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. 2023 Nov 22:7:e52336.
doi: 10.2196/52336.

Investigating the Feasibility, Acceptability, and Appropriation of a Socially Assistive Robot Among Minority Youth at Risk of Self-Harm: Results of 2 Mixed Methods Pilot Studies

A Jess Williams  1 , Ellen Townsend  2 , Nkem Naeche  2 , Amelia Chapman-Nisar  2 , Chris Hollis  2 , Petr Slovak  1 ; Digital Youth With Sprouting Minds  3
Affiliations

Investigating the Feasibility, Acceptability, and Appropriation of a Socially Assistive Robot Among Minority Youth at Risk of Self-Harm: Results of 2 Mixed Methods Pilot Studies

A Jess Williams et al. JMIR Form Res. .

Abstract

Background: Minority youth are at an increased risk of experiencing self-harmful thoughts and behaviors. However, there is limited evidence of successful interventions to support young people in the moment of their distress. Digital interventions are considered a potential solution for providing in-the-moment support for those at risk of adverse mental health and self-harm.

Objective: These pilot studies aim to investigate the feasibility and acceptability of a new in situ intervention tool, Purrble, among two broad groups of minority youth: (1) lesbian, gay, bisexual, transgender, queer, and similar minority (LGBTQ+) youth and (2) racial and ethnic minority youth. Purrble was designed to support in-situ emotion regulation (ER) support when individuals are facing emotionally challenging situations.

Methods: This study consisted of 2 mixed methods pilot studies that followed the same mixed methods design, including 3 weeks of daily and weekly surveys and optional follow-up interviews. Inclusion criteria were (1) aged between 16 and 25 years, (2) part of a minority group, (3) had experiences of self-harmful thoughts or behaviors or elevated symptoms of depression or anxiety, and (4) living in the United Kingdom at the time of the study. The primary outcomes were (1) the feasibility of Purrble as an intervention among pilot samples (analyzed by consent rate, retention rate, adherence to surveys, and engagement with the device) and (2) the acceptability and appropriation of Purrble across pilot studies as a tool to support ER in situ (thematically analyzed qualitative open-ended questions and interview data). The secondary outcomes were descriptive pilot data concerning the mental health outcomes in each sample.

Results: In total, 21 LGBTQ+ young people participated in pilot study 1, with 86% (n=18) completing the baseline and 3 weeks of daily surveys. These young people maintained engagement with Purrble across deployment, across which period there was a decrease in self-harmful thoughts and anxiety symptoms. A total of 19 ethnic and racial minority youths participated in pilot study 2, and 84% (n=16) completed the study. Although pilot study 2 participants also maintained engagement with Purrble across deployment, this was to a lesser degree than participants of pilot study 1, and perceived mental health outcomes did not indicate potential change associated with the device. The thematic analysis indicated three superordinate themes: (1) stopping the self-harm cycle, (2) adopting ER strategies, and (3) stages of change.

Conclusions: These were the first pilot studies of a novel intervention that aimed to provide in situ ER support for young people at risk of self-harm. Both quantitative and qualitative findings indicate that young people found Purrble to be a feasible and acceptable intervention, as they effectively incorporated the device into their ER practices. These engagements with Purrble were described as interrupting the cycle of self-harmful ideation and behavior.

Keywords: digital intervention; emotion regulation; experience sampling; interviews; self-harm; young people.

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Conflict of interest statement

Conflicts of Interest: PS has been involved in the development of what is now Purrble as part of his postdoctoral fellowship and serves as a paid research adviser to the Committee for Children but has no financial stake in either Committee for Children (Purrble brand owners) or Sproutel (company manufacturing Purrbles). Committee for Children has donated the Purrble units used in the study; Sproutel has not been involved. Neither the Committee for Children nor Sproutel had access to the data or had been part of the data collection in any way, and they did not approve or see the publication before it was submitted. All other authors declare no other conflicts of interest.

Figures

Figure 1
Figure 1
Data collection phases for both pilots.
Figure 2
Figure 2
Purrble intervention device.
See this image and copyright information in PMC

References

    1. Kendall T, Taylor C, Bhatti H, Chan M, Kapur N, Guideline Development Group of the National Institute for HealthClinical Excellence Longer term management of self harm: summary of NICE guidance. BMJ. 2011 Nov 23;343(nov23 1):d7073. doi: 10.1136/bmj.d7073.bmj.d7073 - DOI - PubMed
    1. Suicide. World Health Organization. 2023. Aug 28, [2023-03-24]. https://www.who.int/news-room/fact-sheets/detail/suicide .
    1. Gillies D, Christou MA, Dixon AC, Featherston OJ, Rapti I, Garcia-Anguita A, Villasis-Keever M, Reebye P, Christou E, Al Kabir N, Christou PA. Prevalence and characteristics of self-harm in adolescents: meta-analyses of community-based studies 1990-2015. J Am Acad Child Adolesc Psychiatry. 2018 Oct;57(10):733–41. doi: 10.1016/j.jaac.2018.06.018.S0890-8567(18)31267-X - DOI - PubMed
    1. Griffin E, McMahon E, McNicholas F, Corcoran P, Perry IJ, Arensman E. Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007-2016. Soc Psychiatry Psychiatr Epidemiol. 2018 Jul 2;53(7):663–71. doi: 10.1007/s00127-018-1522-1.10.1007/s00127-018-1522-1 - DOI - PubMed
    1. McManus S, Gunnell D, Cooper C, Bebbington PE, Howard LM, Brugha T, Jenkins R, Hassiotis A, Weich S, Appleby L. Prevalence of non-suicidal self-harm and service contact in England, 2000–14: repeated cross-sectional surveys of the general population. Lancet Psychiatry. 2019 Jul;6(7):573–81. doi: 10.1016/s2215-0366(19)30188-9. - DOI - PMC - PubMed

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