Mobilizing Minds: Integrated knowledge translation and youth engagement in the development of mental health information resources

High rates of highly persistent mental health problems can have significantly damaging effects on young adults’ lives, and young adults are less likely to seek treatment for such problems. This article describes a unique Canadian knowledge translation project called Mobilizing Minds: Pathways to Young Adult Mental Health, which aimed to impact not only the mental health literacy of young adults, but to engage young adults in the entire research process from inception to dissemination of results. Knowledge translation is a process that involves producing and assessing the quality of the knowledge to be translated and tailoring the knowledge to be user friendly for particular segments of the population. The article gives particular attention to the ways in which the Mobilizing Minds project was influenced by youth engagement. We discuss three aspects: 1) structures, processes and communication; 2) project products; and 3) challenges and responses. Lessons learned specific to intergenerational collaboration will be of interest to youth as consumers of mental health information and services, mental health practitioners, researchers, and decision-makers seeking to improve mental health at a systemic level.Keywords: knowledge translation, young adult, mental health, participatory research, youth engagement, youth-adult partnership

How Do Young Adults Prefer to Access Mental Health Information?

KT strategies for sharing mental health information need to include both active and passive options for young adults. This includes the use of both old and new media tools.York’s Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c

Les besoins d’information des étudiants postsecondaires et les parcours conçus pour réduire le stress, l’anxiété, et la dépression

 Surveys indicate that prevalence rates of depression, anxiety, and other disorders in postsecondary students are equal to or higher than those in the general population; however, students often do not access help for these problems. Moreover, those who do seek help are confronted by a range of choices involving psychological, pharmacological, or combined treatment, along with multiple sources of information regarding treatment options. In an effort to identify the information needs and preferences of Canadian university students, we conducted a survey of students seeking counselling or medical services on campus. Results indicated that students were more likely to initially seek advice from romantic partners or friends rather than counsellors or health care providers. When asked to consider what information is important when seeking help, students reported that treatment effectiveness, advantages/disadvantages of treatment, side effects, and what happens when treatment is stopped were all very important. Training and experience of service providers were seen as more important than providers’ recommendations for type of treatment. Meetings with a counsellor were preferred over medication as a treatment modality. Preferred sources of information included health care providers, information sheets, and the Internet. Implications of the survey for postsecondary mental health service delivery are discussed. Selon les sondages, les taux de prévalence de la dépression, de l’anxiété, et d’autres troubles chez les étudiants postsecondaires sont équivalents ou plus élevés que dans la population en général, et pourtant, dans bien des cas, ces jeunes n’ont pas recours à de l’aide pour ces problèmes. De plus, ceux et celles qui se décident à chercher de l’aide doivent choisir parmi une gamme de services qui va du traitement psychologique, en passant par la pharmacologie ou une combinaison des deux, ainsi que de multiples sources de renseignements au sujet des options de traitement. Afin de définir les besoins et préférences des étudiants postsecondaires canadiens en matière d’information, nous avons mené un sondage auprès d’étudiants à la recherche de services de counseling ou médicaux sur le campus. Les résultats indiquent que les étudiants sont plus susceptibles de rechercher, dans un premier temps, l’avis de partenaires de coeur ou d’amis plutôt qu’auprès d’un conseiller ou d’un fournisseur de soins de santé. Lorsqu’on leur a demandé de réfléchir au type de renseignements qu’ils jugeaient importants dans leur recherche d’aide, les étudiants ont répondu que l’efficacité du traitement, les avantages et inconvénients qu’il comporte, ses effets secondaires, et ce qui advient à la fin du traitement sont tous des aspects très importants. Ils considéraient aussi la formation et l’expérience des fournisseurs de services des facteurs plus importants que les recommandations de ces fournisseurs concernant le type de traitement. Comme mode de traitement, les étudiants ont dit préférer les rencontres avec un conseiller plutôt que la médication. Parmi les sources de renseignements privilégiées sont les fournisseurs de soins de santé, les fiches de renseignements, et Internet. L’article présente une discussion des implications du sondage pour la prestation de services de soins de santé mentale chez les clients au niveau postsecondaire

Acute HIV Infection in Youth: Protocol for the Adolescent Trials Network 147 (ATN147) Comprehensive Adolescent Research and Engagement Studies (CARES) Study.

