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Research Article
Buaphrao Raphiphatthana
Menzies School of Health Research, Charles Darwin University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Australian farming communities demonstrate significant resilience in the face of many challenges, including drought, bushfires, and more recently COVID-19. Nevertheless, worries related to financial hardship, farm viability and productivity, and remoteness render the population vulnerable to mental health problems. Despite this vulnerability, people in these communities are unlikely to seek help from mental health services due to attitudes, service access and geographic barriers. A tailored, low intensity digital mental health intervention may provide an acceptable and appropriate early wellbeing intervention for the population and help bridge the mental health service gap.
Objectives
This study has three objectives: 1) to adapt an existing tablet-based, therapist-guided, low intensity digital mental health intervention to address the wellbeing needs of Australian farming communities (development of the Weathering Well app), 2) to adapt, deliver, and evaluate training in utilisation of the new app, and 3) to conduct preliminary analyses on app usage data during the 12-months post-app release.
Methods
An Expert Advisory Group, comprising graziers, growers, rural financial counsellors, rural and remote mental health clinicians, Information Technology (IT) experts, Western Queensland Primary Health Networks representatives, Peak Body representatives (New South Wales rice growers), and drought impacted Shire Council representatives, was established. A three-day co-design workshop facilitated by the research team followed by a series of member-checking and user-testing rounds led to release of the new app. Pre-existing training resources were adapted, and the revised training workshops were delivered to service providers working with remote and rural farming communities. Pre- and post-training evaluations and app usage data were analysed.
Results
The final Weathering Well app received approval for public release by all stakeholders in September 2019. Following training, participant scores suggested that the app was accessible, appropriate, and effective with increased perceived knowledge and confidence in app use post-training. Analysis of app usage data indicated good app engagement, providing additional preliminary evidence for feasibility and acceptability. Trainees indicated reservations in terms of successful implementation most notably the need for organizational support for use.
Conclusions
This study provides an example of an intervention tailored to context through collaborative co-design. The preliminary findings suggest high levels of acceptability, providing a good foundation for implementation, further app revision and exploration of effectiveness and sustainability.
Keywords
Weathering, mental health, farmers, Health
No competing interests reported.
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CURRENT STATUS: Under Revision
Version 1
Posted 05 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 13 Apr, 2021
Review #3 received
Received 08 Apr, 2021
Review #1 received
Received 09 Mar, 2021
Review #7 received
Received 09 Mar, 2021
Review #37 received
Received 09 Mar, 2021
Review #20 received
Received 09 Mar, 2021
Review #35 received
Received 09 Mar, 2021
Review #33 received
Received 09 Mar, 2021
Review #32 received
Received 09 Mar, 2021
Review #34 received
Received 09 Mar, 2021
Review #8 received
Received 09 Mar, 2021
Review #2 received
Received 09 Mar, 2021
Review #5 received
Received 09 Mar, 2021
Review #6 received
Received 09 Mar, 2021
Review #19 received
Received 09 Mar, 2021
Review #10 received
Received 09 Mar, 2021
Review #36 received
Received 09 Mar, 2021
Review #21 received
Received 09 Mar, 2021
Review #38 received
Received 09 Mar, 2021
Review #9 received
Received 09 Mar, 2021
Review #31 received
Received 09 Mar, 2021
Reviewer #4 agreed
On 02 Mar, 2021
Reviewer #10 agreed
On 02 Mar, 2021
Reviewer #40 agreed
On 02 Mar, 2021
Reviewer #23 agreed
On 02 Mar, 2021
Reviewer #38 agreed
On 02 Mar, 2021
Reviewer #36 agreed
On 02 Mar, 2021
Reviewer #35 agreed
On 02 Mar, 2021
Reviewer #37 agreed
On 02 Mar, 2021
Reviewer #11 agreed
On 02 Mar, 2021
Reviewer #5 agreed
On 02 Mar, 2021
Reviewer #8 agreed
On 02 Mar, 2021
Reviewer #9 agreed
On 02 Mar, 2021
Reviewer #3 agreed
On 02 Mar, 2021
Reviewer #1 agreed
On 02 Mar, 2021
Reviewer #22 agreed
On 02 Mar, 2021
Reviewer #2 agreed
On 02 Mar, 2021
Reviewer #13 agreed
On 02 Mar, 2021
Reviewer #39 agreed
On 02 Mar, 2021
Reviewer #24 agreed
On 02 Mar, 2021
Reviewer #41 agreed
On 02 Mar, 2021
Reviewer #12 agreed
On 02 Mar, 2021
Reviewer #34 agreed
On 02 Mar, 2021
Reviewers invited
Invitations sent on 02 Mar, 2021
Editor assigned
On 02 Mar, 2021
Editor invited
On 02 Mar, 2021
Submission checks complete
