Figure 1 - uploaded by Barbara Dooley
Content may be subject to copyright.
CopeSmart app screenshots. 

CopeSmart app screenshots. 

Source publication
Article
Full-text available
Background: Early intervention is important in order to improve mental health outcomes for young people. Given the recent rise in mobile phone ownership among adolescents, an innovative means of delivering such intervention is through the use of mobile phone applications (apps). Objective: The aim of this study was to evaluate the feasibility of...

Context in source publication

Context 1
... world now owning smartphones [8-10]. This type of technology is a promising tool for the widespread delivery of telemental health interventions to young people. Because adolescents are familiar with how to use mobile phones (as they use them on a daily basis for texting, taking photos, playing games etc), they are unlikely to have much difficulty in adapting to the intervention interface [11]. Interventions delivered via mobile phones facilitate frequent engagement as users go about their daily lives [12,13] and afford users the opportunity to apply the skills and behaviors promoted by the intervention directly in real time to their real life experiences [14]. They can provide almost constant support to users, in comparison to interventions that can only be accessed at specific times or in specific locations (eg, during visits to a therapist’s office) [14]. Furthermore, as it is not unusual to see young people interacting with their mobile phones in public, they provide a discrete and confidential means of intervention delivery [11]. Over the coming years, it is predicted that the use of mobile technologies in mental health contexts will continue to rapidly increase [15]. Indeed, there are already a plethora of health care mobile apps available to adolescents [15], with over 3000 mental health apps accessible for download between the Android, Apple, and Microsoft app stores [16]. These apps have been developed by a wide range of individuals and organizations and are generally available free or at a small cost [17]. Some are targeted towards the assessment and treatment of specific mental health disorders, whereas others are focused on the more broad promotion of positive mental health [18] (ie, by fostering general well-being and resilience in individuals). Many of these apps are based on self-monitoring principles, where users rate how they are feeling on a day to day basis and are able to track their moods and emotions over time, for example “Moody Me” [19] and “Mood Panda” [20]. Some apps also provide advice on dealing with differing mental health concerns such as “Overcoming Depression” [21] and “Mental Health WATS” [22]. However, the problem with almost all of these apps is that they are not subject to regulatory assessments or empirical evaluations before they are made available to the general public and very few are supported by research indicting their effectiveness and usability [15,17,23]. This lack of research may be a consequence of most apps reaching consumers directly, without going through traditional medical gatekeepers [18]; however, it means that the quality of the content of these apps cannot be verified. Thus, the information these apps provide could be inaccurate or misleading, which at best may not be useful to users or at worst may cause them psychological harm [17]. There is a growing demand for studies evaluating the feasibility and efficacy of rigorously designed, evidence-based apps before they are made publically available through online platforms [7,15,23,24]. As rigorously designed evaluations often require the investment of significant resources, not all interventions can be tested for efficacy and effectiveness. Feasibility studies play an important role in identifying potentially efficacious interventions and ensuring they are prioritized for comprehensive evaluation [25]. Feasibility studies achieve this by exploring factors such as the acceptability of an intervention to participants, adherence and drop-out rates, and aspects of the intervention that may be altered to improve participants’ engagement [26], and are considered a crucial first step prior to the conduction of larger scale efficacy evaluations [27,28]. Whittaker et al [29], for example, explored the acceptability of cognitive behavioral therapy text-messages delivered twice daily to adolescents over nine weeks. They found that three-quarters of participants found the information useful and 90% would recommend the intervention to a friend. Similarly, Reid et al [30] explored usage patterns of a simple diary-based self-monitoring mobile app for adolescents and found engagement with the app was high, with nearly three-quarters of participants completing 80% or more of possible diary entries over the one-week intervention period. Findings from these studies are promising and suggest more complex app-based mental health interventions may be similarly feasible