Developing an innovative standardised image-based measure of adolescent mental health
Lead Research Organisation:
University College London
Department Name: Division of PALS
Abstract
The main way we find out about people's mental health is through written questionnaires. This means we do not hear the voices of certain groups, such as those with literacy or educational needs, neurodivergent people, and those with English as an additional language. These questionnaires have often been developed with White populations, meaning they may be less appropriate for people from Black and minoritized ethnic groups.
Image-based measures may address some of these problems. These measures use images to convey information when asking questions, let people respond using images, or use images both to convey information and for responses. One example could be using a sliding scale to select between dynamic images of different weathers to represent different emotional states. There is no widely used image-based questionnaire for adolescent mental health.
Our aim is to increase the inclusivity of mental health questionnaires. We will develop a digital image-based questionnaire for young people 8 to 18 years. There are 3 stages to our project.
1. We will look at existing image-based mental health questionnaires, so that we have examples to start conversations in the next stage.
2. We will work with a diverse group of 8 to 10 young people with lived experience of mental health difficulties. They will be co-researchers, meaning they will lead the research and take part in it. Over 6 workshops, we will co-develop the content and design of the image-based questionnaire, before testing and refining a prototype. We will provide training and ongoing support for the co-researchers. From the outset, we will discuss their goals of being involved, how they would like to be involved, and any support needs.
At the start of this stage, we will speak to groups of young people, researchers, and practitioners to understand what they would like from an image-based questionnaire. We will speak to them again during co-development for their feedback on the questionnaire.
3. We will speak to 12 to 15 young people to hear their feedback on the questionnaire when it is nearly finished. We will also ask them to complete it, thinking aloud as they do so we can understand in detail how they interpret the questionnaire and what drives their responses.
The main output will be a version of the questionnaire that can be used in a larger study, called the Adolescent Health Study, so that it can be fully tested. The questionnaire and our research materials will be freely available so other people can use it and repeat the study to develop similar questionnaires for other topics.
We aim to empower young people to be able to lead the research. The involvement of co-researchers will provide an opportunity to gain research experience for young people from groups that experience additional barriers to research careers. Our project has been designed based on our rich experience of patient and public involvement to ensure young people lead the decisions and conduct of the research. We will also work with a young person peer researcher who will be trained and supported to be involved in all stages and decisions of the project.
This project will mean that in the future, we will be better able to understand the mental health of all young people, including those from groups who voice is seldom heard in research.
Image-based measures may address some of these problems. These measures use images to convey information when asking questions, let people respond using images, or use images both to convey information and for responses. One example could be using a sliding scale to select between dynamic images of different weathers to represent different emotional states. There is no widely used image-based questionnaire for adolescent mental health.
Our aim is to increase the inclusivity of mental health questionnaires. We will develop a digital image-based questionnaire for young people 8 to 18 years. There are 3 stages to our project.
1. We will look at existing image-based mental health questionnaires, so that we have examples to start conversations in the next stage.
2. We will work with a diverse group of 8 to 10 young people with lived experience of mental health difficulties. They will be co-researchers, meaning they will lead the research and take part in it. Over 6 workshops, we will co-develop the content and design of the image-based questionnaire, before testing and refining a prototype. We will provide training and ongoing support for the co-researchers. From the outset, we will discuss their goals of being involved, how they would like to be involved, and any support needs.
At the start of this stage, we will speak to groups of young people, researchers, and practitioners to understand what they would like from an image-based questionnaire. We will speak to them again during co-development for their feedback on the questionnaire.
3. We will speak to 12 to 15 young people to hear their feedback on the questionnaire when it is nearly finished. We will also ask them to complete it, thinking aloud as they do so we can understand in detail how they interpret the questionnaire and what drives their responses.
The main output will be a version of the questionnaire that can be used in a larger study, called the Adolescent Health Study, so that it can be fully tested. The questionnaire and our research materials will be freely available so other people can use it and repeat the study to develop similar questionnaires for other topics.
We aim to empower young people to be able to lead the research. The involvement of co-researchers will provide an opportunity to gain research experience for young people from groups that experience additional barriers to research careers. Our project has been designed based on our rich experience of patient and public involvement to ensure young people lead the decisions and conduct of the research. We will also work with a young person peer researcher who will be trained and supported to be involved in all stages and decisions of the project.
This project will mean that in the future, we will be better able to understand the mental health of all young people, including those from groups who voice is seldom heard in research.
Technical Summary
Our aim is to increase the inclusivity of self-report mental health measures for adolescents by developing an innovative, digital, standardised image-based measure for young people 8 to 18 years. One example could be using a sliding scale to select between dynamic images of different weathers to represent different emotional states.
There are 3 research questions, each with a corresponding work package:
1. What is the existing evidence on image-based based mental health measures?
We will conduct a systematic review to identify image-based measures. The primary output will be examples of different types of measures to use in the next work package.
2. What do young people 8 to 18 years from diverse groups want from an image-based measure?
We will recruit and train a diverse group of 8 to 10 young people with lived experience. They will be co-researchers, for a community-based participatory action research study. Over 6 workshops, we will co-develop the content and design of the image-based measure, testing and refining a prototype in partnership with our development team. At the outset, we will hold separate focus groups with young people, researchers, and practitioners to understand their needs from such a measure. We will speak to them again during co-development for their feedback on the measure.
3. What are young people's thoughts and experiences when completing the image-based measure?
We will test the final prototype with 12 to 15 young people using interviews and think aloud tasks.
The primary output will be a deployment version of the measure for use in the Adolescent Health Study pilot, so that the psychometric properties can be assessed ahead of potential use in the full study.
The protocol, methods, measure, and underpinning code will be publicly available for other people to use the measure and reproduce the methods. This will enable other researchers to develop similar measures and/or to use the measure.
There are 3 research questions, each with a corresponding work package:
1. What is the existing evidence on image-based based mental health measures?
We will conduct a systematic review to identify image-based measures. The primary output will be examples of different types of measures to use in the next work package.
2. What do young people 8 to 18 years from diverse groups want from an image-based measure?
We will recruit and train a diverse group of 8 to 10 young people with lived experience. They will be co-researchers, for a community-based participatory action research study. Over 6 workshops, we will co-develop the content and design of the image-based measure, testing and refining a prototype in partnership with our development team. At the outset, we will hold separate focus groups with young people, researchers, and practitioners to understand their needs from such a measure. We will speak to them again during co-development for their feedback on the measure.
3. What are young people's thoughts and experiences when completing the image-based measure?
We will test the final prototype with 12 to 15 young people using interviews and think aloud tasks.
The primary output will be a deployment version of the measure for use in the Adolescent Health Study pilot, so that the psychometric properties can be assessed ahead of potential use in the full study.
The protocol, methods, measure, and underpinning code will be publicly available for other people to use the measure and reproduce the methods. This will enable other researchers to develop similar measures and/or to use the measure.
