Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 30, 2022
Date Accepted: Apr 28, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development of an adjunctive strategy to promote engagement with a smartphone application targeting suicidal ideation in young people.
ABSTRACT
Background:
Suicide among young people is a worrying public health concern. Despite this, there is a lack of suitable mental health interventions that are aligned with the needs of this priority population. Emerging evidence supports the effectiveness of digital interventions in alleviating the severity of suicidal thoughts. However, levels of engagement with these interventions are typically low, which could undermine their efficacy. Technology-supported strategies (e.g., electronic prompts and reminders) have been deployed alongside digital interventions with the aim of improving engagement with the latter, but there is insufficient evidence to support their efficacy. User-centred design approaches may be key to developing feasible and effective engagement strategies. Currently, no study has been published on how such an approach might be expressly applied towards developing strategies for promoting engagement with digital interventions.
Objective:
This study aimed to detail the processes and activities involved in developing an adjunctive strategy for promoting engagement with LifeBuoy – a smartphone application that helps young people manage suicidal thoughts.
Methods:
Development of the engagement strategy took place in two phases. The Discovery phase aimed to create an initial prototype by synthesising earlier findings—from two systematic reviews and a cross-sectional survey of the broader mental health app user population—with qualitative insights from LifeBuoy users. Sixteen online interviews were conducted with young people who participated in the LifeBuoy trial. Following the Discovery phase, three interviewees were invited by the research team to take part in the workshops in the Design phase, which sought to create a final prototype by making iteratively improvements to the initial prototype. These improvements were conducted over two workshops. Thematic analysis was used to analyse the qualitative data obtained from the interviews and workshops.
Results:
Main themes from the interviews were on the characteristics of the strategy, timing of notifications, and suitability of social media platforms. These themes were used to guide the creation of the initial prototype. Iterative refinements to the prototype that were made over the workshops included improving the succinctness, applicability, and practical value of content, a greater focus on nature-themed designs, and the addition of a blog with more detailed informational content. The final prototype comprised an Instagram component and a blog component.
Conclusions:
This is the first study to describe the development of a technology-supported adjunctive strategy for promoting engagement with a digital intervention. It was developed by integrating perspectives from end users with lived experience of suicide with evidence from the existing literature. The development process documented in this study may be useful for guiding similar projects aimed at supporting the use of digital interventions for suicide prevention or mental health. Clinical Trial: Not applicable
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