Assessing the usability and user engagement of Thought Spot - A digital mental health help-seeking solution for transition-aged youth.
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ABSTRACT: Objective
To evaluate the perceived usability of and user engagement with a digital platform (Thought Spot) designed to enhance mental health and wellness help-seeking among transition-aged youth (TAY; 17-29-years old).Materials and methods
Survey responses and usage patterns were collected as part of a randomized controlled trial evaluating the efficacy of Thought Spot. Participants given Thought Spot completed an adapted Usefulness, Satisfaction, and Ease of Use (USE) Questionnaire to measure perceived usability of the platform. User engagement patterns on Thought Spot were examined using analytics data collected throughout the study (March 2018-June 2019).Results
A total of 131 transition-aged participants completed the USE questionnaire and logged on to Thought Spot at least once. Ease of learning scored higher than ease of use, usefulness and satisfaction. Participants identified numerous strengths and challenges related to usability, visual appeal, functionality and usefulness of the content. In terms of user engagement, most participants stopped using the platform after 3 weeks. Participants searched and were interested in a variety of resources, including mental health, counselling and social services.Discussion
Participants reported mixed experiences while using Thought Spot and exhibited low levels of long-term user engagement. User satisfaction, the willingness to recommend Thought Spot to others, and the willingness for future use appeared to be influenced by content relevance, ease of learning, available features, and other contextual factors. Analysis of the types of resources viewed and searches conducted by TAY end-users provided insight into their behaviour and needs.Conclusion
Users had mixed perceptions about the usability of Thought Spot, which may have contributed to the high attrition rate. User satisfaction and engagement appears to be influenced by content relevance, ease of learning, and the types of features available. Further investigation to understand the contextual factors that affect TAYs' adoption and engagement with digital mental health tools is required.
SUBMITTER: Shi J
PROVIDER: S-EPMC8079441 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Suicide is a leading cause of death for transition-aged youth (TAY), and yet few studies examine correlates of suicidal ideation specifically in this age demographic (age 18-24 years). The transition to adulthood is a unique context, marked by novel stressors (e.g., joining the workforce) and increased independence, which may influence risk factors for suicidal ideation. This study examined correlates of suicidal ideation in TAY and adults and contrasted profiles across age.We used 4 biannual cycles (2005, 2007, 2009, 2011) of the Canadian Community Health Survey, a population-based cross-sectional survey on health. We used logistic regression to assess the association between suicidal ideation and depression, distress, alcohol use, smoking, exercise, sedentary behaviour, chronic illness, restrictions to daily living, perceived physical and mental health, and perceived social support independently in both TAY ( n = 4427) and adults ( n = 14,452). We subsequently assessed possible interactions with age (18-24 v. 25-44 years) and sex and differences in help-seeking behaviour in a combined model.TAY exhibited higher rates of suicidal ideation than adults did ( P < 0.001). Numerous factors were associated with suicidal ideation in TAY. Notably, alcohol abstinence was associated with decreased suicidal ideation in TAY but not for adults. Moreover, when depressed, TAY were significantly less likely to have received professional mental health help than adults (odds ratio = 0.64, 95% CI, 0.43 to 0.94).Suicidal ideation is more prevalent in TAY than adults, and its consequences may be aggravated by poor treatment-seeking behaviour in at-risk (i.e. depressed) individuals. These different risk profiles substantiate the recent shift toward clinical interventions focusing on transition-aged youth, rather than traditional child (<18 years) and adult (>18 years) services.
| S-EPMC5564895 | biostudies-other
Project description:BackgroundThere is growing interest in using mobile apps and online tools to support postsecondary student mental health, but most of these solutions have suboptimal user engagement in real-world settings. Poor engagement can limit long-term effectiveness and usefulness of these tools. Previous literature has proposed several theories that link factors such as low usability and poor user-centered design to app disengagement. However, few studies provide direct evidence showing what factors contribute to suboptimal user engagement in the context of mobile mental health apps for postsecondary students.ObjectiveThis study focuses on understanding postsecondary students' attitudes and behaviors when using Thought Spot, a co-designed mental health app and online platform, to understand factors related to engagement and user experience.MethodsStudents who were given access to Thought Spot for 6 months during a randomized trial of the intervention were invited to participate in one-on-one semistructured interviews. The interviews explored participants' overall experiences and perceptions of the app, along with factors that affected their usage of various features. All interviews were recorded, and template analysis was used to analyze transcripts.ResultsUser satisfaction was mixed among users of Thought Spot. The degree of engagement with the app appeared to be affected by factors that can be grouped into 5 themes: (1) Students valued detailed, inclusive, and relevant content; (2) Technical glitches and a lack of integration with other apps affected the overall user experience and satisfaction with the app; (3) Using the app to support peers or family can increase engagement; (4) Crowdsourced information from peers about mental health resources drove user engagement, but was difficult to obtain; and (5) Users often turned to the app when they had an immediate need for mental health information, rather than using it to track mental health information over time.ConclusionsContent, user experience, user-centeredness, and peer support are important determinants of user engagement with mobile mental health apps among postsecondary students. In this study, participants disengaged when the app did not meet their expectations on these determinants. Future studies on user engagement should further explore the effectiveness of different features and the relative importance of various criteria for high-quality apps. Further focus on these issues may inform the creation of interventions that increase student engagement and align with their mental health needs.Trial registrationClinicalTrials.gov NCT03412461; https://clinicaltrials.gov/ct2/show/NCT03412461.International registered report identifier (irrid)RR2-10.2196/resprot.6446.
