JMIR Publications

ABSTRACT

Background:

Emerging adults (EAs), typically ranging from late adolescence into mid- to late-twenties, navigate a transitional period marked by rapid developmental, social, and psychological change. Despite heightened vulnerability to mental health concerns during this stage, service systems are often fragmented, with gaps between adolescent and adult care streams that leave many EAs without developmentally appropriate support. In response, developing approaches such as transdiagnostic stratification, which structures care around shared symptom processes and informs treatment intensity, and digital measurement-based care (dMBC), based on routine patient-reported outcome measures (PROMs), have gained traction but remain challenging to implement consistently. This reinforces the need for Rapid Learning Health System (RLHS) approaches that leverage continuous data and feedback for ongoing improvement, as well as co-design methods that meaningfully integrate EA perspectives into service improvement.

Objective:

This research protocol outlines a co-design study situated within an RLHS to develop practical strategies and resources to support the sustained implementation of dMBC within EA mental health services. Anticipated outputs include clinician-facing workflow supports, guidance for using client-reported data in clinical decision-making, EA-oriented materials to support engagement with measures, and implementation planning resources to support uptake across the care pathway. Each co-designed output will be developed to function across core stages of care, including intake, treatment decision-making, therapy, and discharge.

Methods:

A concurrent multi-methods design will be employed, integrating quantitative and qualitative approaches within a dual methodological framework combining User-Centered Design with Participatory Design to structure the co-design process and guide the development of implementation outputs. The process will center the perspectives of EAs accessing services and clinical staff to actively collaborate in informing the development and refinement of study outputs.

Results:

As the study is underway, findings will be reported upon study completion.

Conclusions:

This study is expected to demonstrate the value of integrating co-design within an RLHS to advance more responsive, contextually grounded dMBC implementation in EA mental health care, while also contributing insights that can strengthen future co-design efforts with this population.