Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 23, 2025
Date Accepted: May 25, 2026
Developing a Text-Messaging Intervention to Increase Uptake of the Screening and Treatment for Anxiety and Depression (STAND) Program among Community College Students: Formative Study Using a Human-Centered Design Approach
ABSTRACT
Background:
Community college (CC) students face significant mental health concerns but are unlikely to receive treatment. Barriers to mental health service uptake among CC students have been delineated, but few studies have identified strategies to improve uptake.
Objective:
The goal of this study was to codesign and conduct pilot usability testing for a text messaging intervention to address barriers and increase uptake of a mental health screening and treatment program, called STAND (Screening and Treatment for Anxiety and Depression), among CC students.
Methods:
We conducted 2 parallel sets of 4 codesign focus groups with CC students who had varying levels of engagement with STAND. We utilized rapid qualitative analysis to extract key themes, create prototypes and refine them, and present updated prototypes for feedback across workshops. We also assessed five usability factors on a 5-point Likert: satisfaction, helpfulness, attractiveness, readability, comprehension, and likelihood of getting started with STAND after receiving texts.
Results:
Key themes emerged about perceptions of texting and barriers to STAND, format of messages, and content of messages. Students expressed positive regard for text messaging and general agreement on key barriers to STAND. Format themes included: use short messages, not too many messages, use relevant language, use images, memes and short videos, and making messages “human-like”. Content themes included: reminders that you are not alone, knowledge that STAND has worked for students, express understanding of student stressors, and provide option to speak to a team member. Mean ratings on usability factors ranged from 3.88-4.25.
Conclusions:
This study describes a process for codesigning mental health engagement interventions with CC students following an implementation science and human-centered design framework. Further research is needed to more rigorously test this intervention and make iterative refinements to improve response and effectiveness.
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