Supporting adolescents’ mHealth needs: Qualitative and quantitative insights from a user survey of a mental health promoting app

While mental health apps can help to promote adolescents’ mental health, prevent mental health problems, and reduce symptoms, maintaining sufficient user engagement with these apps remains challenging. This is often caused by a mismatch between the needs and preferences of adolescents and what the apps offer. Therefore, we need a better understanding of i) adolescents’ needs and preferences and ii) potential differences based on user characteristics. To this end, we qualitatively and quantitatively analyzed a dataset describing the user experience of 1312 Dutch adolescents (12 – 25 years) from the general population after they interacted for several weeks with a gamified mHealth app (the Grow It! app) that aims to promote momentary emotional awareness, reflection, and adaptive coping. A total of 4833 free-text survey responses spanning five user experience survey questions were analyzed using an inductive and iterative coding process, while accounting for intercoder reliability. We used i) a thematic analysis to identify adolescents’ needs and preferences related to the app, and ii) an exploratory quantitative analysis of the subthemes to investigate potential differences in which needs and preferences were mentioned by adolescents based on demographics. Through our thematic analysis, we identified three overarching themes related to the app’s design: usability , psychological impact , and meaningful interactive features . Furthermore, we identified two overarching themes that related to the adolescents’ motivation to use the app: intrinsic (de)motivators , and social-environmental factors impacting usage . Each of these themes consisted of four subthemes. Our exploratory statistical analysis shed light on several differences in how frequently these subthemes were mentioned based on age, sex, and educational level. By synthesizing our insights, we identify five design implications that can help tailor future mHealth apps to adolescents’ needs and preferences. These include concrete suggestions to personalize self-monitoring, include actionable insights, align content with personal needs, implement meaningful interactive features (e.g., competitions, gamification, and social communication), and make apps appealing to the entire target group. • Adolescents value the app’s usability, psychological impact, and interactive features. • There is no one-size-fits-all set of adolescents’ needs for mental health apps. • Intrinsic (de)motivators and social-environmental factors may impact their app usage. • We offer design implications for personalizing and improving mHealth apps.