Currently submitted to: JMIR Mental Health
Date Submitted: Apr 10, 2026
Open Peer Review Period: Apr 13, 2026 - Jun 8, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Barriers and facilitators to men’s engagement with digital mental health screening in estonia: a qualitative study of user archetypes and design implications
ABSTRACT
Background:
Mental health issues are prevalent among men, yet help-seeking remains low due to stigma, masculine norms and access barriers. Digital mental health (DMH) screening tools offer opportunities for early detection, but their uptake among men is limited.
Objective:
This study explored the barriers and facilitators influencing men’s willingness to use DMH screening tools, with the aim of informing user-centered design that supports early detection and engagement.
Methods:
A qualitative descriptive study employed semi-structured interviews with 17 purposively sampled Estonian men (aged 20–54) until data saturation. Thematic analysis followed a mixed deductive–inductive approach: deductive codes were derived from theoretical frameworks (Technology Acceptance Model, Health Belief Model, User-Centered Design, Behavioral Design), while inductive themes emerged from participants’ responses across the three research questions, including their evaluations of four screening tools (PHQ-2, PHQ-9, EEK-2, WHO-5). This yielded four archetypes: Skeptic, Conscious Self-Manager, Explorer, and Situational Seeker.
Results:
Key barriers included data privacy fears, distrust of digital solutions, lengthy questionnaires, and poor user experience (UX). Facilitators were anonymity, institutional trust, short (5–10 min) questionnaires, mobile-optimized design, personalized feedback, and clear next steps. Archetypes showed distinct preferences (e.g., Skeptics valued institutional trust), underscoring the need for user-centered design.
Conclusions:
Men’s uptake of DMH screening tools is influenced by a combination of social, psychological, and usability factors. Effective design should integrate anonymity, institutional credibility, and user-centered features to support engagement and early mental health detection. Most importantly, personalized, actionable feedback with transparency, user control, and clear next-step guidance emerged as a key driver of sustained engagement, while poor usability and lack of meaningful feedback led to disengagement. These findings inform the development of DMH tools tailored to male users.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.