publishing date 2018-05-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2213198-X
    ISSN 1440-1665 ; 1039-8562
    ISSN (online) 1440-1665
    ISSN 1039-8562
    DOI 10.1177/1039856218771506
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The role of gamification in digital mental health.

    Fleming, Theresa / Poppelaars, Marlou / Thabrew, Hiran

    World psychiatry : official journal of the World Psychiatric Association (WPA)

    2023  Volume 22, Issue 1, Page(s) 46–47

    Language English
    Publishing date 2023-01-14
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2236130-3
    ISSN 2051-5545 ; 1723-8617
    ISSN (online) 2051-5545
    ISSN 1723-8617
    DOI 10.1002/wps.21041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Acceptability and Feasibility of "Village," a Digital Communication App for Young People Experiencing Low Mood, Thoughts of Self-harm, and Suicidal Ideation to Obtain Support From Family and Friends: Mixed Methods Pilot Open Trial.

    Thabrew, Hiran / Kumar, Harshali / Steadman, Evandah

    JMIR formative research

    2023  Volume 7, Page(s) e41273

    Abstract: Background: Young people experiencing low mood, thoughts related to self-harm, and suicidal ideation often struggle to communicate their emotions and receive timely support from family and friends. Technologically delivered support interventions may be ... ...

    Abstract Background: Young people experiencing low mood, thoughts related to self-harm, and suicidal ideation often struggle to communicate their emotions and receive timely support from family and friends. Technologically delivered support interventions may be useful in addressing this need.
    Objective: This paper aimed to evaluate the acceptability and feasibility of "Village," a communication app co-designed with young people and their family and friends from New Zealand.
    Methods: A mixed methods pilot open trial design was adopted. Participants were primarily recruited via social media advertisements and clinicians in specialist mental health services over an 8-month period. The primary outcomes were acceptability of the app (via thematically analyzed qualitative feedback and retention rates) and feasibility of conducting a larger randomized controlled trial gauged via effectiveness of recruitment methods, completion of chosen outcome measures, and occurrence of unanticipated operational issues. Secondary outcomes were app usability, safety, and changes in symptoms of depression (via the Patient Health Questionnaire-9 modified for adolescents), suicidal ideation (on the Suicidal Ideation Questionnaire), and functioning (using the World Health Organization Disability Assessment Schedule 2.0 or Child and Youth version).
    Results: A total of 26 young people ("users") were enrolled in the trial, of which 21 recruited friends and family members ("buddies") and completed quantitative outcome measures at baseline, 4 weeks, and 3 months. Furthermore, 13 users and 12 buddies also provided qualitative feedback about the app, identifying the key themes of appeal of app features and layout, usefulness of its content, and technological challenges (primarily with onboarding and notifications). Users gave Village a mean rating of 3.8 (range 2.7-4.6) out of 5 on a 5-point scale for app quality and an overall star rating of 3.4 out of 5 for subjective quality. Within this limited sample, users reported a clinically significant reduction in depressive symptoms (P=.007), but nonsignificant changes in suicidal ideation and functioning. The embedded risk detection software was activated on 3 occasions, and no additional support was required for users.
    Conclusions: During this open trial, Village was found to be acceptable, usable, and safe. The feasibility of a larger randomized controlled trial was also confirmed after some modifications to the recruitment strategy and app.
    Trial registration: Australian New Zealand Clinical Trials Network Registry ACTRN12620000241932p; https://tinyurl.com/ya6t4fx2.
    Language English
    Publishing date 2023-03-13
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/41273
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Zebras in the Forest: the experiences of Dual-Trained Child Psychiatrists and Paediatricians in Australia and New Zealand.

    Thabrew, Hiran

    Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists

    2016  Volume 24, Issue 6, Page(s) 578–582

    Abstract: Objectives: The objectives of this study were to examine the experiences of dual-trained child psychiatrists and paediatricians in Australia and New Zealand and inform the review of the Dual Fellowship Training Programme by the Royal Australian and New ... ...

