Implementation of a Population Mental Health and Wellness Text-Message Service: A mixed-methods study

Abstract

Background: Despite the growing adoption of digital health tools as a means to support mental health, many individuals remain unaware of the variety of mental health resources available to them through this format. In an effort to address this knowledge gap and better support population mental health, this study advanced the design, development, and implementation of a text-based service, SaskWell, to raise awareness of evidence based mental health resources and create more immediate connections to these tools. The purpose of this research was to assess, understand, and describe the adoption of text-based support in this mental health context, focusing on acceptability, satisfaction, and potential benefits for users of the intervention. The two primary objectives of the study were to assess and evaluate the adoption of SaskWell by focusing on user acceptance, satisfaction, and perceived benefit, and to identify factors which contributed to user engagement with the SaskWell text-based service. Both quantitative and qualitative data contributed to the final study results. Results: This study utilized a co-designed text-messaging service to provide residents of Saskatchewan an important connection to digital mental health and wellness resources during the height of the COVID-19 pandemic. Using the RE-AIM framework as an implementation guide, four distinct cycles of SaskWell were delivered with modifications to the service in each subsequent cycle based on user engagement, feedback, and the direction of a community advisory group. Conclusions: Both the user engagement survey and the qualitative data supported the worth of ongoing efforts to refine and extend the use of text messaging as a means to engage citizens around the awareness and use of digital mental health and wellness resources. As the pandemic has receded into the background for many as a feature of their daily lives, for healthcare providers, and others who continue to be impacted more heavily by the persistent challenges of this event, this type of service may continue to be timely.