Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study

BackgroundThe gap between mental health needs and resources for Aboriginal and Torres Strait Islander people, the Indigenous people of Australia, is most marked in the prison population. Indigenous people are overrepresented in Australian prisons. In prison, this group experi...

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Main Authors: Elke Perdacher, David Kavanagh, Jeanie Sheffield, Karyn Healy, Penny Dale, Edward Heffernan
Format: Article
Language:English
Published: JMIR Publications 2022-04-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2022/4/e32157
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author Elke Perdacher
David Kavanagh
Jeanie Sheffield
Karyn Healy
Penny Dale
Edward Heffernan
author_facet Elke Perdacher
David Kavanagh
Jeanie Sheffield
Karyn Healy
Penny Dale
Edward Heffernan
author_sort Elke Perdacher
collection DOAJ
description BackgroundThe gap between mental health needs and resources for Aboriginal and Torres Strait Islander people, the Indigenous people of Australia, is most marked in the prison population. Indigenous people are overrepresented in Australian prisons. In prison, this group experiences mental disorders to a greater degree than non-Indigenous prisoners. This group has also been found to experience mental disorder at a higher rate than Indigenous people in the community. In addition to pre-existing determinants of poor mental health, these high prevalence rates may reflect poor engagement in mainstream interventions or the efficacy of available interventions. In community populations, the use of digital mental health resources may help to increase access to well-being support. However, culturally appropriate digital tools have not been available to Indigenous people in prisons. The absence of feasibility and efficacy studies of these tools needs to be addressed. ObjectiveThe aim of this study is to determine the feasibility of the Stay Strong app as a digital well-being and mental health tool for use by Indigenous people in prison. MethodsDual government agency (health and corrective services) precondition requirements of implementation were identified and resolved. This was essential given that the Stay Strong app was to be delivered by an external health agency to Indigenous prisoners. Then, acceptability at a practice level was tested using postuse qualitative interviews with clients and practitioners of the Indigenous Mental Health Intervention Program. All Indigenous Mental Health Intervention Program practitioners (10/37, 27%) and client participants who had completed their second follow-up (review of the Stay Strong app; 27/37, 73%) during the study period were invited to participate. ResultsOwing to the innovative nature of this project, identifying and resolving the precondition requirements of implementation was challenging but provided support for the implementation of the app in practice. Acceptability of the app by clients and practitioners at a practice level was demonstrated, with nine themes emerging across the interviews: satisfaction with the current Stay Strong app, supported client goal setting, increased client self-insight, improved client empowerment, cultural appropriateness, enhanced engagement, ease of use, problems with using an Android emulator, and recommendations to improve personalization. ConclusionsThe Stay Strong Custody Project is a pioneering example of digital mental health tools being implemented within Australian prisons. Using the app within high-security prison settings was found to be feasible at both strategic and practice levels. Feedback from both clients and practitioners supported the use of the app as a culturally safe digital mental health and well-being tool for Aboriginal and Torres Strait Islander people in prison.
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spelling doaj.art-9608f3f16f604009b884a01443e640e52023-08-28T21:22:00ZengJMIR PublicationsJMIR Formative Research2561-326X2022-04-0164e3215710.2196/32157Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility StudyElke Perdacherhttps://orcid.org/0000-0002-1876-6798David Kavanaghhttps://orcid.org/0000-0001-9072-8828Jeanie Sheffieldhttps://orcid.org/0000-0002-9628-5033Karyn Healyhttps://orcid.org/0000-0002-8569-558XPenny Dalehttps://orcid.org/0000-0002-7351-0189Edward Heffernanhttps://orcid.org/0000-0002-7819-6264 BackgroundThe gap between mental health needs and resources for Aboriginal and Torres Strait Islander people, the Indigenous people of Australia, is most marked in the prison population. Indigenous people are overrepresented in Australian prisons. In prison, this group experiences mental disorders to a greater degree than non-Indigenous prisoners. This group has also been found to experience mental disorder at a higher rate than Indigenous people in the community. In addition to pre-existing determinants of poor mental health, these high prevalence rates may reflect poor engagement in mainstream interventions or the efficacy of available interventions. In community populations, the use of digital mental health resources may help to increase access to well-being support. However, culturally appropriate digital tools have not been available to Indigenous people in prisons. The absence of feasibility and efficacy studies of these tools needs to be addressed. ObjectiveThe aim of this study is to determine the feasibility of the Stay Strong app as a digital well-being and mental health tool for use by Indigenous people in prison. MethodsDual government agency (health and corrective services) precondition requirements of implementation were identified and resolved. This was essential given that the Stay Strong app was to be delivered by an external health agency to Indigenous prisoners. Then, acceptability at a practice level was tested using postuse qualitative interviews with clients and practitioners of the Indigenous Mental Health Intervention Program. All Indigenous Mental Health Intervention Program practitioners (10/37, 27%) and client participants who had completed their second follow-up (review of the Stay Strong app; 27/37, 73%) during the study period were invited to participate. ResultsOwing to the innovative nature of this project, identifying and resolving the precondition requirements of implementation was challenging but provided support for the implementation of the app in practice. Acceptability of the app by clients and practitioners at a practice level was demonstrated, with nine themes emerging across the interviews: satisfaction with the current Stay Strong app, supported client goal setting, increased client self-insight, improved client empowerment, cultural appropriateness, enhanced engagement, ease of use, problems with using an Android emulator, and recommendations to improve personalization. ConclusionsThe Stay Strong Custody Project is a pioneering example of digital mental health tools being implemented within Australian prisons. Using the app within high-security prison settings was found to be feasible at both strategic and practice levels. Feedback from both clients and practitioners supported the use of the app as a culturally safe digital mental health and well-being tool for Aboriginal and Torres Strait Islander people in prison.https://formative.jmir.org/2022/4/e32157
spellingShingle Elke Perdacher
David Kavanagh
Jeanie Sheffield
Karyn Healy
Penny Dale
Edward Heffernan
Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study
JMIR Formative Research
title Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study
title_full Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study
title_fullStr Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study
title_full_unstemmed Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study
title_short Using the Stay Strong App for the Well-being of Indigenous Australian Prisoners: Feasibility Study
title_sort using the stay strong app for the well being of indigenous australian prisoners feasibility study
url https://formative.jmir.org/2022/4/e32157
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