    Abstract Objectives: The objectives of this study were to examine the experiences of dual-trained child psychiatrists and paediatricians in Australia and New Zealand and inform the review of the Dual Fellowship Training Programme by the Royal Australian and New Zealand College of Psychiatrists and Royal Australasian College of Physicians.
    Methods: All dual-trained child psychiatrists and paediatricians and current trainees were electronically surveyed in 2015.
    Results: Seven out of eight specialists (88%) and four out of six trainees (67%) responded. Six (55%) completed or were undertaking training as part of the Dual Fellowship Training Programme. Most respondents entered dual training without difficulty, found the transition from paediatrics to adult psychiatry challenging, and were reassured by their decision to undertake dual training on reaching advanced training in child psychiatry. Benefits and downsides of dual training were noted during and following training. A significant proportion of specialists (55%) were working in hospital-based environments, especially consult liaison services, suggesting that they added long-term value to both the fields of child psychiatry and paediatrics.
    Conclusions: The Dual Fellowship Training Programme remains a valuable vehicle for gaining skills in paediatrics and child psychiatry. There is support for its continuation by previous and current participants.
    Language English
    Publishing date 2016-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2213198-X
    ISSN 1440-1665 ; 1039-8562
    ISSN (online) 1440-1665
    ISSN 1039-8562
    DOI 10.1177/1039856216665280
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Young people don't tend to ask for help more than once: Child and adolescent psychiatrists' views on ailing mental health services for young New Zealanders.

    Every-Palmer, Susanna / Grant, Marion L / Thabrew, Hiran

    Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists

    2022  Volume 30, Issue 6, Page(s) 684–688

    Abstract: Objectives: To explore the views of New Zealand doctors working in child and adolescent psychiatry regarding the state of public mental health services.: Methods: All practicing child and adolescent psychiatrists/advanced trainees were electronically ...

    Abstract Objectives: To explore the views of New Zealand doctors working in child and adolescent psychiatry regarding the state of public mental health services.
    Methods: All practicing child and adolescent psychiatrists/advanced trainees were electronically surveyed in August 2021. Quantitative and qualitative analysis of feedback was undertaken.
    Results: Almost 100 specialists responded, an 80% response rate. High levels of dissatisfaction with current services and future service plans were identified. Content analysis identified an overarching theme that child and adolescent services were under great pressure, with subthemes of increased demand, a stretched workforce and social issues driving complex presentations. Recommendations were made for addressing workforce, service design and wider issues.
    Conclusions: Multiple measures are needed to improve currently ailing child mental health services, including urgently expanding the number of psychiatrists and other clinical staff.
    MeSH term(s) Child ; Adolescent ; Humans ; New Zealand ; Psychiatry ; Mental Health Services ; Adolescent Psychiatry ; Workforce
    Language English
    Publishing date 2022-08-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2213198-X
    ISSN 1440-1665 ; 1039-8562
    ISSN (online) 1440-1665
    ISSN 1039-8562
    DOI 10.1177/10398562221115624
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Immersive Reality Experience Technology for Reducing Social Isolation and Improving Social Connectedness and Well-being of Children and Young People Who Are Hospitalized: Open Trial.

    Thabrew, Hiran / Chubb, Laura A / Kumar, Harshali / Fouché, Christa

    JMIR pediatrics and parenting

    2022  Volume 5, Issue 1, Page(s) e29164

    Abstract: Background: Children and young people who are hospitalized can feel disconnected from their peers and families, which can, in turn, predispose them to psychological problems, including anxiety and depression. Immersive reality experience technology, ... ...

    Abstract Background: Children and young people who are hospitalized can feel disconnected from their peers and families, which can, in turn, predispose them to psychological problems, including anxiety and depression. Immersive reality experience technology, recently developed by the New Zealand Patience Project Charitable Trust, may help to overcome these issues. Immersive reality experience technology uses immersive 360° live streaming and a virtual reality headset to enable children and young people who are hospitalized to connect through cameras located in either their school or home environment and via SMS text messaging with a designated buddy.
    Objective: This trial aims to expand qualitative findings from a previous smaller proof of concept trial to ascertain the views of New Zealand children and young people who are hospitalized, their caregivers, and teachers regarding immersive reality experience technology and quantitatively evaluate the effectiveness of immersive reality experience technology in reducing social isolation and improving social connectedness and well-being using validated outcome measures.
    Methods: An open trial of immersive reality experience technology was conducted between December 2019 and December 2020 for which 19 New Zealand children and young people aged 13 to 18 years who had been hospitalized at Starship Hospital-a specialist pediatric hospital in Auckland-for at least 2 weeks were recruited. All young people completed the Short Warwick-Edinburgh Mental Well-Being Scale, an abbreviated version of the Social Connectedness Scale, and the Social Inclusion Scale at baseline. Of the 19 participants, 10 (53%) used immersive reality experience technology as often as they wished over a 6-week period and completed postintervention measures. Semistructured interviews with a subset of the 10 young people, 4 caregivers, and 6 teachers were conducted immediately after the intervention.
    Results: Participants reported improvements in social inclusion (mean change 3.9, SD 2.8; P=.06), social connectedness (mean change 14.2, SD 10.0; P=.002), and well-being (mean change 5.7, SD 4.0; P=.001). Key themes from interviews with participants, caregivers, and teachers were the importance of support for using immersive reality experience technology, connecting versus connectedness, choice and connection, and the value of setting it up and getting it right. Recommendations for improving connectedness via immersive reality experience and related technologies were also provided.
    Conclusions: Immersive reality experience technology can improve the social inclusion, social connectedness, and well-being of New Zealand children and young people who are hospitalized. With some technological modifications and simplified implementation, immersive reality experience and related technology could become part of standard care and support children and young people who are hospitalized in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems, and more easily return to normal life following the completion of treatment.
    Trial registration: Australian New Zealand Clinical Trials Network Registry ACTRN12619000252112; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376837&isReview=true.
    Language English
    Publishing date 2022-03-25
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-6722
    ISSN (online) 2561-6722
    DOI 10.2196/29164
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Youth version, Case-finding and Help Assessment Tool (YouthCHAT): An electronic, psychosocial screener for young people with long-term physical conditions.