| S-EPMC8052598 | biostudies-literature
Project description:BackgroundSeventy percent of lifetime cases of mental illness emerge before the age of 24 years, but many youth are unable to access the support and services they require in a timely and appropriate way. With most youth using the internet, electronic health (eHealth) interventions are promising tools for reaching this population. Through participatory design research (PDR) engagement methods, Thought Spot, a Web- and mobile-based platform, was redeveloped to facilitate access to mental health services by transition-aged youth (aged 16-29 years) in postsecondary settings.ObjectiveThe aim of this study was to describe the process of engaging with postsecondary students through the PDR approaches, with the ultimate goal of optimizing the Thought Spot platform.MethodsConsistent with the PDR approaches, five student-led workshops, attended by 41 individuals, were facilitated to obtain feedback regarding the platform's usability and functionality and its potential value in a postsecondary setting. Various creative engagement activities were delivered to gather experiences and opinions, including semistructured focus groups, questionnaires, personas, journey mapping, and a world café. Innovative technological features and refinements were also brainstormed during the workshops.ResultsBy using PDR methods of engagement, participants knew that their ideas and recommendations would be applied. There was also an overall sense of respect and care integrated into each group, which facilitated an exchange of ideas and suggestions.ConclusionsThe process of engaging with students to redesign the Thought Spot platform through PDR has been effective. Findings from these workshops will significantly inform new technological features within the app to enable positive help-seeking behaviors among students. These behaviors will be further explored in the second phase that involves a randomized controlled trial.
| S-EPMC5861299 | biostudies-literature
Project description:BackgroundMental illness in transition age youth is common and treatment initiation is often delayed. Youth overwhelmingly report utilizing the Internet to gather information while psychiatric symptoms emerge, however, most are not yet ready to receive a referral to care, forestalling the established benefit of early intervention.MethodsA digital outreach campaign and interactive online care navigation platform was developed and deployed in New York State on October 22, 2020. The campaign offers live connection to a peer or counselor, a self-assessment mental health quiz, and educational material all designed to promote help-seeking in youth and their allies.ResultsBetween October 22, 2020 and July 31, 2021, the campaign resulted in 581,981 ad impressions, 16,665 (2.9%) clicks, and 13,717 (2.4%) unique website visitors. A third (4,562, 33.2%) completed the quiz and 793 (0.1%) left contact information. Of those, 173 (21.8%) completed a virtual assessment and 155 (19.5%) resulted in a referral to care. The median age of those referred was 21 years (IQR = 11) and 40% were considered to be from low-income areas. Among quiz completers, youth endorsing symptoms of depression or anxiety were more likely to leave contact information (OR = 2.18, 95% CI [1.39, 3.41] and OR = 1.69, 95% CI [1.31, 2.19], respectively) compared to those not reporting symptoms of depression or anxiety. Youth endorsing symptoms of psychosis were less likely to report a desire to receive a referral to care (OR = 0.58, 95% CI [0.43, 0.80]) compared to those who did not endorse symptoms of psychosis.ConclusionSelf-reported symptomatology impact trajectories to care, even at the earliest stages of help-seeking, while youth and their allies are searching for information online. An online care navigation team could serve as an important resource for individuals with emerging behavioral health concerns and help to guide the transition between online information seeking at baseline to care.
