Development of a Mobile App for the Mental Health Improvement of Youth in Out-of-Home Care: An Intervention Mapping Approach (Preprint)

Abstract

BACKGROUND Youth in out-of-home care encounter substantial mental health challenges because of the absence of stable family and social support systems. Their vulnerability is heightened by trauma, neglect, and abuse. They struggle, especially when transitioning to independent living, coping with loneliness, anxiety, and pressure. OBJECTIVE This study aimed to develop a mobile app with high accessibility and long-term continuous effects to support independent living and improve mental health among youths in out-of-home care. The approach used was the systematic and step-by-step intervention mapping protocol (IMP). METHODS The program was created using IMP and had six steps. Drawing from data from individual and focus group interviews and literature reviews, we developed a logical model of the problem. We established program outcomes and objectives, defining performance objectives and variable determinants. We identified theoretical and evidence-based methods that influence determinants. The app design integrated these methods into practical applications, allowing for the creation of self-management and emotional support tools. The development process included ongoing discussions between app designers and the research team to ensure that user needs and preferences were addressed. RESULTS Individual interviews and focus group discussions revealed challenges in managing daily routines and regulating emotions. The program design was based on the transtheoretical model, social cognitive theory, and elaboration likelihood model. Key features included goal setting, structured routines, emotion recognition flashcards, character models demonstrating emotion regulation strategies, verbal persuasion, and self-monitoring tools to support habit formation and emotion regulation. An implementation plan was developed to facilitate the app’s adoption, execution, and maintenance, while an evaluation plan was established, including app usage analytics, user logs, and feedback surveys. A randomised controlled trial will be conducted to assess the app's impact on mental health outcomes, focusing on reducing anxiety and depressive symptoms, improving emotion regulation, and enhancing daily living skills. CONCLUSIONS The IMP framework was beneficial in developing a mobile app to enhance the mental health of youths in out-of-home care. The study produced a program grounded in theory and evidence which caters to the needs of these individuals. Further research should aim to verify the app’s effectiveness in real-world settings and refine it continuously based on user input. CLINICALTRIAL Not applicable