Implementing an evidence‑based digital resilience intervention in residential youth care: A qualitative study using the RE‑AIM framework

Background Young people living in residential youth care (RYC) face heightened mental health risks due to complex life circumstances and histories of adversity. Strengthening resilience and emotion regulation in these settings is essential but challenging. The START NOW WebApp was developed to support adolescents and caregivers in building emotional and behavioral coping skills. This qualitative study aimed to examine the implementation of the START NOW WebApp in RYC and to identify barriers and facilitators to implementing this digital intervention in these settings. Methods Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, semi-structured interviews were conducted with 27 professionals and managers from 18 RYC institutions across German- and French-speaking Switzerland. Interviews were transcribed verbatim and analyzed using MAXQDA using structured content analysis. A combined deductive–inductive coding process aligned emerging themes with RE-AIM categories to ensure conceptual coherence and contextual sensitivity. Results Caregivers and institutional managers reported that the intervention might support adolescents’ emotional awareness and behavioral regulation and may help establish a shared language around emotions and coping. Implementation success depended on caregiver motivation, digital literacy, and institutional commitment. Challenges included workload constraints, variable staff engagement, and integration into daily routines. Institutional adaptation, peer support, and managerial endorsement facilitated sustainable use across RE-AIM dimensions. Conclusions Organizational readiness, flexible adaptation, and sustained caregiver engagement are central to embedding digital interventions in RYC. The findings provide actionable insights for designing, implementing, and maintaining digital interventions and underscore the need to embed these within institutional digitalization initiatives, strengthen staff digital literacy, and integrate digital tools into blended formats that complement interpersonal care rather than replace it.