Ibrahim Radhwan Hussein, Yaas Marghoob Hussein, Hamarash Mariwan Qadir, Al-Mukhtar Salwa Hazim, Abdulghani Mohammed Faris, Al Mushhadany Osama
Department of Clinical Nursing Sciences, College of Nursing, Ninevah University, Kirkuk St, Mosul, 41001, Iraq, 964 7722112891.
College of Nursing, Al Kitab University, Kirkuk, Iraq.
JMIR Pediatr Parent. 2025 Apr 11;8:e67137. doi: 10.2196/67137.
Mental health challenges, including anxiety and depression, are increasingly common among adolescents. Mobile health (mHealth) apps offer a promising way to deliver accessible cognitive behavioral therapy (CBT) interventions. However, research on the usability and effectiveness of apps explicitly tailored for adolescents is limited.
This study aimed to explore the usability, engagement, and perceived effectiveness of a mobile CBT app designed for adolescents, focusing on user experiences and mental health outcomes.
A qualitative study was conducted with 40 adolescents aged 13-19 years (mean age 15.8, SD 1.9 years; 18/40, 45% male; 22/40, 55% female) who engaged with a CBT app for 4 weeks. Mental health diagnoses included anxiety (20/40, 50%), depression (15/40, 38%), and both (5/40, 13%). Of these, 10 (25%) of the 40 participants had previous CBT experience. Feedback was gathered through focus groups and individual interviews, and thematic analysis identified key themes related to usability, engagement, and perceived effectiveness. Quantitative data on mood and anxiety scores were analyzed with paired t tests.
The mean usability score was 3.8 (SD 0.6), and the mean effectiveness score was 3.9 (SD 0.7). Older participants (aged 16-19 years) reported significantly higher usability (mean 4.1, SD 0.4) and effectiveness scores (mean 4.3, SD 0.5) compared to younger participants (aged 13-15 years) (P=.03). Females had higher usability (mean 4, SD 0.6) and effectiveness scores (mean 4.2, SD 0.7) than males (mean 3.6, SD 0.7, and mean 3.5, SD 0.8, respectively; P=.03). Participants with prior CBT experience had 2.8 times higher odds of reporting high usability scores (95% CI 1.6-5; P=.002) and 3.1 times higher odds of reporting high effectiveness scores (95% CI 1.7-5.6; P=.001). Usability challenges included complex navigation (20/40, 50%), interface design issues (12/40, 30%), and content overload (8/40, 20%). Factors positively influencing engagement were motivation driven by personal relevance (20/40, 50%) and gamification features (10/40, 25%), while lack of personalization (14/40, 35%) and external distractions (18/40, 45%) were significant barriers. Mood improvement (15/40, 38%) and learning new coping skills (12/40, 30%) were the most reported outcomes.
The mobile CBT app shows potential for improving adolescent mental health, with initial improvements in mood and anxiety. Future app iterations should prioritize simplifying navigation, adding personalization features, and enhancing technical stability to support long-term engagement.
心理健康挑战，包括焦虑和抑郁，在青少年中越来越普遍。移动健康（mHealth）应用程序为提供可及的认知行为疗法（CBT）干预措施提供了一种很有前景的方式。然而，针对青少年专门设计的应用程序的可用性和有效性研究有限。
本研究旨在探讨一款为青少年设计的移动CBT应用程序的可用性、参与度和感知有效性，重点关注用户体验和心理健康结果。
对40名年龄在13 - 19岁（平均年龄15.8岁，标准差1.9岁；40人中有18人，45%为男性；40人中有22人，55%为女性）的青少年进行了一项定性研究，他们使用一款CBT应用程序达4周。心理健康诊断包括焦虑（40人中有20人，50%）、抑郁（40人中有15人，38%）以及两者皆有（40人中有5人，13%）。其中，40名参与者中有10人（25%）曾有过CBT经历。通过焦点小组和个人访谈收集反馈，并进行主题分析以确定与可用性、参与度和感知有效性相关的关键主题。使用配对t检验分析情绪和焦虑评分的定量数据。
可用性平均得分为3.8（标准差0.6），有效性平均得分为3.9（标准差0.7）。与较年轻的参与者（13 - 15岁）相比，年龄较大的参与者（16 - 19岁）报告的可用性（平均4.1，标准差0.4）和有效性得分（平均4.3，标准差0.5）显著更高（P = 0.03）。女性的可用性（平均4，标准差0.6）和有效性得分（平均4.2，标准差0.7）高于男性（分别为平均3.6，标准差0.7和平均3.5，标准差0.8；P = 0.03）。有过CBT经历的参与者报告高可用性得分的几率高出2.8倍（95%置信区间1.6 - 5；P = 0.002），报告高有效性得分的几率高出3.1倍（95%置信区间1.7 - 5.6；P = 0.001）。可用性挑战包括导航复杂（40人中有20人，50%）、界面设计问题（40人中有12人，30%）和内容过载（40人中有8人，20%）。对参与度有积极影响的因素是个人相关性驱动的动机（40人中有20人，50%）和游戏化功能（40人中有10人，25%），而缺乏个性化（40人中有14人，35%）和外部干扰（40人中有18人，45%）是显著障碍。报告最多的结果是情绪改善（40人中有15人，38%）和学习新的应对技能（40人中有12人，30%）。
这款移动CBT应用程序显示出改善青少年心理健康的潜力，情绪和焦虑有初步改善。未来应用程序的迭代应优先简化导航、添加个性化功能并提高技术稳定性，以支持长期参与。
