Developing a Web-Based App to Assess Mental Health Difficulties in Secondary School Pupils: Qualitative User-Centered Design Study

Abstract

Background Secondary schools are an ideal setting to identify young people experiencing mental health difficulties such as anxiety or depression. However, current methods of identification rely on cumbersome paper-based assessments, which are lengthy and time-consuming to complete and resource-intensive for schools to manage. Artemis-A is a prototype web app that uses computerized adaptive testing technology to shorten the length of the assessment and provides schools with a simple and feasible solution for mental health assessment. Objective The objectives of this study are to coproduce the main components of the Artemis-A app with stakeholders to enhance the user interface, to carry out usability testing and finalize the interface design and functionality, and to explore the acceptability and feasibility of using Artemis-A in schools. Methods This study involved 2 iterative design feedback cycles—an initial stakeholder consultation to inform the app design and user testing. Using a user-centered design approach, qualitative data were collected through focus groups and interviews with secondary school pupils, parents, school staff, and mental health professionals (N=48). All transcripts were thematically analyzed. Results Initial stakeholder consultations provided feedback on preferences for the user interface design, school administration of the assessment, and outcome reporting. The findings informed the second iteration of the app design and development. The unmoderated usability assessment indicated that young people found the app easy to use and visually appealing. However, school staff suggested that additional features should be added to the school administration panel, which would provide them with more flexibility for data visualization. The analysis identified four themes relating to the implementation of the Artemis-A in schools, including the anticipated benefits and drawbacks of the app. Actionable suggestions for designing mental health assessment apps are also provided. Conclusions Artemis-A is a potentially useful tool for secondary schools to assess the mental health of their pupils that requires minimal staff input and training. Future research will evaluate the feasibility and effectiveness of Artemis-A in a range of UK secondary schools.

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“…According to Evans and Lindsay (2005), a prototype is a model for testing the intended properties of a product under actual operating conditions, including reactions from users. Presenting the prototype to test the interface and navigation is a core component of the usability assessment of an app as Burn et al. (2022) did during the development of a mental health app.…”

“…Lucio-Ramírez et al. (2020) and Burn et al. (2022) applied pilots to retrieve stakeholder feedback from their health education apps.…”

“…According to Evans and Lindsay (2005), a prototype is a model for testing the intended properties of a product under actual operating conditions, including reactions from users. Presenting the prototype to test the interface and navigation is a core component of the usability assessment of an app as Burn et al (2022) did during the development of a mental health app. The MLIA prototype was prepared between January and April 2021 considering previous recommendations presented by Lucio-Ram ırez et al (2020) such as customizable instruments, availability for both Android and iOS platforms, student profile picture, friendly usability for different faculty generations, and available reports for student, faculty, and steering committee.…”

“…(2020) and Burn et al (2022) applied pilots to retrieve stakeholder feedback from their health education apps. The MLIA pilot took place from October to December 2021 with 24 students and 5 faculty members.…”