A Delphi method investigation to prioritize activity-related determinants thought to affect mental health in adolescent populations

Early Interv Psychiatry. 2024 Feb 8. doi: 10.1111/eip.13512. Online ahead of print.

Abstract

Introduction: Emergent mental illness during adolescence affects daily functioning, causing disruption to daily activities, routines, and patterns. Multiple inter-related personal, social and environmental determinants influence the onset, nature and subsequent course of those difficulties. Research suggests a bi-directional relationship exists between mental health and activity choices. Activity-focused interventions such as occupational therapy may improve adolescent mental health related outcomes. In this study, we identify and select which activity-related determinants should be prioritized in the development of an occupation therapy-based intervention for adolescents with emerging mental health difficulties using expert consensus.

Method: A modified two-round Delphi survey method was conducted with occupational therapists and researchers to ascertain a consensus opinion on the prioritization of specific activity-related determinants that influence 16- to 17-year-olds'.

Results: Eighty-nine determinants were identified and prioritized. Fourteen of these were personal activity-related determinants including 'types of activity' in which young people engage, the 'balance of activities' in which they engage, their 'over and under consumptions of activities', and their 'underdeveloped occupation-based coping skills'. The expert panel prioritized 'personal self-confidence', 'values', and 'perception of confidence' in relation to the activities adolescents do.

Conclusions: This study generated a detailed picture of the activity-related determinants that are important in adolescence, and aligns with the adolescent model of occupational choice. Our findings have potential to inform activity-related intervention development and policy. Further research is needed, particularly to understand young people's perspectives on these determinants and to investigate the determinants that would benefit from further empirical research.

Keywords: Delphi technique; mental health; occupational therapy; social determinants of health; young people.

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