for use with adolescents. The objective of the present study was to evaluate the feasibility of a telemental health app, which aimed to foster positive mental health, for use by adolescents on their personal mobile phones. This study expands on previous research [29,30] by capturing detailed qualitative and quantitative feedback from adolescents pertaining to their satisfaction with, perceived usefulness of, and overall engagement with a telemental health app. The app in the present study was designed and programed for use on android and iOS mobile devices, following focus group consultation with adolescents in relation to their needs from mental health mobile technologies [31]. The aim of the app was to foster positive mental health via two key mechanisms: (1) emotional self-monitoring, and (2) the promotion of positive coping strategies. Increasing awareness of emotions is a process frequently used in therapeutic contexts [32] and periodically monitoring one’s emotions (ie, engaging in emotional self-monitoring) has been shown to facilitate increases in emotional self-awareness and improvement in mental health outcomes [33,34]. There is also a growing awareness in research literature that the ways in which young people cope with stressors may be significantly correlated with their mental health outcomes [1,35,36], and educating adolescents about coping strategies has been linked to increased use of positive coping strategies and improved mental health [37-39]. The app was branded “CopeSmart” and contains five main sections (see Figure 1 for sample screenshots). Section 1 (Settings) gives users the option to set and change their password for accessing the app and to manage their notification settings. By default the app is set to send reminder notifications to users to engage with it at 8pm each evening, as typically by this time of the day most adolescents are finished with school and after-school activities. Section 2 (Rate My Mood) allows users engage in emotional self-monitoring by rating how happy, angry, sad, stressed or worried they feel on a scale of 1-10. Section 3 of the app (Coping Tips) contains a series of “tips” for coping with problems. These tips were devised based on the “Think Positively” school-based course for developing positive ...

Similar publications

Article
Full-text available
The aim of this study was to summarize data on the prevalence of global physical activity (PA) among children and adolescents in Brazil. This systematic review included an electronic search in 8 databases (PubMed, Scopus, Web of Science, LILACS, SPORTDiscus, BIREME, Scielo, and Google Scholar) and a manual search in the references of retrieved stud...
Article
Full-text available
Reproductive health is a reflection of health during childhood, and crucial during adolescence and adulthood, sets the stage for health beyond the reproductive years for women and affects the health of the next generation. Many different types of educational programs, based on local peculiarities have been shown to positively affect reproductive he...
Article
Full-text available
Background: Studies suggest that sexual minority adolescents experience higher rates of sleep disturbance than their heterosexual peers, and disturbed sleep is a well-known risk factor for suicidality. This study aimed to explore whether sleep quality had mediating effects on the relationship between sexual minority status and suicidal behavior in...
Article
Full-text available
Background: Researchers have emphasized the importance of integrating mental health education with academic curriculum. The focus of the current studies was Mental Health Matters (MHM), a mental health curriculum that is integrated with English language arts. It is taught by trained community member volunteers and aims to increase knowledge and de...
Article
Full-text available
Objective: Problematic video-gaming or social media use may seriously affect adolescents’ health status. However, it is not very well known which health-related problems are most strongly related to these issues. To inform the development of prevention and intervention strategies, this study aims to gain a better understanding of the health-related...

Citations

... Additionally, two reports each provided data for two independent samples (Flett et al., 2020;O'Dea et al., 2020). A manual search of the reference lists of 17 reviews on mHealth for young people identified three additional reports (Kenny et al., 2015;Paul & Fleming, 2019;Pisani et al., 2018). The final sample therefore comprised 15 independent samples, sourced from 13 independent studies and interventions. ...
... wide CIs) were associated with the three smallest samples (Kageyama et al., 2021;Lim et al., 2019;Paul & Fleming, 2019). Although Flett et al., (2020, sample B) and Kenny et al. (2015) reported attrition rates as high as 57% for their respective app interventions, these values were not significantly different from the population rate (p > 0.05). ...
