Title: A co-produced qualitative exploration of young women’s perspectives on psychological distress in their population and priority actions for responding
Funder: Department of Health and Social Care

Abstract: Our aims: _x000D_ We want to ask young women themselves what they think is happening at the moment that might be causing psychological distress and how we can help. We have three questions we want to answer: _x000D_ 1. What do young women think is causing high rates of psychological distress for other young women like them? _x000D_ 2. What do young women think can be done to help reduce this distress? _x000D_ 3. What actions they think are most important for us to take first, and how might we do that? _x000D_ _x000D_ Approach: _x000D_ We will talk with young women in focus groups, where groups of young women can come together to talk together about their ideas on this topic. We will speak to 40-45 diverse young women from a variety of backgrounds who are aged 16 to 18 across England. We will meet with these young women once, in a discussion that will last about 90 minutes. We will work with two young women to co-produce the project, involving them as researchers at each stage. These co-researchers will be involved in leading these conversations with other young women, along with another researcher, to help create a more balanced and open discussion. We will explore and agree on ground rules in each focus group to help create a safe space, and we will not ask anyone to share deeply personal experiences or talk about anything they may find upsetting, and at the end of focus groups we will share information about services that young women can contact if they would like to talk further with a professional about any of the issues discussed. We will record the focus groups and analyse what young women tell us about what they think is causing psychological distress and how we can help, and then we will meet with stakeholders to identify some of the ways that we can take action to deliver that help. We will store data securely, and make sure when we share what participants have said that they cannot be identified. _x000D_ _x000D_ We met with a group of young women to help us design this project, talking through what the project can add, thinking about the language and ideas that we focus on, and planning how we can best meet the needs of young women who take part in this project. This has helped us think about how we can reach young women from diverse backgrounds, how we can create a safe space within these discussions, and how we can ask questions that will be most helpful in thinking about how we can respond to this issue moving forward. _x000D_ _x000D_ Project impact: _x000D_ We think this study can offer helpful information that can contribute to how we help young women and lessen psychological distress. We want to use this information to help us better understand the causes of this distress and to help us understand how our team and other people can support and help young women. We will share what we learn with young women themselves, with people who make decisions about interventions and policy for young women, as well as people who are supporting young women like their parents and teachers. We will also share what we learn with the general public, through the press, to help reach as many people as we can.

Lay abstract: Background: _x000D_ Evidence suggests that young women are experiencing increasing rates of psychological distress. Crucially, there is no clarity regarding the causes of this increase, limiting our capacity to respond effectively and sensitively. Researchers have posited several possible factors that may explain increases, but these are speculative and, critically, have been posited by researchers without input from young women, both in exploring their perspectives and in involving them as co-producers of research in this area. To date, there is no understanding of young women’s perspectives on these issues, limiting our ability to identify intervention approaches that meet their needs. _x000D_ _x000D_ Aims and research questions: _x000D_ Thus, we propose a co-produced study aiming to explore young women’s perspectives of psychological distress in their population, including causal contributors and appropriate responses. We offer three detailed research questions: _x000D_ 1. What do young women perceive to be causing their population’s high rates of psychological distress? _x000D_ 2. What do young women think could be helpful actions that could lessen psychological distress in their population? _x000D_ 3. What are priority actions to lessen psychological distress, and what approaches could be implemented to achieve these? _x000D_ _x000D_ Methods: _x000D_ The study adopts a co-produced qualitative design, generating data using online focus groups with 40-45 diverse young women aged 16 to 18 years in England. Focus groups will be co-led by a research assistant and a young co-researcher. We adopt a collective 'problem-solving' approach to directly raise current concerns about rates of psychological distress among young women and explore participants’ responses, including what they would consider ‘priority’ actions. We will then create a shortlist of priority actions and engage in consultation with key stakeholders to explore how these could be targeted through intervention, which will enable us to begin preparing to trial and evaluate an intervention and apply for evaluation funding via the subsequent NIHR intervention call. The project design has been informed through advisory discussion with diverse young women and will be co-produced with young women throughout the research process. _x000D_ _x000D_ Timelines for delivery: _x000D_ Focus groups will take place in Months 3 and 4 of the project. Qualitative analysis and stakeholder consultation will occur in 4 and 5. We anticipate completion of the report two weeks after the end of the project, and can undertake further impact and dissemination work beyond this. _x000D_ _x000D_ Anticipated impact and dissemination: _x000D_ This study can offer real-world impact for responding to rates of psychological distress among young women, and will be of interest to various audiences. Briefly, our impact goals are to: _x000D_ _x000D_ 1. Contribute to knowledge and understanding of young women’s own perspectives on psychological distress rates in their population;_x000D_ 2. Inform policy and funding allocation, including interventions and provision; and_x000D_ 3. Facilitate greater public awareness of young women’s views on their mental health, including among those supporting young women (e.g., teachers, parents/carers)._x000D_ _x000D_ We will produce a report describing findings and how this will support future evaluative work, presenting thematic findings and indicative interventions. We intend to create a summary for dissemination with stakeholders, and to undertake policy engagement work and communicate findings to the general public.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MENTAL HEALTH