Early Evaluation of IMAGINATOR 2.0 Intervention Targeting Self-Harm in Young People: Single-Arm Feasibility Trial
Notice bibliographique
Résumé
BACKGROUND: Self-harm (SH) affects around 20% of all young people in the United Kingdom. Treatment options for SH remain limited and those available are long and costly and may not suit all young people. There is an urgent need to develop new scalable interventions to address this gap. IMAGINATOR is a novel imagery-based intervention targeting SH initially developed for individuals aged 16 to 25 years. It is a blended digital intervention delivering functional imagery training via therapy sessions and a smartphone app. OBJECTIVE: This study aimed to pilot a new version of the app, IMAGINATOR 2.0, extended to adolescents from the age of 12 years and coproduced with a diverse group of young people with lived experience. Our aim was also to test the feasibility and acceptability of delivering IMAGINATOR 2.0 in secondary mental health services. METHODS: A total of 4 co-design workshops were conducted online with UK-based lived-experience co-designers aged 14-25 years to develop the IMAGINATOR 2.0 app. The intervention was then piloted with participants recruited from West London NHS Trust Tier 2 Child and Adolescent Mental Health Services and adult Mental Health Integrated Network Teams. Participants received 3 face-to-face functional imagery training sessions in which the app was introduced and 5 brief phone support sessions. Outcome assessments were conducted after completing therapy, approximately 3 months post baseline. Two focus groups gathered the therapists' perspectives on IMAGINATOR 2.0's acceptability and means of improvement. For quantitative data, descriptives are reported. Qualitative data were analyzed using a coproduced thematic analysis method with young people with lived experiences. RESULTS: Overall, 83 participants were referred, and 29 (gender: n=28 women, n=1 transgender; mean age 18.9, SD 3.74 years) were eligible and completed screening. Of the 27 participants who started, 59% (n=16) completed therapy per protocol, while only 15 (55.6%) completed the quantitative outcome assessment. There was an overall reduction in the number of SH episodes over 3 months from pre- to postintervention (baseline: median 7, IQR 3.5-21.5 months; postintervention: median 0, IQR 0-7 months; median difference=-6.5; r=0.69). Six themes were identified through thematic analysis of therapists' feedback, including mental imagery's potential and boundaries, therapy expectations, experience and effectiveness, accessibility of digital support, and adaptation of the IMAGINATOR 2.0 app to complement care pathways. The app was valued by therapists who highlighted the need for an intervention like IMAGINATOR 2.0 in their services. CONCLUSIONS: IMAGINATOR 2.0 shows initial promise as an acceptable brief intervention targeting SH in young people under adolescent and adult mental health services. Challenges with attrition need to be addressed for a definitive randomized controlled trial to test the intervention efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06311084; https://clinicaltrials.gov/study/NCT06311084.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,003 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,014 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».