Article
Full-text available
Psychological interventions provided via mobile, wireless technological communication devices (mHealth) are a promising method of healthcare delivery for young people. However, high attrition is increasingly recognised as a challenge to accurately interpreting and implementing the findings of mHealth trials. The present meta-analysis consolidates this research and investigates potential methodological, sociodemographic, and intervention moderators of attrition. A systematic search of MEDLINE, PsycInfo, and Embase was conducted. Study reporting quality was evaluated (QualSyst tool), and attrition rates (proportions) were calculated and pooled, using both random- and mixed-effects models. The pooled attrition rate, sourced from 15 independent samples (Nparticipants = 1766), was 17% (CI [9.14, 30.13]). This increased to 26% (CI [15.20, 41.03]) when adjusting for publication bias. Attrition was significantly higher among application-based interventions (26%, CI [14.56, 41.86]) compared to those delivered via text or multimedia message (6%, CI [1.88, 16.98]). These data were, however, characterised by significant between-study variance. Attrition in mHealth trials with young people is common but may be mitigated by using message-based interventions. Taken together, the results can provide guidance in accounting for attrition across future mHealth research, clinical practice, public policy, and intervention design. However, sustained research focus on the effectiveness of different engagement strategies is needed to realise mHealth’s promise of equitable and efficient healthcare access for young people globally.
... Young people reflected on the effectiveness of DHP for supporting behavior change and increasing confidence in their health choices (54%). Receiving feedback on one's progress, and recognition of improved personal health behaviors after engagement with health promotion technology, were mentioned as positive aspects [41,44,[67][68][69][70][71]. Finally, DHP technology offered young people the benefit of privacy and confidentiality (36%), allowing users to be open and honest about matters of health, and reducing the need to engage with a healthcare professional face to face [38,68,70,72,73]. ...
... Receiving feedback on one's progress, and recognition of improved personal health behaviors after engagement with health promotion technology, were mentioned as positive aspects [41,44,[67][68][69][70][71]. Finally, DHP technology offered young people the benefit of privacy and confidentiality (36%), allowing users to be open and honest about matters of health, and reducing the need to engage with a healthcare professional face to face [38,68,70,72,73]. ...
Article
Full-text available
Background As digital technology presents the potential to enhance the accessibility and effectiveness of health promotion campaigns, adolescents and young adults are an important target population. Young people are establishing behaviors that will contribute to the quality of their health later in life, and thus understanding their particular perspectives and receptivity to digital technologies for health promotion is crucial. With this review we aimed to synthesize the published literature reporting perspectives on digital health promotion (DHP) from adolescents and young adults worldwide. Methods We conducted a scoping review of the literature on five research databases. We included papers which defined a target population of young people, and encompassed qualitative, quantitative, and mixed methods studies. Two independent reviewers thematically analyzed the included publications and provided both a quantitative and a narrative synthesis of the views of youth (namely opportunities and concerns) on digital health promotion. Results We retrieved and analyzed 50 studies which met our inclusion and exclusion criteria. The large majority of these studies were conducted in high-income countries, while only a few collected the perspectives of youth in low- or middle-income countries. Findings revealed the importance of certain technology features, such as user interface design, as well as the significance of lack of personalization or user experience friction, for example, as deterrents to engagement with DHP tools. Ethically relevant aspects, such as those related to privacy or scientific reliability of the tools, did not receive much attention from youth. Yet, DHP for particularly sensitive areas of health elicited more frequent concerns about data security and evidence of effectiveness. Conclusions Young people express distinct opinions and preferences concerning the use of digital technologies for health promotion. Our review identified a general appreciation and receptivity on the part of adolescents and young adults towards these technologies, even when taking potential risks into account.
... While some students reported being stymied by the unfamiliarity of the technology it appears that many discovered new digital abilities in software product conceptualisation and design. This is important given that the world of smartphone technology has revolutionised the field of adolescent mental health work which is often categorised by adolescent resistance to engage in traditional mental health practices as well as being cost effective (Kenny, Dooley & Fitzgerald, 2015). With further technology developments, it may be possible to include new interfaces with smartphones such as video that can connect users with their therapists (Luxton, McCann, Bush, Mishkind, & Reger, 2011). ...
