JMIR Publications

ABSTRACT

Background:

Peer support groups or online ‘chats’ for young people offer anonymous peer support, in judgement-free spaces, where users may share their thoughts and feelings with others who may have experienced similar situations. User engagement is crucial for effective online peer support, yet levels of engagement vary. Moderation of peer support groups can have a positive impact on the engagement of young people, yet effective moderation can be challenging to implement.

Objective:

The aim of the study was to identify barriers and facilitators to user engagement with, and moderation of, online peer support groups among young people aged 16 to 25 years and to provide recommendations for enhancing this service.

Methods:

Drawing upon the Theoretical Domains Framework and the Behaviour Change Wheel, this study conducted qualitative interviews and gathered open-ended questionnaires from service-users and moderators of The Mix, UK’s leading online mental health platform providing peer support group chats for young people. Semi-structured interviews were conducted with 2 service users and 8 moderators, and open-ended questionnaires were obtained from 7 service users. Themes were coded using the COM-B model and Theoretical Domains Framework (TDF), and the Behaviour Change Wheel (BCW) tools were then used to identify relevant behaviour change techniques (BCTs) to improve user engagement in, and moderation of, the service.

Results:

Thematic analysis revealed a total of 20 inductive themes within 10 TDF domains, 9 for engagement and 11 for moderation. Of these, 3 were facilitators of engagement and 7 of moderation; 4 barriers for moderation and 6 for engagement. Results suggest that skills and knowledge, beliefs about consequences and intentions, emotions and both the social and physical environment are important factors influencing service users and moderators of group chats. In particular, supporting the improvement of memory, attention and decision-making skills of those involved, adapting the physical environment to facilitate effective interactions and reducing negative emotions are suggested to optimise the value and effectiveness of group chats for young people’s mental health support for both the service users and moderators of these services.

Conclusions:

The study demonstrates the effectiveness of the BCW approach and the use of the TDF and COM-B to understand the influences on behaviour in a systematic manner, especially for mental health and wellbeing interventions. The findings can be applied to design structured interventions to change behaviours related to the engagement with, and moderation of, online peer support groups and, in turn, improve mental health outcomes for young people. Clinical Trial: N/A