On 02 Mar, 2021
First submitted
On 22 Feb, 2021
Metrics
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Buaphrao Raphiphatthana
Menzies School of Health Research, Charles Darwin University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 05 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 13 Apr, 2021
Review #3 received
Received 08 Apr, 2021
Review #1 received
Received 09 Mar, 2021
Review #7 received
Received 09 Mar, 2021
Review #37 received
Received 09 Mar, 2021
Review #20 received
Received 09 Mar, 2021
Review #35 received
Received 09 Mar, 2021
Review #33 received
Received 09 Mar, 2021
Review #32 received
Received 09 Mar, 2021
Review #34 received
Received 09 Mar, 2021
Review #8 received
Received 09 Mar, 2021
Review #2 received
Received 09 Mar, 2021
Review #5 received
Received 09 Mar, 2021
Review #6 received
Received 09 Mar, 2021
Review #19 received
Received 09 Mar, 2021
Review #10 received
Received 09 Mar, 2021
Review #36 received
Received 09 Mar, 2021
Review #21 received
Received 09 Mar, 2021
Review #38 received
Received 09 Mar, 2021
Review #9 received
Received 09 Mar, 2021
Review #31 received
Received 09 Mar, 2021
Reviewer #4 agreed
On 02 Mar, 2021
Reviewer #10 agreed
On 02 Mar, 2021
Reviewer #40 agreed
On 02 Mar, 2021
Reviewer #23 agreed
On 02 Mar, 2021
Reviewer #38 agreed
On 02 Mar, 2021
Reviewer #36 agreed
On 02 Mar, 2021
Reviewer #35 agreed
On 02 Mar, 2021
Reviewer #37 agreed
On 02 Mar, 2021
Reviewer #11 agreed
On 02 Mar, 2021
Reviewer #5 agreed
On 02 Mar, 2021
Reviewer #8 agreed
On 02 Mar, 2021
Reviewer #9 agreed
On 02 Mar, 2021
Reviewer #3 agreed
On 02 Mar, 2021
Reviewer #1 agreed
On 02 Mar, 2021
Reviewer #22 agreed
On 02 Mar, 2021
Reviewer #2 agreed
On 02 Mar, 2021
Reviewer #13 agreed
On 02 Mar, 2021
Reviewer #39 agreed
On 02 Mar, 2021
Reviewer #24 agreed
On 02 Mar, 2021
Reviewer #41 agreed
On 02 Mar, 2021
Reviewer #12 agreed
On 02 Mar, 2021
Reviewer #34 agreed
On 02 Mar, 2021
Reviewers invited
Invitations sent on 02 Mar, 2021
Editor assigned
On 02 Mar, 2021
Editor invited
On 02 Mar, 2021
Submission checks complete
On 02 Mar, 2021
First submitted
On 22 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Australian farming communities demonstrate significant resilience in the face of many challenges, including drought, bushfires, and more recently COVID-19. Nevertheless, worries related to financial hardship, farm viability and productivity, and remoteness render the population vulnerable to mental health problems. Despite this vulnerability, people in these communities are unlikely to seek help from mental health services due to attitudes, service access and geographic barriers. A tailored, low intensity digital mental health intervention may provide an acceptable and appropriate early wellbeing intervention for the population and help bridge the mental health service gap.
Objectives
This study has three objectives: 1) to adapt an existing tablet-based, therapist-guided, low intensity digital mental health intervention to address the wellbeing needs of Australian farming communities (development of the Weathering Well app), 2) to adapt, deliver, and evaluate training in utilisation of the new app, and 3) to conduct preliminary analyses on app usage data during the 12-months post-app release.
Methods
An Expert Advisory Group, comprising graziers, growers, rural financial counsellors, rural and remote mental health clinicians, Information Technology (IT) experts, Western Queensland Primary Health Networks representatives, Peak Body representatives (New South Wales rice growers), and drought impacted Shire Council representatives, was established. A three-day co-design workshop facilitated by the research team followed by a series of member-checking and user-testing rounds led to release of the new app. Pre-existing training resources were adapted, and the revised training workshops were delivered to service providers working with remote and rural farming communities. Pre- and post-training evaluations and app usage data were analysed.
Results
The final Weathering Well app received approval for public release by all stakeholders in September 2019. Following training, participant scores suggested that the app was accessible, appropriate, and effective with increased perceived knowledge and confidence in app use post-training. Analysis of app usage data indicated good app engagement, providing additional preliminary evidence for feasibility and acceptability. Trainees indicated reservations in terms of successful implementation most notably the need for organizational support for use.
Conclusions
This study provides an example of an intervention tailored to context through collaborative co-design. The preliminary findings suggest high levels of acceptability, providing a good foundation for implementation, further app revision and exploration of effectiveness and sustainability.
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