Article
Full-text available
... To assess participants' concerns about meditation apps, we adopted 10 items from the studies by Stoyanov et al [41], Torous et al [42,43], and Kenny et al [44]. Example items include "cost of apps," "I am not interested in them," "they do not target or help with my goals," and "technical problems" (Multimedia evaluated associations between app use and individual concerns, as well as with the total number of concerns. ...
Article
Full-text available
Background: Meditation apps have the potential to increase access to evidence-based strategies to promote mental health. However, it is currently unclear how meditation apps are situated within the broader landscape of meditation practice and what factors may influence engagement with them. Objective: This study aimed to clarify the prevalence and correlates of meditation app use in a population-based sample of individuals with lifetime exposure to meditation in the United States. In addition, we sought to identify the concerns and desired features of meditation apps among those with lifetime exposure to meditation. Methods: A total of 953 participants completed an initial screening survey. Of these 953 participants, 434 (45.5%) reported lifetime exposure to meditation and completed a follow-up survey (434/470, 92.3% response rate) assessing their meditation app use, anxiety, depression, loneliness, initial motivation for meditation, and concerns about and desired features of meditation apps. Results: Almost half (434/953, 45.5%) of the participants who completed the screening survey reported lifetime exposure to meditation. Among those with lifetime exposure to meditation (ie, meditators), more than half (255/434, 58.8%) had used meditation apps at least once in their lives, and 21.7% (94/434) used meditation apps weekly or daily (ie, active users). Younger age, higher anxiety, and a mental health motivation for practicing meditation were associated with lifetime exposure to meditation apps. Among meditators, those with lifetime exposure to meditation apps were more likely to report concerns about apps, including concerns regarding the cost and effectiveness of apps, time required for use, technical issues with apps, and app user-friendliness. Meditators who used meditation apps weekly or daily (ie, active users) were younger, less likely to be men and non-Latinx White individuals and have lower income, and more likely to have an initial spiritual motivation for meditation. Active users reported more concerns regarding usability and technical problems and were less likely to report disinterest in apps. Headspace and Calm were the most frequently used apps. Tips and reminders for practice, encouragement of “mini” practices, and mental health content were the most desired features. Participants were less interested in social features (eg, the ability to communicate with other users or teachers). Conclusions: Meditation apps are commonly used by meditators in the United States, with a higher use among certain demographic groups. Future studies may increase user engagement in meditation apps by addressing concerns (eg, cost and effectiveness) and incorporating desired features (eg, tips and reminders for practice).
... Meta-analyses have provided evidence that phone-based mental health interventions that include self-monitoring components, are tailored to individuals, and increase social interaction are significantly more effective for adolescents than apps that do not use these features [15,[22][23][24]. Self-monitoring involves the ability to log behaviors through the app [24]. ...
... Mobiletype [26] demonstrated an increase in the coordination of care between adolescent patients and pediatricians. At the time of this study, there were only 13 mental health apps whose use among adolescents was extensively studied (Table S1 in Multimedia Appendix 1 [23,[26][27][28][29][30][31][32][33][34][35][36][37]), and none of them focused primarily on resilience. Out of these 13 apps, 5 (38%) focused on mental health treatment (eg, coping strategies for anxiety and decreasing suicidal ideation), 4 (31%) focused on self-assessment (eg, mood rating scales and tracking sleep quality), and 4 (31%) focused on mental health illness prevention (eg, prevention of anxiety disorders and prevention of psychosis). ...
... Clinicians focused on improving engagement by incorporating interesting activities and a reward system. The lack of engagement has previously deterred youth from gaining the benefits of mental health apps [23,28]. ...
