A School-Based Mobile App Intervention for Enhancing Emotion Regulation in Children: Exploratory Trial

Abstract

Background Most mental health disorders are first experienced in childhood. The rising rates of mental health difficulties in children highlight the need for innovative approaches to supporting children and preventing these difficulties. School-based digital interventions that address shared risk factors and symptoms, such as emotion dysregulation, present exciting opportunities to enhance mental health support for children on a larger scale. Objective This study investigates the use of a new app-based intervention designed to support children’s emotion regulation in schools. The aim is to optimize the usability, acceptability, and utility of the app and explore its scope for implementation with the target user in the school context. Methods As part of an interdisciplinary development framework, the app is being evaluated in a 3-month trial across 4 primary schools. In total, 144 children (aged 10-12 years) took part and accessed the intervention app in the classroom or at home. Outcomes regarding usability, acceptability, and implementation opportunities were assessed through digital user data, self-report questionnaires (132/144, 91.6%), and semistructured interviews with children (19/144, 13.2%) and teachers (6/8, 75%). Results The app usage data showed that 30% (128/426) of the users were returning users. Self-report data indicated that 40.1% (53/132) of the children had not used the app, whereas 57.5% (76/132) had used it once or more. Of the children who had used the app, 67% (51/76) reported that the app was helpful. Interviews with children and teachers suggested positive experiences with the app and that it helped them to calm down and relax. Children reported that they perceived the app as acceptable, usable, and helpful. In terms of the intervention’s usability, most features functioned well; however, certain technical issues were reported, which may have led to reduced engagement levels. Teachers not only reported overall positive experiences but also discussed access difficulties and reported a lack of content as one of the main barriers to implementing the app. Having a web-based app significantly enhanced accessibility across devices and settings and provided teachers with more opportunities to use it. We identified the need for new, activating app features in addition to the existing, primarily relaxing ones. The findings indicated that it is possible to use and evaluate an app intervention in the school context and that the app could help enhance children’s emotion regulation. We discuss areas for improvement regarding the app, study design, and future implementation strategies. Conclusions We share important insights with regard to the development, implementation, and evaluation of a new app for supporting children’s emotion regulation in schools. Our results demonstrate that mental health apps represent a promising means to facilitate effective mental health service provision in and outside of the school context. Important lessons learned are shared to support other researchers and clinicians on similar journeys.

A Pilot Study of Improving Self-Regulation and Social Interaction with Peers: An “Exciting School”

“…To be included, the children had to have reading and writing skills according to their educational level, aged between 7 and 10 years old, and with no diagnosis of autism spectrum disorder (ASD) moderate or severe. The initial sample consisted of 128 children between 7 and 10 years old who were recruited in coordination with teachers and psychologists, using a non-probabilistic convenience sampling procedure [ 17 ]. Written informed consent was obtained from the parents prior to the intervention.…”

“…Improving the social and emotional well-being of the child population in vulnerable situations is a priority objective in mental health programs. It has recently been indicated that between 10 to 20% of the world’s population of children and adolescents have mental health problems, with the main cause of disability emerging at these ages [ 17 ]. The relevance of the development of emotional well-being in the educational field has been emphasized, considering that schools or educational centers are the ideal contexts to promote their development from the beginning of formal education to university education, to improve the quality of life, prevent the onset of mental disorders and improve academic performance [ 8 , 10 ].…”

“…Despite the recognized importance of socio-emotional development and self-regulation, in our context, there are no regular programs implemented in educational centers. Interventions focused on improving self-regulation are considered transdiagnostic interventions, that promote mental health and usually are performed by professionals such as occupational therapists, which can reduce the burden on teachers [ 17 ].…”

A Transdiagnostic, Emotion Regulation App (Eda) for Children: Design, Development, and Lessons Learned

“…Therefore, we only present the research activities of the first 2 stages, as depicted in Figure 2. The findings of the third stage, the exploratory trial, are published elsewhere [29].…”

“…We would like to encourage the field to free itself from this notion as it can significantly hinder us from reaching the actual potential of digital mental health interventions [71]. In relation to this, we would like to refer the readers to the findings of our exploratory trial [29], where we discuss promising future directions for the present app.…”