A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation
Abstract 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 #LIF...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17260-9 |
| _version_ | 1797362787193716736 |
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| author | Carmen Peuters Laura Maenhout Greet Cardon Annick De Paepe Ann DeSmet Emelien Lauwerier Kenji Leta Geert Crombez |
| author_facet | Carmen Peuters Laura Maenhout Greet Cardon Annick De Paepe Ann DeSmet Emelien Lauwerier Kenji Leta Geert Crombez |
| author_sort | Carmen Peuters |
| collection | DOAJ |
| description | Abstract 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. Trial registration ClinicalTrials.gov [NCT04719858], registered on 22/01/2021. |
| first_indexed | 2024-03-08T16:12:27Z |
| format | Article |
| id | doaj.art-8be906a3d86b44bc8693451295f34b24 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T16:12:27Z |
| publishDate | 2024-01-01 |
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| series | BMC Public Health |
| spelling | doaj.art-8be906a3d86b44bc8693451295f34b242024-01-07T12:51:40ZengBMCBMC Public Health1471-24582024-01-0124111910.1186/s12889-023-17260-9A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluationCarmen Peuters0Laura Maenhout1Greet Cardon2Annick De Paepe3Ann DeSmet4Emelien Lauwerier5Kenji Leta6Geert Crombez7Department of Experimental-Clinical and Health Psychology, Ghent UniversityDepartment of Experimental-Clinical and Health Psychology, Ghent UniversityDepartment of Movement and Sports Sciences, Ghent UniversityDepartment of Experimental-Clinical and Health Psychology, Ghent UniversityFaculty of Psychology, Educational Sciences and Speech Therapy, Université Libre de BruxellesDepartment of Experimental-Clinical and Health Psychology, Ghent UniversityDepartment of Public Health and Primary Care, Ghent UniversityDepartment of Experimental-Clinical and Health Psychology, Ghent UniversityAbstract 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. Trial registration ClinicalTrials.gov [NCT04719858], registered on 22/01/2021.https://doi.org/10.1186/s12889-023-17260-9Mobile health applicationsAdolescentsMental health promotionHealthy lifestylesDigital behavior change interventionsParticipatory development |
| spellingShingle | Carmen Peuters Laura Maenhout Greet Cardon Annick De Paepe Ann DeSmet Emelien Lauwerier Kenji Leta Geert Crombez A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation BMC Public Health Mobile health applications Adolescents Mental health promotion Healthy lifestyles Digital behavior change interventions Participatory development |
| title | A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation |
| title_full | A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation |
| title_fullStr | A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation |
| title_full_unstemmed | A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation |
| title_short | A mobile healthy lifestyle intervention to promote mental health in adolescence: a mixed-methods evaluation |
| title_sort | mobile healthy lifestyle intervention to promote mental health in adolescence a mixed methods evaluation |
| topic | Mobile health applications Adolescents Mental health promotion Healthy lifestyles Digital behavior change interventions Participatory development |
| url | https://doi.org/10.1186/s12889-023-17260-9 |
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