Article
Full-text available
Background: Resilience is defined as the ability to rely on internal characteristics and external strengths to adapt to adverse events. Although universal resilience-enhancing programs are effective for adolescents, there is a need for interventions that are more easily accessible and can be customized for individual teens. Phone apps are easy to use, can be tailored to individuals, and have demonstrated positive effects for mental health outcomes. Objective: This study aimed to examine the feasibility and acceptability of a resilience app for adolescents. This app aimed to enhance resilience through modules focused on depression prevention, stress management, and healthy lifestyle approaches containing videos, measures, and practice suggestions. Furthermore, the study aimed to evaluate the effect of short-term app use on changes in resilience. Methods: In study 1, individual interviews and focus groups were conducted with adolescents, parents, teachers, and clinicians to discuss possible incentives for using a mental health app, the benefits of app use, and concerns associated with app use. Feedback from study 1 led to ideas for the prototype. In study 2, individual interviews and focus groups were conducted with adolescents, parents, teachers, and clinicians to gather feedback about the resilience app prototype. Feedback from study 2 led to changes in the prototype, although not all suggestions could be implemented. In study 3, 40 adolescents used the app for 30 days to determine feasibility and acceptability. Additionally, resilience and secondary mental health outcomes were measured before and after app use. Dependent samples 2-tailed t tests were conducted to determine whether there were changes in resilience and secondary mental health outcomes among the adolescents before and after app use. Results: Multiple themes were identified through study 1 individual interviews and focus groups, including app content, features, engagement, benefits, concerns, and improvement. Specifically, the adolescents provided helpful suggestions for making the prototype more appealing and functional for teen users. Study 2 adolescents and adults reported that the prototype was feasible and acceptable through the Computer System Usability Questionnaire (mean 6.30, SD 1.03) and Mobile App Rating Scale (mean 4.08, SD 0.61). In study 2, there were no significant differences in resilience and mental health outcomes after using the app for 30 days. There was variation between the participants in the extent to which they used the app, which may have led to variation in the results. The users appeared to prefer the depression module and survey sections, which provided mental health feedback. Conclusions: Qualitative and quantitative data provide evidence that youth are interested in a resilience mental health app and that the current prototype is feasible. Although there were no significant mental health changes in study 3 users, practical implications and future directions are discussed for mental health app research.
... Discussions with study participants revealed that some viewed the app as a friendly tool promoting self-awareness and personal growth. They found the app enabled them to increase their emotional awareness and gain a better understanding of themselves, as reported in previous studies on self-monitoring tools [32,33]. Participants perceived the app interface as engaging and less clinical. ...
Article
Full-text available
Background: Children and young people's mental health is a growing public health concern, which is further exacerbated by the COVID-19 pandemic. Mobile health apps, particularly those using passive smartphone sensor data, present an opportunity to address this issue and support mental well-being. Objective: This study aimed to develop and evaluate a mobile mental health platform for children and young people, Mindcraft, which integrates passive sensor data monitoring with active self-reported updates through an engaging user interface to monitor their well-being. Methods: A user-centered design approach was used to develop Mindcraft, incorporating feedback from potential users. User acceptance testing was conducted with a group of 8 young people aged 15-17 years, followed by a pilot test with 39 secondary school students aged 14-18 years, which was conducted for a 2-week period. Results: Mindcraft showed encouraging user engagement and retention. Users reported that they found the app to be a friendly tool helping them to increase their emotional awareness and gain a better understanding of themselves. Over 90% of users (36/39, 92.5%) answered all active data questions on the days they used the app. Passive data collection facilitated the gathering of a broader range of well-being metrics over time, with minimal user intervention. Conclusions: The Mindcraft app has shown promising results in monitoring mental health symptoms and promoting user engagement among children and young people during its development and initial testing. The app's user-centered design, the focus on privacy and transparency, and a combination of active and passive data collection strategies have all contributed to its efficacy and receptiveness among the target demographic. By continuing to refine and expand the app, the Mindcraft platform has the potential to contribute meaningfully to the field of mental health care for young people.
... Advantages of app-based interventions, broadly referred to today as digital therapeutics (DTx), include flexibility in use (i.e., time of day, location), tailored content, lower cost, and increased service capacity. Moreover, adolescents' perspectives on telehealth services are generally positive [29][30][31] and their digital literacy is unprecedented. ...
