JoyPop App + Usual Care for Mental Health in Indigenous Youth

Overseen By Aislin R Mushquash, Ph.D.

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Lakehead University

Disqualifiers: Non-Indigenous, Not on wait-list, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

110 Participants Needed

Trial Summary

What is the purpose of this trial?

Indigenous youth in Northwestern Ontario who need mental health supports experience longer waits than non-Indigenous youth within the region and when compared to youth in other more urban areas. Limited access and extended waits can exacerbate symptoms, prolong distress, and increase risk for more serious outcomes. Novel, innovative approaches are urgently needed to provide support for Indigenous youth in Northwestern Ontario. In partnership with Dilico Anishinabek Family Care, the investigators are evaluating the impact of a mental health app (JoyPop) as a tool for Indigenous youth who are waiting for mental health services. The JoyPop app was developed to support improved emotion regulation - a key difficulty for youth presenting with mental health challenges. A two-arm randomized controlled trial (RCT) will be used to evaluate the effectiveness of the app compared to usual practice while Indigenous youth are waiting for mental health services.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on using an app alongside usual care, so you may not need to change your current medication routine.

What data supports the effectiveness of the treatment JoyPop app for mental health in Indigenous youth?

The JoyPop app is a resilience-building tool that has been considered for use with Indigenous youth, and similar mobile health interventions like the ibobbly app have shown promise in reducing suicidal thoughts and psychological distress among Indigenous youth in Australia. ^{1 2 3 4 5}

Is the JoyPop app safe for use in humans?

The available research on the JoyPop app focuses on its acceptability and feasibility for Indigenous youth, but does not provide specific safety data. However, it is generally considered a promising tool for improving mental health and resilience among youth. ^{1 5 6 7 8}

How is the JoyPop app treatment different from other mental health treatments for Indigenous youth?

The JoyPop app is unique because it is a mobile application designed to enhance resilience among Indigenous youth by leveraging technology, making it accessible even in remote communities. Unlike traditional treatments, it focuses on self-help and resilience-building, which can be particularly beneficial for Indigenous youth facing ongoing trauma and mental health challenges. ^{1 2 3 5 6}

Research Team

Aislin R Mushquash, Ph.D.

Principal Investigator

Lakehead University

Eligibility Criteria

This trial is for Indigenous youth aged 12-17 in Northwestern Ontario who are on the wait-list for mental health services at Dilico Anishinabek Family Care. Participants must be able to attend an orientation and need access to an iOS device, which can be provided.

Inclusion Criteria

I am an Indigenous youth aged 12-17 waiting for mental health services at Dilico.

Participants will need access to an iOS device (e.g., iPhone, iPad) in order to download the JoyPop app. Refurbished iPhones containing just the JoyPop app will be provided to participants to use for the duration of the trial if they do not have access to their own.

Eligible youth will also need to be available to attend a virtual or in-person orientation session

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Usual Practice

Participants will be monitored through existing wait-list practices which involve regular phone calls to check in and assess functioning

4 weeks

Regular phone calls

Usual Practice + JoyPop

Participants will be monitored through existing wait-list practices and will receive access to the JoyPop app

4 weeks

Regular phone calls

Follow-up

Participants are monitored for changes in emotion regulation and mental health difficulties after the intervention

4 weeks

Treatment Details

Interventions

• JoyPop

Trial Overview The trial is testing a mobile app called JoyPop, designed to help with emotion regulation, against usual practices while waiting for mental health services. It's a two-arm randomized controlled trial assessing the app's effectiveness.

Participant Groups

Group I: Usual Practice + JoyPop Experimental Treatment 1 Intervention

Participants will be monitored through the existing wait-list practices, which involve regular phone calls to check in and assess functioning, and will receive access to the JoyPop app for 4 weeks.

Group II: Usual Practice Active Control 1 Intervention

Participants will be monitored through existing wait-list practices which involve regular phone calls to check in and assess functioning. After 4 weeks in the Usual Practice condition, participants will be offered access to the JoyPop app.

JoyPop is already approved in Canada for the following indications:

Approved in Canada as JoyPop for:

• Emotion regulation difficulties
• Stress
• Depression
• Anxiety

Who Is Running the Clinical Trial?

Lakehead University

Lead Sponsor

Trials

29

Recruited

3,900+

Dilico Anishinabek Family Care

Collaborator

Trials

2

Recruited

220+

Findings from Research

The ibobbly mobile app, designed for Indigenous youth in remote Australia, significantly reduced symptoms of depression and psychological distress, as measured by the PHQ-9 and K10 scales, compared to a waitlist group.

