Macro-engagement in mHealth: Exploring user engagement beyond the screen

BACKGROUND University students are experiencing a multitude of challenges and a rise in mental health issues impacting their academic performance and overall well-being. In response, Erasmus University Rotterdam started the Student Wellbeing Programme in 2019, offering comprehensive, tailored support through a stepped-care framework to enhance student success and well-being. One of the tools developed for the students is an anonymous and accessible preventative mental health app, ROOM. OBJECTIVE This paper aims to describe the process of ROOM’s development guided by the Centre for eHealth Research roadmap (CeHRes) roadmap and privacy-by-design principles, highlighting lessons learned throughout this process. METHODS This study describes the first three phases of the CeHRes Roadmap: Contextual Inquiry, Value Specification, and Design. It details the population (i.e., stakeholders) included, methods employed (i.e., literature reviews, expert groups, cognitive walkthroughs, interviews, experimental designs) and the outcomes of each phase. RESULTS The four-year development process resulted in ROOM, an adaptive mental health intervention that uses a transdiagnostic approach. The intervention targets underlying factors of most prevalent mental health problems among this population, namely emotion regulation (ER) skills and self-awareness. ROOM employs various therapeutic approaches, including Acceptance and Commitment Therapy, Cognitive Behavioural Therapy, Positive Psychology, Mindfulness, and Self-Compassion, to suit diverse student needs. To address this demographic’s reported technostress, ROOM integrates tools that support the application of skills in real life. Altogether, the minimal viable product consists of 26 ER exercises, tools stimulating the transfer of learned skills into real-life environments, self-assessments evaluating user states (e.g., stress levels) and traits (e.g., perfectionism), a mood tracker, and an intelligent recommender system that increases the relevance and responsiveness of the tool. CONCLUSIONS We detailed the development of ROOM, including the trade-offs and challenges encountered. The trade-offs needed to be made to balance user needs, resource constraints, and privacy-by-design standards, often compromising ROOM’s interactivity. Other challenges included simplifying complex psychological concepts into brief formats, fostering interdisciplinary collaboration, balancing academic rigor with industry production pace, and operating with fixed resources while committing to an iterative process. This paper may serve as a primer for designing transdiagnostic, adaptive mental health interventions for youth, blending therapeutic approaches and fostering skill transfer.

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Macro-engagement in mHealth: Exploring user engagement beyond the screen

Cited by 2 publications

References 27 publications

Effectiveness and uptake of a transdiagnostic emotion regulation mobile intervention among university students: Protocol for a randomized controlled trial

Effectiveness and uptake of a transdiagnostic emotion regulation mobile intervention among university students: Protocol for a randomized controlled trial

Design Process of ROOM: A Mobile Intervention Supporting University Students’ Well-Being (Preprint)

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