From role-play to situated feedback: re-envisioning child mental health promotion interventions with digital technology

The aims of the fellowship are to examine how emerging technologies can fundamentally re-envision the conceptual models and mechanisms-of-delivery for existing prevention interventions in the context of child mental health. Such an innovative approach is needed to address the unprecedented mental health treatment gap faced across the UK and worldwide: more than 1 in 10 children and young people have a clinically diagnosable mental health disorder, yet only 30% have had access to appropriate intervention, and less than half of these improve from the treatment. Mental health promotion interventions are seen as one of the principled ways of addressing these issues: by developing key protective factors (such as emotion regulation or parenting techniques) for both at-risk and general populations, such interventions can improve wellbeing and reduce the incidence of mental disorders. However, even the most effective programmes are still dependent on in-person delivery techniques and intervention mechanisms available since the 60s, thus lacking scalable mechanisms to support children in the everyday settings where protective competencies are needed, and being developed.


The core vision proposed by the fellowship research agenda is that digital technologies can lead to entirely new model of prevention interventions that are fully incorporated into the lives of target populations, thus addressing the need for situated learning support. However, beyond PI's pilot work, HCI and Prevention Science fields lack even a basic understanding of the fundamental research questions necessary to deliver such situated interventions: it is not at all clear, for example, how to design technologies that provide useful contextualised support for children and their adults around protective competencies (technical RQs), how to do so in a psychologically effective way (psychological RQs), and how to design interventions that are engaging for users and are addressing their immediate needs (socio-technical RQs).

The fellowship takes up these challenges and lays out an ambitious programme of work designed to start unpacking these broader issues at the intersection of technology, psychological theory, and human-centred design. We address such highly interdisciplinary agenda by grounding the work in specific case studies that target fundamental protective factors for child mental health --- emotion regulation and positive parenting --- while encompassing all of the issues outlined above. The case study interventions then serve not only as exemplar proof-of-concept of how situated interventions can be developed (and shown to be efficacious), but also as initial steps towards extrapolating the psychological mechanisms and design patterns that are generalisable to other populations and protective factors. By focusing on carefully selected case studies---complemented with a strong interdisciplinary mentorship network across KCL, Oxford, Stanford, Harvard, Northwestern U, and U of Michigan, among others--- the ambition is to not only create effective interventions that can be deployed at scale, but also influence the wider research communities, and contribute to the UK and EU policy calls to deliver new approaches for mental health promotion.

PI's personal and career growth will be substantially boosted by the fellowship. Beyond enabling a full cycle of truly interdisciplinary work, which would traditionally span a range of UKRI panels and epistemological commitments, the fellowship structure will facilitate a network of academic and clinical partnerships across a range of leading research centres worldwide, developing the basis for PI's interdisciplinary thought leadership for years to come. These will include, among others, long-term residency at Oxford; as well as close collaboration and repeated visits to US-based mentors (Harvard, Stanford, University of Michigan, Northwestern University).

The fellowship aims to develop a fundamentally novel model of situated intervention delivery to start addressing the key challenges of scale, impact, and reach faced by existing prevention programmes; enabling a wider shift in how prevention interventions are conceptualised and designed. We have identified 3 key impact objectives to contribute to this long term goal, both during and beyond the duration of the fellowship: >> (1) Transfer of proof-of-concept research prototypes to large scale deployments. A crucial focus of the fellowship work is not only to envision novel intervention approaches, but also enable their real-world application and wide deployment, beyond the duration of the fellowship funding. A range of project partners and research plans are in place to support this process: - In depth engagements with clinical partners (KCL, UCL, Stanford, Georgetown) to enable rigorous validation of the proof-of-concept interventions, enabling their transfer to clinical practice. - We will partner with Committee for Children (leading US non-profit developer of SEL interventions used in over 70 countries worldwide) and Silvercloud (online mental health treatment platform used by NHS among other partners). This provides the team with access to two parallel pathways to real-world, large-scale deployments beyond academic settings. - Finally, a partnership with Westminster City Council provides a pathway to local impact and exemplar council deployments for developed interventions. >> (2) Influencing wider research agenda to impact provision of mental health interventions. The impact of the newly developed situated intervention models will be further compounded by rapid dissemination and their application across clinical and research environments beyond the immediate PI's mentorship and collaborators' circle. To support such dissemination, the PI will: - Dedicate at least 5% of his time to serve as an expert advisor to external research groups-across disciplinary settings to apply the emerging conceptual ideas to other related projects. This will speed up transfer of knowledge, develop interdisciplinary community of researchers and clinicians, and lead to follow-up funding ensuring the sustainability of the broader research agenda. - The open-source toolkits, developed in years 4-7, will further support the cross-disciplinary collaboration. Through a range of engagements, we will facilitate the uptake, use, and development of new interventions based on the toolkits for at least 15 research and/or clinical groups worldwide. - Finally, the mentorship and collaboration arrangements with world-leading academics will provide a platform to influence the conceptual models and mechanisms of delivery within the research communities broadly; including publications in high-impact journals and workshops/panels at leading conferences. >> (3) Sustainable economic and public sector impact. The ethical and policy implications of IoT technologies are stark, especially in a sensitive context such as mental health. We will draw on the responsible innovation (RI) approaches as outlined in the proposal, to provide a unique opportunity to foresee and deliver an `anticipatory governance', impacting relevant policies as the notions of embedded, situated mental health interventions are first examined and developed. The PI will utilise the ongoing Oxford secondment to draw on Prof Jirotka's and Prof Shadbolt's expertise in engaging with and influencing policy in the UK and elsewhere. Finally, we will utilise both internal (IAA) and external grant mechanisms (Innovate UK and KTP) to support transfer of knowledge to local start-up companies in this space: we will work with start up incubators (such as Promise Ventures
) to identify suitable companies, and then develop competitive proposals (such as at least 5x Innovate UK) to facilitate academy-to-commerce knowledge transfer.