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Adolescence can be a fertile time for relationship issues, with interpersonal conflict being a risk factor for poor mental health. Mobile app interventions may have a significant appeal to young people in assisting with relationship distress. However, currently available apps have not been formally evaluated. Youths’ perspectives on engaging with mobile technology to assist with relationships are also unknown.
This study aimed to examine adolescents’ attitudes toward the concept of a mobile phone app for relationship help and support, and whether they would be likely to use such an intervention.
A cross-sectional Web survey consisting of 42 questions, including 13 free responses, was delivered. The proposed app, including character vignettes, was presented, and participants were asked to indicate whether they had experienced the same relationship issues, whether their peers would relate to the issues, and how helpful they found the proposed advice. Participants were also asked to provide their own suggestions for help, which were analyzed using thematic analyses.
A total of 150 adolescents (aged 15 to 18) participated. Overall, 60.7% (91/150) were likely to use an app for relationship problems, and this was not associated with demographics or social support (all
Adolescents were likely to use a mobile phone app for relationship support, and use was not influenced by gender, age, social support, or any other background characteristic. Instead, likely use was influenced by need, personal beliefs, usability, and the appropriateness of app content. App developers must address these factors if the app is to have a wide-scale uptake.
Across the lifespan, relationships are important to well-being [
In general, little is known about adolescents’ help-seeking specifically for relationships. Much more is known about adolescents’ help-seeking for mental health issues, which has been found to be inhibited by stigma, accessibility, and self-reliance [
There are evidence-based therapies (eg, cognitive behavioral therapy [CBT] and interpersonal therapy [IPT]) that have been found to be effective for relationships [
Given the emotional impact of relationship conflict, the lack of help being sought for these issues, and the preference for digital health solutions, there is a clear need for an evidence-based mobile app that has universal appeal, covers a range of relationship types (eg, friendships, family relationships, romantic relationships) and psychosocial issues (eg, anxiety, body image, negative thinking, help-seeking), and is easily accessible to youths. Researchers at the Black Dog Institute have developed the content for such an app. However, to ensure that the proposed app has uptake, acceptability needs to be assessed. In the context of health care, acceptability is defined as a multifaceted construct that reflects the extent to which people delivering or receiving an intervention consider it to be appropriate, and suited to their needs, based on anticipated or experimental responses [
A cross-sectional Web survey was delivered. This study was approved by the University of New South Wales Human Research Ethics Committee (#HC15583).
Australian adolescents aged 15 to 18 years were invited to participate in the study by responding to an online advertisement, which included a link to the online survey published on Facebook as well as the Black Dog Institute’s website, Facebook, Twitter, and Instagram platforms. The online survey was delivered by the Key Survey software, hosted by the University of New South Wales. The survey included the participant information sheet and consent form in which participants were asked to provide consent online. Parental consent was not required, as young people aged 15 years and over were deemed to be mature minors capable of consenting to their own participation in this low-risk research. Once consent was given, the survey questions appeared. After completion of the survey, participants were redirected to a separate webpage on which they were asked to enter their name and email address to be reimbursed with an Aus $20 online gift voucher. Personal details were not linked to survey responses.
The survey consisted of 42 questions, including 13 free-response questions.
A total of 7 questions were asked, assessing age, gender (male, female, or other), country of birth (Australia or other), language spoken at home (English or other), living situation (with both parents together or all other), work and study status (high school, working, university, apprenticeship, or none of the above), and whether they identified as lesbian, gay, bisexual, trans, intersex (LGBTI; answered yes, no, or rather not say) or Aboriginal and, or, Torres Strait Islander (ATSI; answered yes, no, or rather not say). Participants were also asked whether they owned a smartphone (yes or no) or mobile tablet (yes or no) and the primary device used to access the Internet.
To determine whether the acceptability of the app was associated with current social support levels, the Schuster Social Support Scale [
Participants were asked how likely they were to use a mobile phone app for relationships (answered likely, neutral, or unlikely). Using free response, they were also asked to provide reasons why or why not, which were to be analyzed qualitatively.
