Our catalyst project, Seamless Transitions for Adolescent Trajectories in Care (STATIC) addresses a major gap in mental health and addictions services in Canada that negatively impact youth and their families. The Principle Knowledge User on this project is the "Stay Connected Mental Health Project" team who work under the Mental Health and Addictions Program Specialty Services, Nova Scotia Health Authority. This service aims to shift the culture and practice of how youth and their families transition from pediatric to adult-based mental health and addictions services. Youth, parents and clinicians in the program are interested in using innovative and sophisticated technologies to better engage in the behaviour change necessary for continuity and well-managed mental health care. A systematic review by our team showed text message interventions can provide timely support, include reminders and prompts to engage in recommended transition behaviors, link young people to mental health resources and offer quick self-monitoring checks. While the use of these technologies is unlikely to replace face to face services there is undeniable potential to harness these tools in ways that are meaningful to youth health outcomes. Relevant text-messaging intervention, co-design and eMental health implementation work previously undertaken by members of our team provide a foundation in methods and project management expertise to see this project successfully completed.

Success in both improving services and building a more robust evidence base requires researchers, clinicians and managers of both child and adult mental health services to adopt a shared responsibility for success of this transition period. The members represented in this catalyst grant reflects a multi-sectorial team with a strong focus on first-voice of youth and parents as co-designers. The team of collaborators represent numerous institutions and organizations across the Atlantic region and an exciting new partnership between policy makers, clinicianscientists and a range of knowledge users in the community. The work aligns with provincial and national policy mandates and the expertise and research infrastructure brought by the team will ensure the project is successful.

Project Goals: 1) stimulate research collaborations and capacity among youth, health authorities, industry to expand affordable digital pathways to care; 2) generate new knowledge about first voice perspectives on technology-based transition-focused interventions, and 4) inform co-design methods and processes for reducing the research to practice gap in mental health services.

Consensus analysis - 4 months: The Delphi technique is a widely used, structured method to derive consensus on issues for which evidence is scarce. A multi-round analysis involving youth, parents, administrators, and clinicians will culminate in a refined list of key transition-stage behaviors and information needs in order of consensus magnitude and the optimal chronology of when families need to undertake different activities. We will explore moderating variables, gender, age, technical experience. We will discuss the findings at 2 stakeholder education events and co-present at a national conference.

Co-designed intervention - 3 months: Following co-design best practices we will complete a rapid 6-phase codesign process for a text-message delivered intervention to support transition pathways that is grounded in theories of behaviour change. We will draw on existing resources developed by our PKU and leverage our industry-partnership to secure the most versatile technology functionality available. We will publish peer-reviewed manuscripts on the methods and results of this process. A prototype of the intervention will be created.

Usability study - 5 months: We will enroll 15 youth and 15 parents in a brief usability study. Primary outcomes will include: performance expectancy (belief that the intervention will help), effort expectancy (ease of use), social influences (important others who believe using the intervention is important) and facilitating conditions (features and functionality that support engagement). A validated survey and interview protocol will be used. Results will inform refinement of a full-version of the intervention in preparation for a large clinical trial. We will publish and present usability-study findings.

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