TY - JOUR
T1 - A mobile healthy lifestyle intervention to promote mental health in adolescence
T2 - a mixed-methods evaluation
AU - Peuters, Carmen
AU - Maenhout, Laura
AU - Cardon, Greet
AU - De Paepe, Annick
AU - DeSmet, Ann
AU - Lauwerier, Emelien
AU - Leta, Kenji
AU - Crombez, Geert
N1 - © 2023. The Author(s).
PY - 2024
Y1 - 2024
N2 - BACKGROUND: A healthy lifestyle may improve mental health. It is yet not known whether and how a mobile intervention can be of help in achieving this in adolescents. This study investigated the effectiveness and perceived underlying mechanisms of the mobile health (mHealth) intervention #LIFEGOALS to promote healthy lifestyles and mental health. #LIFEGOALS is an evidence-based app with activity tracker, including self-regulation techniques, gamification elements, a support chatbot, and health narrative videos.METHODS: A quasi-randomized controlled trial (N = 279) with 12-week intervention period and process evaluation interviews (n = 13) took place during the COVID-19 pandemic. Adolescents (12-15y) from the general population were allocated at school-level to the intervention (n = 184) or to a no-intervention group (n = 95). Health-related quality of life (HRQoL), psychological well-being, mood, self-perception, peer support, resilience, depressed feelings, sleep quality and breakfast frequency were assessed via a web-based survey; physical activity, sedentary time, and sleep routine via Axivity accelerometers. Multilevel generalized linear models were fitted to investigate intervention effects and moderation by pandemic-related measures. Interviews were coded using thematic analysis.RESULTS: Non-usage attrition was high: 18% of the participants in the intervention group never used the app. An additional 30% stopped usage by the second week. Beneficial intervention effects were found for physical activity (χ 2 1 = 4.36, P = .04), sedentary behavior (χ 2 1 = 6.44, P = .01), sleep quality (χ 2 1 = 6.11, P = .01), and mood (χ 2 1 = 2.30, P = .02). However, effects on activity-related behavior were only present for adolescents having normal sports access, and effects on mood only for adolescents with full in-school education. HRQoL (χ 2 2 = 14.72, P < .001), mood (χ 2 1 = 6.03, P = .01), and peer support (χ 2 1 = 13.69, P < .001) worsened in adolescents with pandemic-induced remote-education. Interviewees reported that the reward system, self-regulation guidance, and increased health awareness had contributed to their behavior change. They also pointed to the importance of social factors, quality of technology and autonomy for mHealth effectiveness. CONCLUSIONS: #LIFEGOALS showed mixed results on health behaviors and mental health. The findings highlight the role of contextual factors for mHealth promotion in adolescence, and provide suggestions to optimize support by a chatbot and narrative episodes.
AB - BACKGROUND: A healthy lifestyle may improve mental health. It is yet not known whether and how a mobile intervention can be of help in achieving this in adolescents. This study investigated the effectiveness and perceived underlying mechanisms of the mobile health (mHealth) intervention #LIFEGOALS to promote healthy lifestyles and mental health. #LIFEGOALS is an evidence-based app with activity tracker, including self-regulation techniques, gamification elements, a support chatbot, and health narrative videos.METHODS: A quasi-randomized controlled trial (N = 279) with 12-week intervention period and process evaluation interviews (n = 13) took place during the COVID-19 pandemic. Adolescents (12-15y) from the general population were allocated at school-level to the intervention (n = 184) or to a no-intervention group (n = 95). Health-related quality of life (HRQoL), psychological well-being, mood, self-perception, peer support, resilience, depressed feelings, sleep quality and breakfast frequency were assessed via a web-based survey; physical activity, sedentary time, and sleep routine via Axivity accelerometers. Multilevel generalized linear models were fitted to investigate intervention effects and moderation by pandemic-related measures. Interviews were coded using thematic analysis.RESULTS: Non-usage attrition was high: 18% of the participants in the intervention group never used the app. An additional 30% stopped usage by the second week. Beneficial intervention effects were found for physical activity (χ 2 1 = 4.36, P = .04), sedentary behavior (χ 2 1 = 6.44, P = .01), sleep quality (χ 2 1 = 6.11, P = .01), and mood (χ 2 1 = 2.30, P = .02). However, effects on activity-related behavior were only present for adolescents having normal sports access, and effects on mood only for adolescents with full in-school education. HRQoL (χ 2 2 = 14.72, P < .001), mood (χ 2 1 = 6.03, P = .01), and peer support (χ 2 1 = 13.69, P < .001) worsened in adolescents with pandemic-induced remote-education. Interviewees reported that the reward system, self-regulation guidance, and increased health awareness had contributed to their behavior change. They also pointed to the importance of social factors, quality of technology and autonomy for mHealth effectiveness. CONCLUSIONS: #LIFEGOALS showed mixed results on health behaviors and mental health. The findings highlight the role of contextual factors for mHealth promotion in adolescence, and provide suggestions to optimize support by a chatbot and narrative episodes.
KW - Humans
KW - Adolescent
KW - Quality of Life
KW - Mental Health
KW - Pandemics/prevention & control
KW - Healthy Lifestyle
KW - Mobile Applications
U2 - 10.1186/s12889-023-17260-9
DO - 10.1186/s12889-023-17260-9
M3 - Article
C2 - 38166797
SN - 1471-2458
VL - 24
SP - 1
EP - 19
JO - BMC Public Health
JF - BMC Public Health
M1 - 44
ER -