| S-EPMC9157179 | biostudies-literature
Project description:BACKGROUND:Mental health disorders are the most prevalent health issues among postsecondary students, yet few solutions to this emerging crisis exist. While mobile health technologies are touted as promising solutions for the unmet mental health needs of these students, the efficacy of these tools remains unclear. In response to these gaps, this study evaluates Thought Spot, a mobile and web app created through participatory design research. OBJECTIVE:The goal of the research is to examine the impact of Thought Spot on mental health and wellness help-seeking intentions, behaviors, attitudes, self-stigma, and self-efficacy among postsecondary students in Canada. METHODS:A 2-armed randomized controlled trial involving students from three postsecondary institutions was conducted. Students were eligible if they were aged 17 to 29 years, enrolled in full-time or part-time studies, functionally competent in English, and had access to a compatible digital device. The usual care group received a mental health services information pamphlet. The intervention group received the Thought Spot app on their digital device. Thought Spot is a standalone app that allows users to add, review, and search crowdsourced information about nearby mental health and wellness services. Users can also track their mood on the app. Outcomes were self-assessed through questionnaires collected at baseline and 3 and 6 months. The primary outcome was change in formal help-seeking intentions from baseline to 6 months, measured by the General Help-Seeking Questionnaire. A mixed-effects model was used to compare the impact of usual care and intervention on the primary outcome (formal help-seeking intentions). Secondary outcomes included changes in informal help-seeking intentions and help-seeking behaviors, help-seeking attitudes, self-stigma, and self-efficacy. RESULTS:A total of 481 students were randomized into two groups: 240 to usual care, and 241 to the intervention group. There were no significant differences in help-seeking intentions between the usual care and intervention groups over 6 months (F2,877=0.85; P=.43, f=0.04). Both groups demonstrated similar increases in formal help-seeking intentions at 3 and 6 months (F2,877=23.52; P<.001, f=0.21). Compared with males, females sought more help from formal resources (OR 1.86; 95% CI 1.22 to 2.83, P=.001). Females were less likely to seek help from informal sources than males (OR 0.80; 95% CI 0.22 to 0.73, P<.001). CONCLUSIONS:Prompting postsecondary students about mental health and help-seeking appears to increase help-seeking intentions. mHealth interventions may be as effective as information pamphlets in increasing formal help-seeking but may confer a small advantage in driving help-seeking from informal sources. Although there is enthusiasm, developers and health policy experts should exercise caution and thoroughly evaluate these types of digital tools. Future studies should explore the cost-effectiveness of digital interventions and develop strategies for improving their efficacy. TRIAL REGISTRATION:ClinicalTrials.gov NCT03412461; https://clinicaltrials.gov/ct2/show/NCT03412461. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):RR2-10.2196/resprot.6446.
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Project description:BackgroundSeventy percent of lifetime cases of mental illness emerge prior to age 24. While early detection and intervention can address approximately 70% of child and youth cases of mental health concerns, the majority of youth with mental health concerns do not receive the services they need.ObjectiveThe objective of this paper is to describe the protocol for optimizing and evaluating Thought Spot, a Web- and mobile-based platform cocreated with end users that is designed to improve the ability of students to access mental health and substance use services.MethodsThis project will be conducted in 2 distinct phases, which will aim to (1) optimize the existing Thought Spot electronic health/mobile health intervention through youth engagement, and (2) evaluate the impact of Thought Spot on self-efficacy for mental health help-seeking and health literacy among university and college students. Phase 1 will utilize participatory action research and participatory design research to cocreate and coproduce solutions with members of our target audience. Phase 2 will consist of a randomized controlled trial to test the hypothesis that the Thought Spot intervention will show improvements in intentions for, and self-efficacy in, help-seeking for mental health concerns.ResultsWe anticipate that enhancements will include (1) user analytics and feedback mechanisms, (2) peer mentorship and/or coaching functionality, (3) crowd-sourcing and data hygiene, and (4) integration of evidence-based consumer health and research information.ConclusionsThis protocol outlines the important next steps in understanding the impact of the Thought Spot platform on the behavior of postsecondary, transition-aged youth students when they seek information and services related to mental health and substance use.
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Project description:The Institute of Image-Guided Surgery (IHU) of Strasbourg develops new minimally invasive therapies, the benefit of which is maximized by an integrated approach to the care pathway (pre, per and postoperative).
Encouraging patient engagement in the process responds to its growing demand for information and consideration, enhances its care experience and clinical outcomes.
Medtronic has designed an digital solution for patient engagement (current name: "Get Ready") for scheduled colorectal surgery. The IHU is a pilot experiment site for this solution. This research protocol, of which the IHU is the promoter, aims at evaluating the use and the impact of this solution made available to the patients of the Hepato-Digestive Pole (PHD) of the New Civil Hospital.
