Background Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We investigated the associations between social isolation, COVID-19-related cognitive preoccupation, worries, and anxiety, objective social risk indicators, and psychological distress, as well as use of, and attitude toward, mobile health (mHealth) interventions in youth. Methods Data were collected as part of the “Mental Health And Innovation During COVID-19 Survey”—a cross-sectional panel study including a representative sample of individuals aged 16–25 years (N = 666; Mage = 21.3; assessment period: May 5, 2020 to May 16, 2020). Results Overall, 38% of youth met criteria for moderate or severe psychological distress. Social isolation worries and anxiety, and objective risk indicators were associated with psychological distress, with evidence of dose–response relationships for some of these associations. For instance, psychological distress was progressively more likely to occur as levels of social isolation increased (reporting “never” as reference group: “occasionally”: adjusted odds ratio [aOR] 9.1, 95% confidence interval [CI] 4.3–19.1, p < 0.001; “often”: aOR 22.2, CI 9.8–50.2, p < 0.001; “very often”: aOR 42.3, CI 14.1–126.8, p < 0.001). There was evidence that psychological distress, worries, and anxiety were associated with a positive attitude toward using mHealth interventions, whereas psychological distress, worries, and anxiety were associated with actual use. Conclusions Public health measures during pandemics may be associated with poor mental health outcomes in youth. Evidence-based digital interventions may help mitigate the negative psychosocial impact without risk of viral infection given there is an objective need and subjective demand.

Background: Public health measures to curb SARS-CoV-2 transmission rates may have negative psychosocial consequences in youth. Digital interventions may help to mitigate these effects. We aimed to investigate the associations between social isolation, COVID-19-related worries/anxieties, objective social risk indicators, psychological distress and use of digital mobile health (mHealth) interventions in youth during the COVID-19 pandemic.Methods: Data were collected as part of the “Health And Innovation During COVID-19 Survey” —a cross-sectional panel study including a representative sample of individuals aged 16 to 25 years (N=666; Mage 21·3) (assessment period: 07.05.-16.05.2020). Data were collected on social isolation, COVID-19-related worries/anxieties, objective social risk indicators, psychological distress as well as the current use of and attitude towards digital interventions.Outcomes: Social isolation, lack of company, worrying, and objective social risk indicators were associated with psychological distress during the COVID-19 pandemic. Dose-response relationships were found. For instance, psychological distress was progressively more likely to occur as levels of reported social isolation increased (with reporting ‘never’ as reference group: ‘very rarely’: adjusted odds ratio [aOR] 2·4,CI 1·0 – 5·7, p=0·041; ‘rarely’: aOR 3·6, CI 1·7 – 7·7, p=0·001; ‘occasionally’: aOR 8·4, CI 4·0 – 17·5, p&lt;0·001; ‘often’: aOR 20·6, CI 9·3 – 45·7, p&lt;0·001;’very often’: aOR 43·4, CI 14·7 – 128·2, p&lt;0·001). There was evidence that psychological distress, and high levels of social isolation, lack of company, and worrying were associated with a positive attitude towards using digital interventions, whereas only severe levels of psychological distress and worries were associated with actual use (aOR 2·0, CI 1·3 - 3·0, p=0·001; aOR 1·6, CI 1·1 – 2·2, p=0·005, respectively).Interpretation: Public health measures during pandemics may be associated with social isolation and poor mental health outcomes in youth. Digital interventions may help mitigate the negative psychosocial impact without risk for viral infection given there is an objective need and subjective demand.

Background Youth are particularly affected by mental health problems, but their use of preventive interventions remains limited. The advances in Artificial Intelligence (AI) enable the development of digital interventions for mental health promotion and prevention. This applies to ecological momentary interventions (EMI), which offer adaptive training components in daily life. Methods In a preparatory phase, focus groups (N = 2, aged: 15-21 years) and a representative survey (N = 666, aged: 16-24) with young individuals as well as qualitative interviews with stakeholders in routine public mental health provision were conducted. Results None of the stakeholders used digital interventions in their everyday work but were interested in their use. The importance of data protection and security, usability, and participation of the target population in all stages of the research process was emphasized. The risk of a digital divide, acceptance of used terminology, and difficulties of structural embedding were mentioned as important barriers for successful implementation. Young individuals had a positive attitude toward digitization and AI and their use in mental health promotion and prevention and underlined the importance of practical benefits for users. They had a pragmatic attitude toward data use policies. Around 70% of young individuals were already using mHealth apps. Psychological distress was associated with the use of, and positive attitude towards, mHealth apps. Discussion Findings have contributed to the ongoing main phase. The living lab AI4U will be carried out in transdisciplinary projects involving direct participation of relevant stakeholders, users from the target population and an interdisciplinary research group. Each of these projects includes one or more real-world experiments. These will be embedded in a transdisciplinary infrastructure, which will ensure ongoing quality assurance, sustainability assessment, public relations and networking.

Background The implementation of person-centred, need-oriented and flexible care for people with substance-related problems is often insufficient, in large part due to the complexity of addiction support services among different providers. A standardized online assessment and subsequent sector-independent treatment coordination could provide individuals with more appropriate services, thereby making better use of individual services and leading to a more effective addiction support system as a whole. The aim of this study is to determine the effectiveness and cost-effectiveness of sector-independent treatment coordination following an online assessment, in comparison with the current standard of care and treatment process in Germany. Methods The sample size of this randomized, controlled trial has been set to a total of 400 participants with substance-related problems. Participants living in Stuttgart, Germany, will be randomly allocated to (1) the intervention group with immediate online assessment and subsequent sector-independent treatment coordination (ASSIST) or (2) the waitlist group. Participants in the waitlist group will initially remain in usual care and only be provided with the online assessment 6 months later. Short-term effects (over 2 months) and medium-term effects (over 6 months) of ASSIST will be compared between the intervention and the waitlist groups. The primary outcome is improved treatment satisfaction. Secondary outcomes include improved subjective quality of life and empowerment, reductions in patients’ substance use, unmet needs and illness-related clinical and social impairment. Health economic evaluation as well as quantitative and qualitative process evaluations will be conducted. Discussion The results of this study are expected to provide information on whether sector-independent treatment coordination following an online assessment contributes to improved health care service provision for people with substance-related problems. This randomized controlled trial will help identify facilitators and barriers to the sustainable implementation of a cross-sectoral care concept in substance abuse services. Trial registration German Clinical Trial Register DRKS00026996. Registered on 29 October 2021