... In the present study, participants highlighted the accessibility of the DTx and the fact that it was not in person as a positive attribute. This is in line with other pilot feasibility trials that investigated the acceptability of mobile-based interventions for youth [29][30][31]. ...
Preprint
BACKGROUND A third of adolescents experiencing a concussion will suffer from persistent post-concussion symptoms lasting a month or beyond. The ability to cope with concussion symptoms, regulate emotions, and manage stress is an important determinant of risk for prolonged symptoms. Early psychological interventions, such as mindfulness-based interventions, might improve concussion recovery. OBJECTIVE This open-label mixed-methods pilot study assessed the acceptability and credibility of a mindfulness-based intervention delivered through a digital therapeutic (DTx; therapeutic smartphone app) for pediatric concussion. METHODS Participants aged 12-18 years were recruited from an emergency department within 48 hours of a concussion (acute cohort) or from a tertiary care clinic at least 1 month post-concussion (persistent symptom cohort). Participants completed a novel 4-week mindfulness-based intervention, for 10-15 min/day, at a minimum of 4 days/week. At 2 weeks post-concussion, participants completed a credibility questionnaire. At 4 weeks, participants completed questionnaires assessing satisfaction, usability, and working alliance, as well as a semi-structured phone interview. RESULTS 10 participants completed the study outcomes, including 7 acute (5 females; median [IQR] age=14.73 [13.94,16.94] years and 3 persistent symptom patients (2 females; median [IQR] age=17.62 [17.48,17.86] years). Across cohorts, half-way through the intervention, the treatment expectation was moderate (median=6.00 [3.58,7.75], maximum possible=9.00). Moreover, the intervention was perceived as credible (median=6.50 [6.83,8.75], maximum possible=9.00). At 4 weeks, the DTx was considered usable (median=70.00 [55.00,82.50], maximum possible=100.00). Participants rated their satisfaction with the DTx (median=27.00 [24.50,29.50], maximum possible=32.00) and the working alliance with the digital mindfulness guides (median=3.92 [3.38-4.33], maximum possible=5.00) as high. Four themes were identified from the qualitative data: 1) positive attributes (including accessibility, ease of use, perceived effectiveness, variety of features, and meditation guides); 2) negative attributes (technical issues that acted as a barrier to use, and sounds and lights that were triggering headaches); 3) ideas for modifications; and 4) technical issues. CONCLUSIONS Adolescents were very satisfied with a mindfulness-based intervention delivered via a smartphone app and considered it to be usable and credible. Results inform modifications to the DTx, instructions, and mindfulness intervention, and potential ways to increase adherence by leveraging positive attributes. A randomized control trial will assess the effectiveness of the DTx to decrease the risk of persistent symptoms and reduce the symptom burden following pediatric concussion. The present mixed-methods study and the iterative approach to intervention design we are using will ensure better translation and impact of interventions for adolescents with concussions.
... Going beyond applications related to health and well-being, Glasgow et al. discussed how aspects like destinations, travel choices, and social ambiance are related to mood [35]. Further, in this context, prior work that uses mood tracking has focused on different populations such as college students [55,112], adolescents [49] and clinically diagnosed, high-risk populations with mental well-being related issues [29,63,111]. Hence, most prior studies relied on user engagement to keep track of mood. ...