While the app did not show significant reductions in suicidal ideation or impulsivity, it demonstrates potential as a feasible self-help tool for improving mental health in underserved communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial. Tighe, J., Shand, F., Ridani, R., et al.[2022]

Digital health solutions for Indigenous mental well-being include remote access to specialists, local capacity building, and patient-directed interventions, with telemental health showing the strongest evidence of effectiveness.

Despite the promise of these digital solutions, there is limited evidence specifically in Indigenous contexts, highlighting the need for further research and adherence to best practices that respect Indigenous history and ideologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Digital Health Solutions for Indigenous Mental Well-Being. Hensel, JM., Ellard, K., Koltek, M., et al.[2020]

AIMhi-Y App was co-designed with 45 Aboriginal and Torres Strait Islander youth, highlighting their need for culturally relevant mental health resources to address psychological distress and barriers to help-seeking.

Participants identified key app features such as a strengths-based approach, relatable content, and an engaging interface, indicating that a well-designed mental health app could enhance mental health literacy and provide accessible support for young people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Drafting the Aboriginal and Islander Mental Health Initiative for Youth (AIMhi-Y) App: Results of a formative mixed methods study. Povey, J., Sweet, M., Nagel, T., et al.[2022]

A culturally appropriate mental health treatment model for Indigenous Australians with depression should prioritize Indigenous autonomy, identity, and wellbeing, as identified through focus groups with 24 participants and interviews with 2 Elders.

Effective treatment approaches must integrate Indigenous concepts of social and emotional wellbeing alongside traditional clinical methods, emphasizing the importance of community-led design and delivery in public health initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A community-led design for an Indigenous Model of Mental Health Care for Indigenous people with depressive disorders. Farah Nasir, B., Brennan-Olsen, S., Gill, NS., et al.[2021]

The JoyPop™ mobile app received positive feedback from 19 adult community members of Six Nations of the Grand River, indicating its potential relevance and appropriateness for Indigenous youth mental wellness.

Participants suggested adaptations to the app, such as incorporating more cultural elements and localized resources, to better meet the specific needs of SN youth before further research and implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the relevance of a psychology-based resilience app (JoyPop™) for Indigenous youth. Kim, K., Au-Yeung, A., Dagher, D., et al.[2023]

The JoyPop™ mobile app was well-received by Indigenous youth, with all five participants using it daily and finding it easy to navigate, indicating strong acceptability and feasibility for mental wellness support.

Participants highlighted the app's cultural resonance, particularly appreciating features like water sounds and the alignment with the 'Good Mind' perspective, while suggesting enhancements such as more gaming options and Indigenous design elements for better cultural appropriateness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the feasibility of a mental health application (JoyPopTM) for Indigenous youth. Au-Yeung, A., Marfatia, D., Beers, K., et al.[2023]

The JoyPop™ app was well-received by both youth (6 participants aged 12-17) and mental health service providers (7 participants aged 32-60), with users finding it easy to learn and use, and beneficial for accessing coping skills and improving mental health outcomes.

Both groups expressed positive feelings about the app's integration into traditional mental health services, although they also raised concerns about mobile health apps in general and provided suggestions for improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Female youth and mental health service providers' perspectives on the JoyPop™ app: a qualitative study. Malik, I., Perez, A., Toombs, E., et al.[2023]

The study involved eight Indigenous adolescents who participated in Design Circles to share their experiences and preferences for a mental health screening app, emphasizing the importance of integrating Indigenous perspectives in digital health tools.

Using a Two-Eyed Seeing approach, the research highlighted that collective storytelling and user involvement are crucial for designing eMental health apps that effectively meet the needs of Indigenous youth in primary care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Application of Two-Eyed Seeing in Adolescent Mental Health to Bridge Design Thinking and Indigenous Collective Storytelling. Sam, J., Richardson, CG., Currie, LM.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Digital Health Solutions for Indigenous Mental Well-Being. [2020]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Drafting the Aboriginal and Islander Mental Health Initiative for Youth (AIMhi-Y) App: Results of a formative mixed methods study. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

A community-led design for an Indigenous Model of Mental Health Care for Indigenous people with depressive disorders. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Exploring the relevance of a psychology-based resilience app (JoyPop™) for Indigenous youth. [2023]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Exploring the feasibility of a mental health application (JoyPopTM) for Indigenous youth. [2023]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Female youth and mental health service providers' perspectives on the JoyPop™ app: a qualitative study. [2023]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Application of Two-Eyed Seeing in Adolescent Mental Health to Bridge Design Thinking and Indigenous Collective Storytelling. [2023]