Date of Award
1-1-2025
Document Type
Dissertation
Degree Name
Ph.D. in Health and Kinesiology
First Advisor
Allison Ford-Wade
Second Advisor
Marie Barnard
Third Advisor
Hannah Allen
School
University of Mississippi
Relational Format
dissertation/thesis
Abstract
Background: One in five youth experience a mental health challenge each year (CDC, 2021). Mental Health Literacy (MHL) is vital for addressing this crisis as it involves the knowledge, attitudes, and skills necessary to promote mental well-being, understand mental health conditions, and seek appropriate help. MHL interventions for adolescents have been developed; however, recent reviews indicate research is needed in school settings with community input. Youth Participatory Action Research (YPAR) places youth as co-researchers in intervention development. This methodology aligns with Bartholomew’s Intervention Mapping (IM) framework, which ensures interventions are theoretically grounded. Utilizing these two frameworks, this study aimed to foster a collaborative environment in which adolescents work to address their community’s MHL needs.
Study Objectives: 1) Conduct a scoping review on how YPAR has been used to explore MHL in adolescents; 2) Utilize a YPAR approach to conduct a needs assessment related to MHL; 3) Develop and pilot a MHL intervention.
Methods: 1) A scoping review was conducted to map the published literature on how YPAR has been employed in studies about MHL in adolescents. 2) A YPAR needs assessment was conducted by training teen researchers who planned and executed the assessment with guidance from a public health researcher. Training knowledge assessment checks and qualitative analysis of their experiences were conducted. The teen researchers and public health researcher analyzed the needs assessment data using quantitative and qualitative methods. 3) A MHL pilot intervention was developed utilizing IM, guided by the YPAR needs assessment findings. The intervention was piloted in a health class(es) in a public high school in a Mississippi community. A quasi-experimental mixed methods approach to evaluation of the pilot was utilized. Implementation data and satisfaction measures were summarized using descriptive statistics. Outcome evaluation included a pre/post assessment of relevant MHL components to examine impact of the intervention. Findings were used to adapt and improve the intervention for potential broader implementation.
Results: The scoping review identified 25 studies that utilized YPAR to explore MHL in adolescents. While all studies incorporated a collaboration approach and nearly all included some level of empowerment for the youth, only two addressed all five components of MHL, and less than half implements the full YPAR approach. This highlights a significant gap in literature and underscores the need for more comprehensive, and youth driven MHL efforts. In the second study, teen researchers conducted a needs assessment after completing a five-session training series on YPAR, MHL, and research methods. The teens expressed high satisfaction with the training and demonstrated increased understanding of research concepts and mental health topics. Their assessment found that although peers had a general understanding of mental health, they lacked awareness of specific resources such as the 988 crisis line, and many held stigmatizing attitudes or were uncomfortable discussing mental health. The final study was a one-hour MHL pilot intervention developed using IM and guided by the needs assessment findings. The intervention, grounded in the Theory of Planned Behavior and aligned with state health education standards, was co-designed with the teen researchers. A process evaluation revealed strong satisfaction from both students and the health teacher. Students rated the lesson a valuable, and qualitative feedback emphasized the usefulness of strategies like box breathing, supporting peers, and learning how to seek help. Outcome evaluation using the Wilcoxon signed-rank test showed a statistically significant improvement in students’ mental health knowledge and attitudes (p=0.013) based on the Knowledge and Attitude to Mental Health Scale (KAMHS) tool. Although the sample size was small (n<30) for the outcome evaluation assessment, the findings suggest that a brief, youth informed intervention can positively influence MHL and promote help-seeking behaviors. Feedback also indicated areas for improvement, including increased interactivity and more teen-centered examples, which can inform future adaptations.
Recommended Citation
Johnson, Teresa, "Mental Health Literacy: What’s the Value of Youth Engagement in Intervention Development?" (2025). Electronic Theses and Dissertations. 3304.
https://egrove.olemiss.edu/etd/3304