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Youth and other stakeholder perspectives on public health implementation of a risk calculator for prediction of adolescent depression

Abstract Description

A prediction model for adolescent depression has been developed and tested in multiple global settings. This opens the door for implementation of risk calculators for depression to be used in educational, health, and other settings for prediction of which adolescents may develop depression. This qualitative study explores perspectives among youth and other stakeholders about implementation of such a risk calculator. Theory of change workshops (n=6), key informant interviews (n=180), focus group discussions (n=6), and consultations with youth advisory boards were held in Brazil, Nepal, Nigeria, and UK. Participants included youth affected by depression, parents, teachers, social workers, health professionals, and policymakers. Youth affected by depression advocated for implementation of risk calculators to improve early prevention and intervention services. Parents and teachers described potential stigmatization of labeling at-risk youth. Health workers in some settings were concerned about the lack of resources within the health system to accommodate additional screening and prevention services. Data privacy and use of information were concerns for online administration of a risk calculator. All stakeholders recommended that any risk calculator implementation would require strengthening of adolescent mental health services. Risk calculators for prediction of future depression have the potential to improve prevention but many issues require consideration before implementation.