Promoting Engagement With Smartphone Apps for Suicidal Ideation in Young People: Development of an Adjunctive Strategy Using a Lived Experience Participatory Design Approach.

Content Provider	Europe PMC
Author	Gan, Daniel Z Q McGillivray, Lauren Larsen, Mark Erik Bloomfield, Taylor Torok, Michelle
Editor	Mavragani, Amaryllis
Copyright Year	2023
Abstract	BackgroundSuicide among young people is a worrying public health concern. Despite this, there is a lack of suitable interventions aligned with the needs of this priority population. Emerging evidence supports the effectiveness of digital interventions in alleviating the severity of suicidal thoughts. However, their efficacy may be undermined by poor engagement. Technology-supported strategies (eg, electronic prompts and reminders) have been deployed alongside digital interventions to increase engagement with the latter. However, evidence of their efficacy is inconclusive. User-centered design approaches may be key to developing feasible and effective engagement strategies. Currently, no study has been published on how such an approach might be expressly applied toward developing strategies for promoting engagement with digital interventions.ObjectiveThis study aimed to detail the processes and activities involved in developing an adjunctive strategy for promoting engagement with LifeBuoy—a smartphone app that helps young people manage suicidal thoughts.MethodsDevelopment of the engagement strategy took place in 2 phases. The discovery phase aimed to create an initial prototype by synthesizing earlier findings—from 2 systematic reviews and a cross-sectional survey of the broader mental health app user population—with qualitative insights from LifeBuoy users. A total of 16 web-based interviews were conducted with young people who participated in the LifeBuoy trial. Following the discovery phase, 3 interviewees were invited by the research team to take part in the workshops in the design phase, which sought to create a final prototype by making iterative improvements to the initial prototype. These improvements were conducted over 2 workshops. Thematic analysis was used to analyze the qualitative data obtained from the interviews and workshops.ResultsMain themes from the interviews centered around the characteristics of the strategy, timing of notifications, and suitability of social media platforms. Subsequently, themes that emerged from the design workshops emphasized having a wider variety of content, greater visual consistency with LifeBuoy, and a component with more detailed information to cater to users with greater informational needs. Thus, refinements to the prototype were focused on (1) improving the succinctness, variety, and practical value of Instagram content, (2) creating a blog containing articles contributed by mental health professionals and young people with lived experience of suicide, and (3) standardizing the use of marine-themed color palettes across the Instagram and blog components.ConclusionsThis is the first study to describe the development of a technology-supported adjunctive strategy for promoting engagement with a digital intervention. It was developed by integrating perspectives from end users with lived experience of suicide with evidence from the existing literature. The development process documented in this study may be useful for guiding similar projects aimed at supporting the use of digital interventions for suicide prevention or mental health.
Journal	JMIR Formative Research
Volume Number	7
PubMed Central reference number	PMC10282914
PubMed reference number	37279058
e-ISSN	2561326X
DOI	10.2196/45234
Language	English
Publisher	JMIR Publications
Publisher Date	2023-06-06
Publisher Place	Toronto, Canada
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included. ©Daniel Z Q Gan, Lauren McGillivray, Mark Erik Larsen, Taylor Bloomfield, Michelle Torok. Originally published in JMIR Formative Research (https://formative.jmir.org), 06.06.2023.
Subject Keyword	eHealth digital mental health smartphone app engagement youth suicide prevention qualitative methods suicide development youth mental health support user-centered design survey interview prototype prevention participatory design mobile phone
Content Type	Text
Resource Type	Article
Subject	Health Informatics Medicine