The solution deployed at the Strasbourg IHU aims to improve the patient’s preparation for his colorectal surgery and follow his rehabilitation after surgery, by reinforcing his compliance with existing protocols and enriching it with complementary practices.
The solution is not a medical device. It is limited to advice, monitoring and restitution of data declared by the patient; it is not intended to prevent, diagnose or treat the pathology; it is independent of any other medical device.
This study aims to assess the pre-operative impact of the solution, in terms of patients’ adherence to the pre-operative program and correlations with their physical and psychological condition until their admission to surgery. The secondary purpose of the study is to precise the acceptability of the solution.
| 2321206 | ecrin-mdr-crc
Project description:Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension ("adaptive salience"). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αβ = .22, 95% CI = 0.02, 0.48) and social functioning (αβ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL.
| S-EPMC8530392 | biostudies-literature
Project description:BackgroundWhile many digital mental health interventions (DMHIs) have been found to be efficacious, patient engagement with DMHIs has increasingly emerged as a concern for implementation in real-world clinical settings. To address engagement, we must first understand what standard engagement levels are in the context of randomized controlled trials (RCTs) and how these compare with other treatments.ObjectiveThis scoping review aims to examine the state of reporting on intervention engagement in RCTs of mobile app-based interventions intended to treat symptoms of depression. We sought to identify what engagement metrics are and are not routinely reported as well as what the metrics that are reported reflect about standard engagement levels.MethodsWe conducted a systematic search of 7 databases to identify studies meeting our eligibility criteria, namely, RCTs that evaluated use of a mobile app-based intervention in adults, for which depressive symptoms were a primary outcome of interest. We then extracted 2 kinds of information from each article: intervention details and indices of DMHI engagement. A 5-element framework of minimum necessary DMHI engagement reporting was derived by our team and guided our data extraction. This framework included (1) recommended app use as communicated to participants at enrollment and, when reported, app adherence criteria; (2) rate of intervention uptake among those assigned to the intervention; (3) level of app use metrics reported, specifically number of uses and time spent using the app; (4) duration of app use metrics (ie, weekly use patterns); and (5) number of intervention completers.ResultsDatabase searching yielded 2083 unique records. Of these, 22 studies were eligible for inclusion. Only 64% (14/22) of studies included in this review specified rate of intervention uptake. Level of use metrics was only reported in 59% (13/22) of the studies reviewed. Approximately one-quarter of the studies (5/22, 23%) reported duration of use metrics. Only half (11/22, 50%) of the studies reported the number of participants who completed the app-based components of the intervention as intended or other metrics related to completion. Findings in those studies reporting metrics related to intervention completion indicated that between 14.4% and 93.0% of participants randomized to a DMHI condition completed the intervention as intended or according to a specified adherence criteria.ConclusionsFindings suggest that engagement was underreported and widely varied. It was not uncommon to see completion rates at or below 50% (11/22) of those participants randomized to a treatment condition or to simply see completion rates not reported at all. This variability in reporting suggests a failure to establish sufficient reporting standards and limits the conclusions that can be drawn about level of engagement with DMHIs. Based on these findings, the 5-element framework applied in this review may be useful as a minimum necessary standard for DMHI engagement reporting.
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Project description:BackgroundTransition-aged youth are particularly vulnerable to mental health problems, yet they are one of the least likely demographic groups to seek help.ObjectiveThe aim of this study is to explore the influences on and patterns in help-seeking for mental health concerns among transition-aged youth who attend postsecondary schools in Canada.MethodsA qualitative research design was used, involving 12 semistructured focus groups with transition-aged youth (17-29 years) who attended postsecondary schools in Canada. A thematic analysis was conducted to code the transcripts and develop themes.ResultsFour main themes and subthemes regarding the process and experience of help-seeking were generated: (1) the influence of formal service providers (accessibility and experiences), (2) the influence of social factors (system navigation and stigma), (3) the influence of health literacy (symptom recognition, acting on symptoms, digital tools and the internet, and mental health awareness campaigns), and (4) the influence of low-intensity sources of support, namely, self-help.ConclusionsTransition-aged youth seek help for mental health problems in different ways. Despite efforts to improve access to mental health services, transition-aged youth continue to face barriers to accessing these services, especially formal sources of support. The factors identified in this study that either hinder or facilitate help-seeking have pragmatic implications for developing help-seeking interventions and delivering mental health services for this population. In addition to other facilitators, family physicians are an important resource in the help-seeking process. Furthermore, digital help-seeking tools have unique characteristics that may make them an important source of support for transition-aged youth.
| S-EPMC7573698 | biostudies-literature