Preprint
Full-text available
Mood inference with mobile sensing data has been studied in ubicomp literature over the last decade. This inference enables context-aware and personalized user experiences in general mobile apps and valuable feedback and interventions in mobile health apps. However, even though model generalization issues have been highlighted in many studies, the focus has always been on improving the accuracies of models using different sensing modalities and machine learning techniques, with datasets collected in homogeneous populations. In contrast, less attention has been given to studying the performance of mood inference models to assess whether models generalize to new countries. In this study, we collected a mobile sensing dataset with 329K self-reports from 678 participants in eight countries (China, Denmark, India, Italy, Mexico, Mongolia, Paraguay, UK) to assess the effect of geographical diversity on mood inference models. We define and evaluate country-specific (trained and tested within a country), continent-specific (trained and tested within a continent), country-agnostic (tested on a country not seen on training data), and multi-country (trained and tested with multiple countries) approaches trained on sensor data for two mood inference tasks with population-level (non-personalized) and hybrid (partially personalized) models. We show that partially personalized country-specific models perform the best yielding area under the receiver operating characteristic curve (AUROC) scores of the range 0.78-0.98 for two-class (negative vs. positive valence) and 0.76-0.94 for three-class (negative vs. neutral vs. positive valence) inference. Overall, we uncover generalization issues of mood inference models to new countries and how the geographical similarity of countries might impact mood inference.
... It should focus on "logging" emotions. On the other hand, some applications such as CopeSmart [39] also have the additional feature of promoting positive coping strategies. Some applications were developed to assist in improving mental health. ...
... Literature suggests that the benefits of emotional self-awareness spread across multiple aspects of life [15,63]. A majority of current work that empirically shows supporting for emotional awareness heavily depends on self-reporting of emotions [5,18,34,39] which could be a hassle in real-life deployment [3]. We overcome the burden of self-reporting by automatically recognising emotions. ...
Article
Full-text available
Emotional Self-Awareness (ESA) plays a vital role in physical and mental well-being. Recent advancements in artificial intelligence technologies have shown promising emotion recognition results, opening new opportunities to build systems to support ESA. However, little research has been done to understand users' perspectives on artificial-intelligence-based emotion recognition systems. We introduce Troi, an automatic emotion recognition mobile app using wearable signals. With Troi, we ran a multi-day user study with 12 users to understand user preference parameters, such as perceived accuracy, confidence, preferred emotion representations, effect of self-awareness of emotions, and real-time use cases. Further, we extend our study to evaluate the machine learning model in-the-wild to understand behaviours in-the-wild. We found that users perceived accuracy of the emotion recognition model is higher than the actual model prediction accuracy; there was no strong preference for one specific emotion representation, and users' self-awareness of emotions improved over time.
... Overall, the implementation of a patient-centered digital intervention was well received by adolescents, clinicians and stakeholders alike, which is consistent with findings from other studies [23][24][25][26]. The incorporation of technology during consultation is particularly appealing to young people who are more likely to be familiar with digital devices and the internet in general [27]. ...
Article
Full-text available
Background Patient and stakeholders’ involvement in the development of mental health interventions is a central part of the research process as end-user’s input can improve the design of patient-centered interventions. This is particularly important when developing interventions directed towards improving the mental health of children and adolescents. The rising prevalence of mental health disorders in this population requires special attention and the development of interventions that include them as active participants is crucial. Objective Our aim is to explore the perspectives and opinions of adolescents, parents, educators/youth workers, and clinicians regarding the appeal and usability of an existing patient-centered digital intervention (DIALOG+), which aims to improve quality of life. Methods As part of a broader study aiming to adapt and test DIALOG+, we conducted Online Focus Groups (OFGs) with adults and adolescents in two cities in Colombia. The existing DIALOG+ intervention was introduced to participants, followed by a structured discussion regarding the opinions and views of stakeholders. A framework approach was used to identify the main themes followed by content analysis to aid adaptation. Results We conducted 10 OFGs with a total of 45 participants. A positive feature highlighted by all groups was the innovation of including a digital intervention in a traditional medical visit. Additionally, participants considered that the active role that adolescents have when using the intervention empowers them. Barriers identified included concerns from clinicians related to the time required during consultations and confusion with terminology. Furthermore, additional domains that are particularly relevant for the adolescent population were suggested. Conclusions Data obtained suggest that overall, the DIALOG+ intervention and supporting app are seen as innovative and appealing to adolescents as well as adult stakeholders. However, concerns raised about the availability of time to apply the intervention, the app interface and the language and terminology require modification.