JMIR Publications

ABSTRACT

Background:

Digital Mental Health Interventions (DHMIs) may help increase access to psychological treat-ment for adolescents with anxiety disorders. However, many clinical evaluations of digital treatments report low adherence and engagement, and high rates of drop-out, which remain challenges when implemented in routine care. Involving intended end-users in the development process by using user-centered design methods may help maximize user engagement and proof interventions for implementation.

Objective:

The objective of this study was to describe the methods used to develop a new Internet-based cognitive behavioral intervention (ICBT), CoolMinds, within a user-centered design framework.

Methods:

The initial outline of the intervention was conceptualized based on current literature in the field and expertise of senior researchers and experienced clinical psychologists. The development of intervention content progressed in three iterative design phases: 1) identifying needs and design specifications, 2) designing and testing prototypes, and 3) running feasibility tests with end-users. In phase 1, 24 adolescents participated in a user-involvement workshop exploring adolescents’ preferences on graphic identity and communication styles as well as adolescent help-seeking behavior. In phase 2, 4 adolescents attended individual usability tests where they were presented with a prototype of a psychoeducational session and asked to speak out loud about their actions in the platform. In phase 3, 7 families from the feasibility trial participated in a semi-structured interview about their satisfaction with and initial impressions of the platform and intervention content while in treatment. Activities in all three phases were audio-recorded, transcribed and coded. The intervention was continuously revised after each phase based on the feedback.

Results:

In phase 1, adolescent feedback guided the look and feel of the intervention content, i.e., color scheme, animation style, communication style etc. Participants generally liked content that was relatable, age-appropriate, and felt motivating. In phase 2, adolescents perceived the platform as intuitive and easy to navigate and the session content as easy to understand but lengthy. In phase 3, families were generally satisfied with the intervention content. Their feedback helped identify areas for further improvement such as editing down the material and including more in-session breaks.

Conclusions:

Utilizing user-involvement practices in the development of interventions helps ensure continued alignment of the intervention with end-user needs and may help proof the intervention for implementation in routine care practice.