Developing collaboratively a shared decision making tool for home-based videoconferencing versus in person care in child and youth mental health

In response to the COVID-19 pandemic, the switch from in-person to virtual care has resulted in an unprecedented mass adoption of home-based videoconferencing (HBVC), using personal devices (e.g., computers, tablets, smartphones) for Child and Youth Mental Health (CYMH) care. The pandemic experience showed that the experiences of patients and families were largely positive, and that HBVC can be combined with in-person CYMH care. Most mental health services aim at implementing a sustainable hybrid model, which will improve delivery and quality of care, costs, patient engagement, and access inequities. However, there is presently no tool to help youth, parents and mental health care providers (MHCPs) to decide whether a consultation should be done in person or through HBVCs. We will build a shared decision making tool (SDMT) supported by an educational website to support this decision, which is the cornerstone of the hybrid model. We have set up a network that comprises key CYMH university centers from 6 regions across Canada, the Ontario Centre of Excellence for Child and Youth Mental Health, family advisory councils, family and young patient organizations. The project has two phases: Exploration and Design-build. In the Exploration phase, we will use surveys and semi-structured interviews to map decision needs on health quality outcomes evaluated by parents/guardians, children/youth, MHCPs. We will further explore the decision needs in focus groups. In parallel, we will identify contents for the educational website and the different rules governing HBVC across Canada. On this basis, in the Design-build phase, a steering group made up of knowledge-users and researchers, supported by web designers, will plan a prototype SMDT and a website blueprint. We will reach consensus on key aspects of the tools by using the nominal group technique. We will test the final SDMT and supporting web site for acceptability and usability.