Evaluating a Peer-Support Mobile App for Mental Health and Substance Use Among Adolescents Over 12 Months During the COVID-19 Pandemic: Randomized Controlled Trial

Abstract

Background Although it is well known that adolescents frequently turn to their friends for support around mental health and substance use problems, there are currently no evidence-based digital programs to support them to do this. Objective The aim of this study was to evaluate the efficacy of the Mind your Mate program, a digital peer-support program, in improving mental health symptoms, reducing the uptake of substance use, and increasing help seeking. The Mind your Mate program consists of a 40-minute web-based classroom lesson and a companion smartphone mobile app. The active control group received school-based health education as usual. Methods A cluster randomized controlled trial was conducted with 12 secondary schools and 166 students (mean age 15.3, SD 0.41 years; 72/166, 43.4% female; and 133/166, 80.1% born in Australia). Participants completed self-reported questionnaires assessing symptoms of mental health (depression, anxiety, and psychological distress), substance use (alcohol and other drug use), and help-seeking measures at baseline and at 6-month and 12-month follow-ups. Results Students who received the Mind your Mate program had greater reductions in depressive symptoms over a 12-month period than controls (b=−1.86, 95% CI −3.73 to 0.02; Cohen d=−0.31). Anxiety symptoms decreased among students in the intervention group; however, these reductions did not meet statistical significance thresholds. No differences were observed in relation to psychological distress or help-seeking. Conclusions Small to moderate reductions in depression symptoms were observed among students allocated to receive the Mind your Mate intervention. Although the current results are encouraging, there is a need to continue to refine, develop, and evaluate innovative applied approaches for the prevention of mental disorders in real-world settings. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000753954; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000753954 International Registered Report Identifier (IRRID) RR2-10.2196/26796

Facilitators and Barriers to Digital Mental Health Interventions for Depression, Anxiety and Stress in Adolescents and Young Adults: A Systematic Review (Preprint)

“…Previous studies have rarely investigated the experiences, attitudes, or perceptions of AYAs regarding DMHIs as a main focus [32,33]. Lots of research often collected participants' feedback after evaluating a particular DMHI [17,33]. Consequently, the present findings on the facilitators or barriers of DMHI utilisation are predominantly indirect and fragmented and necessitate a cohesive and logical integration of information about the factors that hinder and promote the use of DMHIs.…”

“…A total of 19 studies contained a conflict-of-interest component, of which seven [5,8,10,16,17,41,42] declared a potential or actual conflict of interest. Via quality assessment (Table 2), it was found that the quality of qualitative studies and quantitative randomised controlled trial studies was generally good, while all quantitative descriptive studies vary in degrees of sample representativeness.…”

“…c. Individual level Physically unwell was a common reason that would keep participants from attending appointments [8]. Additional causes linked to lacking confidence and connections to complete internet therapies [17,32]. No motivation was proposed for not even downloading the app [17].…”

“…Whereas traditional approaches to psychotherapy, like counselling, take a significant amount of a visitor's time to queue and wait, DMHIs have greatly enhanced AYAs' access to mental health support through digital and online mediums [15]. At the same time, DMHIs can somewhat overcome the inaccessibility of mental health services due to geographical remoteness or special periods such as lockdowns during infectious disease outbreaks [16,17]. Fifth, scalability.…”

“…Although DMHIs have multiple advantages as outlined above, and their effectiveness has been proven [8,10,17], the usage/intention to use varies. For effectiveness, a web-based mental health intervention program for adolescents showed that participants with high levels of adherence (using the site for 30 minutes or more per week) reported significantly lower depression and stress, and significantly improved well-being [7]; Another study that examined the effectiveness of a new computerised cognitive-behavioural therapy showed that the program resulted in significant improvements in participants' depression levels [8].…”