    Thabrew, Hiran / Goodyear-Smith, Felicity

    Journal of paediatrics and child health

    2019  Volume 56, Issue 1, Page(s) 102–106

    Abstract: Aim: This study investigated the acceptability, clinical utility and preliminary effectiveness of Youth version, Case-finding and Help Assessment Tool (YouthCHAT), a novel electronic, tablet-based screener designed to identify issues similar to Home, ... ...

    Abstract Aim: This study investigated the acceptability, clinical utility and preliminary effectiveness of Youth version, Case-finding and Help Assessment Tool (YouthCHAT), a novel electronic, tablet-based screener designed to identify issues similar to Home, Education/Employment, Activity, Drugs, Sexuality, Suicide/Depression, Safety assessment.
    Methods: YouthCHAT was administered to a group of 30 young people aged 13-17 years with different long-term physical conditions attending outpatient clinics between September and December 2017. Outcome measures were: (i) acceptability and feasibility of YouthCHAT as assessed via feedback from young people and clinicians and the time taken to complete YouthCHAT screening; and (ii) detection rates for each domain of YouthCHAT measured by mental health or life-style issues 'present' or 'absent', and where relevant, validated symptom scores.
    Results: YouthCHAT was quick to administer and positively received by both young people and clinicians. Rates of anxiety (37%) and depression (13%) detected using YouthCHAT were similar to those in previous studies of young people with long-term physical conditions. Rates of other problems were similar to a previously screened high school sample.
    Conclusions: YouthCHAT is a viable and acceptable psychosocial screener with the potential to improve the holistic care of young people with long-term physical conditions attending outpatient clinics.
    Trial registration: This study has been registered with the Australian New Zealand Clinical Trials Network Registry ACTRN12616001243404p.
    MeSH term(s) Adolescent ; Anxiety ; Anxiety Disorders ; Australia ; Electronics ; Humans ; Mental Health
    Language English
    Publishing date 2019-05-29
    Publishing country Australia
    Document type Clinical Study ; Journal Article
    ZDB-ID 1024476-1
    ISSN 1440-1754 ; 1034-4810
    ISSN (online) 1440-1754
    ISSN 1034-4810
    DOI 10.1111/jpc.14503
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Exploring the Usability and Acceptability of a Well-Being App for Adolescents Living With Type 1 Diabetes: Qualitative Study.

    Garner, Katie / Thabrew, Hiran / Lim, David / Hofman, Paul / Jefferies, Craig / Serlachius, Anna

    JMIR pediatrics and parenting

    2023  Volume 6, Page(s) e52364

    Abstract: Background: Adolescents living with either type 1 diabetes (T1D) or type 2 diabetes (T2D) have an increased risk of psychological disorders due to the demands of managing a chronic illness and the challenges of adolescence. Psychological disorders ... ...

