Werner-Seidler Aliza, O'Dea Bridianne, Shand Fiona, Johnston Lara, Frayne Anna, Fogarty Andrea S, Christensen Helen
Black Dog Institute, University of New South Wales, Sydney, Australia.
JMIR Ment Health. 2017 Jul 28;4(3):e28. doi: 10.2196/mental.7614.
Sleep disturbances are common in young people and have consequences for academic, social, emotional, and behavioral development. The most effective treatment is cognitive behavioral therapy for insomnia (CBT-I), with evidence suggesting that it is efficacious even when delivered digitally.
There are no commercially available digitally delivered CBT-I programs for use by young people. The aim of this project was to develop a smartphone app that delivers CBT-I to young people to improve sleep.
To inform the development of the app, young people (N=21) aged between 12 and 16 years attended one of the 3 focus groups (each with 4-10 participants). These focus groups were conducted at different stages of the development process such that the process could be iterative. Participants were asked the reasons why they might use an app to help them sleep, the kinds of features or functions that they would like to see in such an app, and any concerns they may have in using the app. Data were analyzed using a thematic analysis approach. Of the issues discussed by the participants, the researchers selected themes associated with content, functionality, and accessibility and user experience to examine, as these were most informative for the app design process.
In terms of content, young people were interested in receiving information about recommended sleep guidelines and personalized information for their age group. They reported that keeping a sleep diary was acceptable, but they should be able to complete it flexibly, in their own time. They reported mixed views about the use of the phone's accelerometer. Young people felt that the functionality of the app should include elements of game playing if they were to remain engaged with the app. Flexibility of use and personalized features were also desirable, and there were mixed views about the schedule of notifications and reminders. Participants reported that for the app to be accessible and usable, it should be from a trusted developer, have engaging aesthetics, have a layout that is easy to navigate, not rely on Internet coverage, and preferably be free. Participants felt that being able to conceal the purpose of the app from peers was an advantage and were willing to provide personal information to use the app if the purpose and use of that information was made clear. Overall, participants endorsed the use of the app for sleep problems among their age group and reported motivation to use it.
The Sleep Ninja is a fully-automated app that delivers CBT-I to young people, incorporating the features and information that young people reported they would expect from this app. A pilot study testing the feasibility, acceptability, and efficacy of the Sleep Ninja is now underway.
睡眠障碍在年轻人中很常见，会对学业、社交、情感和行为发展产生影响。最有效的治疗方法是失眠认知行为疗法（CBT-I），有证据表明，即使以数字化方式提供，该疗法也有效。
目前没有可供年轻人使用的商业化数字化CBT-I项目。本项目的目的是开发一款智能手机应用程序，为年轻人提供CBT-I以改善睡眠。
为了为应用程序的开发提供参考，12至16岁的年轻人（N = 21）参加了3个焦点小组中的一个（每个小组有4 - 10名参与者）。这些焦点小组在开发过程的不同阶段进行，以便该过程可以迭代。参与者被问及他们可能使用应用程序帮助睡眠的原因、他们希望在这样的应用程序中看到的功能或特性，以及他们在使用应用程序时可能存在的任何担忧。使用主题分析方法对数据进行分析。在参与者讨论的问题中，研究人员选择了与内容、功能、可及性和用户体验相关的主题进行研究，因为这些对应用程序设计过程最具参考价值。
在内容方面，年轻人有兴趣获取有关推荐睡眠指南的信息以及针对其年龄组的个性化信息。他们表示记睡眠日记是可以接受的，但应该能够在自己方便的时候灵活完成。他们对使用手机加速度计的看法不一。年轻人认为，如果要让他们持续使用该应用程序，其功能应包括游戏元素。使用的灵活性和个性化功能也很受欢迎，对于通知和提醒的时间安排看法不一。参与者表示，为了使应用程序易于访问和使用，它应该来自可信赖的开发者，具有吸引人的美学设计，布局易于导航，不依赖网络覆盖，并且最好是免费的。参与者认为能够向同龄人隐瞒应用程序的用途是一个优点，如果应用程序的目的和信息使用方式明确，他们愿意提供个人信息来使用该应用程序。总体而言，参与者认可该应用程序可用于解决他们这个年龄组的睡眠问题，并表示有使用它的动机。
“睡眠忍者”是一款为年轻人提供CBT-I的全自动应用程序，融入了年轻人表示期望从该应用程序中获得的功能和信息。一项测试“睡眠忍者”可行性、可接受性和有效性的试点研究正在进行中。
