Acceptability of an mHealth App for Youth With Substance Use and Mental Health Needs: Iterative, Mixed Methods Design

Abstract

Background Treating substance use disorders (SUDs) during adolescence can prevent adult addiction and improve youth outcomes. However, it can be challenging to keep adolescents with SUDs engaged in ongoing services, thus limiting potential benefits. Developmentally appropriate tools are needed to improve treatment engagement during and between sessions for youth with SUDs and mental health disorders. Mobile health apps may augment or replace psychotherapy components; however, few have been developed specifically for youth with SUDs following user-guided design principles, which may limit their appropriateness and utility. Formative research on acceptability to intended end users is needed before the efficacy of such tools can be examined. Objective This study involves user-centered, iterative development and initial user testing of a web-based app for adolescents with SUDs and mental health concerns. Methods Adolescents aged 14 to 17 years with past-year involvement in outpatient psychotherapy and behavioral health clinicians with adolescent SUD treatment caseloads were recruited. Across 2 assessment phases, 40 participants (alpha: 10 youths and 10 clinicians; beta: 10 youths and 10 clinicians) viewed an app demonstration and completed semistructured interviews and questionnaires about app content and functionality. Results Participants expressed positive impressions of the app and its potential utility in augmenting outpatient therapy for youth with SUDs and mental health concerns. Noted strengths included valuable educational content, useful embedded resources, and a variety of activities. Adolescents and clinicians favored the app over conventional (paper-and-pencil) modalities, citing convenience and familiarity. The app was found to be user-friendly and likely to improve treatment engagement. Adolescents suggested the inclusion of privacy settings, and clinicians recommended more detailed instructions and simplified language. Conclusions The novel app developed here appears to be a promising, acceptable, and highly scalable resource to support adolescents with SUDs and mental health concerns. Future studies should test the efficacy of such apps in enhancing adolescent behavioral health treatment engagement and outcomes.

Using Human-Centered Design Strategies to Identify Unmet Adolescent Sexual Health Wants and Needs

“…Findings from this study also represent cross-cutting themes that may be useful for research and practice involving additional health behaviors (e.g., drinking, smoking, vaping). Indeed, adolescent researchers focused on substance use (Adams et al, 2021) as well as alcohol use and suicidal behavior (O'Brien et al, 2019) reported similar findings regarding the desire for a mobile application to provide health information and social support among adolescents. Finally, findings regarding peer learning are echoed in previous research.…”

Mobile applications in adolescent psychotherapy during the COVID-19 pandemic: a systematic review

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Promoting mental health in children and adolescents through digital technology: a systematic review and meta-analysis

“…Similar to apps for treating depression and anxiety, adolescent patients believe that the apps have good usability and ease of use and can encourage them to share their thoughts, feelings, and behavioral information more openly and honestly while protecting their privacy ( Adams et al, 2021 ). However, due to the severe condition of patients with mental illness, the apps not only are used independently by patients but also serves as a bridge between therapists and patients.…”