    Abstract Background: Adolescents living with either type 1 diabetes (T1D) or type 2 diabetes (T2D) have an increased risk of psychological disorders due to the demands of managing a chronic illness and the challenges of adolescence. Psychological disorders during adolescence increase the risk of suboptimal glycemic outcomes and may lead to serious diabetes-related complications. Research shows that digital health interventions may increase access to psychological support for adolescents and improve physical and mental health outcomes for youth with diabetes. To our knowledge, there are no evidence-based, publicly available mental health apps with a focus on improving the psychological well-being of adolescents with diabetes.
    Objective: This study aimed to explore the acceptability and usability of our evidence-based well-being app for New Zealand adolescents, Whitu: 7 Ways in 7 Days (Whitu), to allow us to further tailor it for youth with diabetes. We interviewed adolescents with T1D and T2D, their parents, and health care professionals to explore their views on the Whitu app and suggestions for tailoring the app for adolescent with diabetes. We also explored the cultural acceptability of the Whitu app for Māori and Pacific adolescents.
    Methods: A total of 34 participants, comprising 13 adolescents aged 12-16 years (11 with T1D and 2 with T2D), 10 parents, and 11 health care professionals, were recruited from a specialist diabetes outpatient clinic and Facebook diabetes groups. Each participant attended one 1-hour focus group on Zoom, in person, or via phone. Researchers gathered general feedback on what makes an effective and engaging app for adolescents with diabetes, as well as specific feedback about Whitu. Transcribed audio recordings of the focus groups were analyzed using directed content analysis.
    Results: Adolescents with T1D, their parents, and health care professionals found Whitu to be acceptable and usable. Adolescents with T1D and their parents signaled a preference for more diabetes-specific content. Health care professionals expressed less awareness and trust of digital health interventions and, as such, recommended that they be used with external support. Due to challenges in recruitment and retention, we were unable to include the views of adolescents with T2D in this qualitative study.
    Conclusions: There appears to be sufficient openness to the use of an app such as Whitu for supporting the well-being of adolescents with T1D, albeit with modifications to make its content more diabetes specific. Based on this qualitative study, we have recently developed a diabetes-specific version of Whitu (called LIFT: Thriving with Diabetes). We are also planning a qualitative study to explore the views of youth with T2D and their perspectives on the new LIFT app, where we are using alternative research approaches to recruit and engage adolescents with T2D and their families.
    Language English
    Publishing date 2023-12-22
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-6722
    ISSN (online) 2561-6722
    DOI 10.2196/52364
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Identifying neurodevelopmental disabilities from nationalised preschool health check.

    Mujoo, Himang / Bowden, Nicholas / Thabrew, Hiran / Kokaua, Jesse / Audas, Richard / Taylor, Barry

    The Australian and New Zealand journal of psychiatry

    2023  Volume 57, Issue 8, Page(s) 1140–1149

    Abstract: Objective: Models of psychometric screening to identify individuals with neurodevelopmental disabilities (NDDs) have had limited success. In Aotearoa/New Zealand, routine developmental surveillance of preschool children is undertaken using the Before ... ...

    Abstract Objective: Models of psychometric screening to identify individuals with neurodevelopmental disabilities (NDDs) have had limited success. In Aotearoa/New Zealand, routine developmental surveillance of preschool children is undertaken using the Before School Check (B4SC), which includes psychometric and physical health screening instruments. This study aimed to determine whether combining multiple screening measures could improve the prediction of NDDs.
    Methods: Linked administrative health data were used to identify NDDs, including attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability, within a multi-year national cohort of children who undertook the B4SC. Cox proportional hazards models, with different combinations of potential predictors, were used to predict onset of a NDD. Harrell's c-statistic for composite models were compared with a model representing recommended cutoff psychometric scores for referral in New Zealand.
    Results: Data were examined for 287,754 children, and NDDs were identified in 10,953 (3.8%). The best-performing composite model combining the Strengths and Difficulties Questionnaire, the Parental Evaluation of Developmental Status, vision screening and biological sex had 'excellent' predictive power (C-statistic: 0.83) compared with existing referral pathways which had 'poor' predictive power (C-statistic: 0.68). In addition, the composite model was able to improve the sensitivity of NDD diagnosis detection by 13% without any reduction in specificity.
    Conclusions: Combination of B4SC screening measures using composite modelling could lead to significantly improved identification of preschool children with NDDs when compared with surveillance that rely on individual psychometric test results alone. This may optimise access to academic, personal and family support for children with NDDs.
    MeSH term(s) Humans ; Child, Preschool ; Autism Spectrum Disorder/diagnosis ; Autism Spectrum Disorder/epidemiology ; Attention Deficit Disorder with Hyperactivity/diagnosis ; Attention Deficit Disorder with Hyperactivity/epidemiology ; Schools ; Educational Status ; New Zealand/epidemiology
    Language English
    Publishing date 2023-02-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 221140-3
    ISSN 1440-1614 ; 0004-8674
    ISSN (online) 1440-1614
    ISSN 0004-8674
    DOI 10.1177/00048674231151606
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