BackgroundEarly treatment studies have shown that prompt treatment of HIV with combination antiretroviral therapy (cART) can limit the size of latent viral reservoirs, thereby providing clinical and public health benefits. Studies have demonstrated that adolescents have a greater capacity for immune reconstitution than adults. Nevertheless, adolescents who acquired HIV through sexual transmission have not been included in early treatment studies because of challenges in identification and adherence to cART.ObjectiveThis study aimed to identify and promptly treat with cART youth aged 12 to 24 years in Los Angeles and New Orleans who have acute, recent, or established HIV infection, as determined by Fiebig stages 1 to 6 determined by viral RNA polymerase chain reaction, p24 antigen presence, and HIV-1 antigen Western blot. The protocol recommends treatment on the day of diagnosis when feasible. Surveillance and dedicated behavioral strategies are used to retain them in care and optimize adherence. Through serial follow-up, HIV biomarkers and response to antiretroviral therapy (ART) are assessed. The study aims to assess viral dynamics, decay and persistence of viral reservoirs over time, and correlate these data with the duration of viral suppression.MethodsA total of 72 youth (36 acutely infected and 36 treatment naïve controls) are enrolled across clinical sites using a current community-based strategy and direct referrals. Youth are prescribed ART according to the standard of care HIV-1 management guidelines and followed for a period of 2 years. Assessments are conducted at specific time points throughout these 2 years of follow-up for monitoring of adherence to ART, viral load, magnitude of HIV reservoirs, and presence of coinfections.ResultsThe study began enrolling youth in July 2017 across study sites in Los Angeles and New Orleans. As of September 30, 2018, a total of 37 youth were enrolled, 12 with recently acquired, 16 with established HIV infection as determined by Fiebig staging, and 9 pending determination of Fiebig status. Recruitment and enrollment are ongoing.ConclusionsWe hypothesize that the size of the HIV reservoir and immune activation markers will be different across groups treated with cART, that is, those with acute or recent HIV infection and those with established infection. Adolescents treated early who are virally suppressed will have diminished HIV reservoirs than those with established infection. These youth may be potential candidates for a possible HIV vaccine and additional HIV remission intervention trials. Our study will inform future studies of viral remission strategies.International registered report identifier (irrid)DERR1-10.2196/10807

Acute HIV Infection in Youth: Protocol for the Adolescent Trials Network 147 (ATN147) Comprehensive Adolescent Research and Engagement Studies (CARES) Study.

BackgroundEarly treatment studies have shown that prompt treatment of HIV with combination antiretroviral therapy (cART) can limit the size of latent viral reservoirs, thereby providing clinical and public health benefits. Studies have demonstrated that adolescents have a greater capacity for immune reconstitution than adults. Nevertheless, adolescents who acquired HIV through sexual transmission have not been included in early treatment studies because of challenges in identification and adherence to cART.ObjectiveThis study aimed to identify and promptly treat with cART youth aged 12 to 24 years in Los Angeles and New Orleans who have acute, recent, or established HIV infection, as determined by Fiebig stages 1 to 6 determined by viral RNA polymerase chain reaction, p24 antigen presence, and HIV-1 antigen Western blot. The protocol recommends treatment on the day of diagnosis when feasible. Surveillance and dedicated behavioral strategies are used to retain them in care and optimize adherence. Through serial follow-up, HIV biomarkers and response to antiretroviral therapy (ART) are assessed. The study aims to assess viral dynamics, decay and persistence of viral reservoirs over time, and correlate these data with the duration of viral suppression.MethodsA total of 72 youth (36 acutely infected and 36 treatment naïve controls) are enrolled across clinical sites using a current community-based strategy and direct referrals. Youth are prescribed ART according to the standard of care HIV-1 management guidelines and followed for a period of 2 years. Assessments are conducted at specific time points throughout these 2 years of follow-up for monitoring of adherence to ART, viral load, magnitude of HIV reservoirs, and presence of coinfections.ResultsThe study began enrolling youth in July 2017 across study sites in Los Angeles and New Orleans. As of September 30, 2018, a total of 37 youth were enrolled, 12 with recently acquired, 16 with established HIV infection as determined by Fiebig staging, and 9 pending determination of Fiebig status. Recruitment and enrollment are ongoing.ConclusionsWe hypothesize that the size of the HIV reservoir and immune activation markers will be different across groups treated with cART, that is, those with acute or recent HIV infection and those with established infection. Adolescents treated early who are virally suppressed will have diminished HIV reservoirs than those with established infection. These youth may be potential candidates for a possible HIV vaccine and additional HIV remission intervention trials. Our study will inform future studies of viral remission strategies.International registered report identifier (irrid)DERR1-10.2196/10807