Adolescents' Preferences, Experiences, and Views of 2 Online Programs for Anxiety and Depressive Symptoms:...

Anxiety and depression are among the most prevalent mental health problems affecting adolescents. Digital mental health interventions have emerged as promising means of addressing these challenges. Understanding adolescents' experiences and perspectives, and incorporating them into intervention design, can enhance their relevance, engagement, and effectiveness, ensuring interventions meet young people's needs.

This qualitative study aimed to identify how adolescents aged 16-19 years engaged with 2 distinct interventions (Bite Back [Black Dog Institute] and Project YES [Youth Empowerment & Support; Lab for Scalable Mental Health and Koko]). It explored (1) barriers and facilitators to engagement, (2) young people's preferred design features and content, and (3) perceptions of their potential usefulness and helpfulness.

Adolescents aged 16-19 years living in the United Kingdom were eligible to take part and were recruited through a university and a charity using convenience sampling. The final sample comprised 22 participants aged 18-19 years. They were asked to use Bite Back and Project YES for 30 minutes each over a 2-week period. Following this, 1-hour semistructured online interviews were conducted between January and March 2025. Anonymized transcripts were managed in NVivo (version 14; Lumivero) and analyzed using a pragmatic, inductive thematic analysis.

Seven themes were identified that captured young people's views on factors influencing engagement, preferred design features and content, and the perceived usefulness of digital mental health interventions. Participants' views were shaped by whether the content felt age-appropriate, culturally relevant, and relatable, and by how clear and transparent the interventions were. Interactive, visually appealing, and tailored features were generally preferred. Although most participants found Bite Back helpful, useful elements were identified in both interventions.

This study contributes to the growing understanding of how young people engage with digital mental health interventions by identifying a set of interconnected factors that influence young people's experiences. It highlights the importance of designing interventions that align with young people's stage of life, culture, and experiences. Even small age differences appeared to influence how relevant the interventions felt to the individual. Furthermore, involving young people in co-design and ensuring clear, accessible communication may support trust and engagement, ultimately enhancing the benefits of such interventions.