Adolescents’ preferences, experiences, and views of online programs for anxiety and depressive symptoms – qualitative study (Preprint)

BACKGROUND Anxiety and depression are among the most prevalent mental health disorders affecting adolescents. Digital mental health interventions have emerged as promising means of addressing these challenges. Understanding adolescents’ experiences and perspectives and incorporating these in intervention design can enhance their relevance, engagingness, and effectiveness, ensuring interventions meet young people’s needs. OBJECTIVE This qualitative study aimed to identify how adolescents aged 16 to 19 engaged with two distinct interventions (Bite Back and Project YES), as well as their preferences and their perceptions of usefulness. METHODS Participants were asked to use Bite Back and Project YES for 30 minutes each within a two-week period. Following this, twenty-two one-hour, semi-structured online interviews were conducted between January and March 2025. An inductive thematic analysis was used to analyse the anonymised transcripts. RESULTS Seven themes were identified: (1) relatability, (2) transparency, (3) design and usability, (4) autonomy and personalisation, (5) patterns of engagement, (6) interactive and motivational elements, and (7) perceptions of usefulness. These themes captured young people’s views on factors influencing engagement, preferred design features and content, and perceived usefulness of digital mental health interventions. CONCLUSIONS This study contributes to the growing understanding of how young people engage with digital mental health interventions by identifying a set of interconnected factors that influence young people’s experiences. It highlights the importance of designing interventions that align with young people’s stage of life, culture, and experiences. Even small age differences appeared to influence how relevant the interventions felt to the young person. Furthermore, involving young people in co-design and ensuring clear, accessible communication may support trust and engagement, ultimately enhancing the benefits of such interventions.