The survey included 4 nonstandardized character vignettes that each described relationship issues experienced by 4 young people named Abigail, Jasper, Emily, and Angus. Outlined in
Participants were asked to read the vignettes and report whether they or a friend had experienced this situation (experience answered yes, no, or not sure). They were then asked to rate how much they felt their peers would relate to the character (relatedness answered not at all, a little, moderately or a lot). Given that the aim was to design a universal app with broad appeal, the relatedness variable was collapsed (a lot, moderately, a little vs not at all) to better capture what types of youths did not at all relate to the content. Using free response, participants were asked to report what they would do if faced with the character’s issue, and what they would suggest a friend do in a similar situation. Finally, evidence-based coping strategies were presented. Participants were then asked to rate the helpfulness of these using a 5-point scale of not at all helpful (1) to extremely helpful (5).
Relationship issues and coping strategies outlined in the character vignettes.
Character | Issues explored | Coping strategies |
Abigail | Peer conflict, intimate relationship problems, eating disorders, negative thinking, and low self-esteem | Coping with distress, help-seeking, and relaxation and meditation |
Jasper | Relationship breakdown, social anxiety, bullying, online relationships, and low self-esteem | Problem solving, sleep strategies, anxiety desensitization, and help-seeking |
Emily | Academic pressure, parental conflict, peer conflict, drug use, sexuality, and negative thinking | Help-seeking, relaxation, cognitive restructuring, and social mapping |
Angus | Family conflict, parent separation, intimate relationship problems, anger management, substance use, and change | Help-seeking, relaxation, conflict resolution, and cognitive restructuring |
There were no minimum levels of experience, relatedness, or helpfulness expected. Instead, the study aimed to identify the aspects of the app content that may influence acceptability.
The data were exported from Key Survey, and statistical analyses were conducted in SPSS v22 (Chicago, IL, USA). Descriptives were conducted and reported. Correlational and chi-square tests were used to examine whether background factors were associated with having experienced a character’s issues, peer relatedness, and helpfulness ratings. This would help to determine whether the app content was more likely to be acceptable among certain youths. Due to the low cell counts, participants who reported that their gender was other (n=5) or that they would rather not report their LGBTI status (n=3) were excluded. Furthermore, this sample was inappropriate for examining ATSI effects because of low numbers (2.0%; 3/150), and the saturation of technology ownership (98.0%; 147/150) meant that these variables were inappropriate for inclusion in the variance analyses. For the analyses including the experience variable, participants who reported that they were unsure were excluded. This was done to ensure integrity of the data. Free-response data were analyzed using Braun and Clarke’s thematic analysis guidelines [
A total of 150 adolescents completed the survey (age range: 15-18 years, mean 16.8 years [SD 1.1]).
Participant characteristics (N=150).
Demographic | n (%) | |
Female | 104 (69.3) | |
Born in Australia | 130 (86.7) | |
English is main language | 138 (92.0) | |
LGBTIa | 38 (25.3) | |
ATSIb | 3 (2.0) | |
At high school | 98 (65.3) | |
At university | 39 (26.0) | |
Working full-time | 6 (4.0) | |
Living with both parents together | 95 (63.3) | |
In a relationship | 44 (29.3) | |
Owned a smartphone | 147 (98.0) | |
Owned a tablet | 92 (61.3) | |
Owned both | 90 (60.0) | |
Did not own either | 1 (0.7) | |
Personal laptop or desktop computer | 77 (51.3) | |
Smartphone | 69 (46.0) | |
Tablet | 4 (2.7) |
aLGBTI: lesbian, gay, bisexual, trans, intersex.
bATSI: Aboriginal and/or Torres Strait Islander.
Social support levels within the sample.
Support source and nature of support | n | Mean (SD) | Range | |
Positive | 147 | 3.22 (0.63) | 1.5-4 | |
Negative | 145 | 2.42 (0.65) | 1-4 | |
Positive | 149 | 3.31 (0.74) | 1-4 | |
Negative | 148 | 2.96 (0.70) | 1-4 | |
Positive | 44 | 3.34 (0.77) | 1.4-4 | |
Negative | 44 | 2.03(0.72) | 1-3.4 |
A total of 60.7% (91/150) of participants reported that they were likely to seek help from a mobile app for relationship issues, 26.7% (40/150) had a neutral response, and 12.7% (19/150) were unlikely. Likelihood of app use was not significantly associated with any participant characteristics or social support (all
Overall, only 10.6% (16/150) of participants reported that they had not experienced any of the issues presented; that is, most participants (134/150, 89.4%) had experienced 1 or more of the issues presented. All participants reported that their peers would relate to at least one of the characters, with 94.0% (141/150) reporting that their peers would relate moderately or a lot to 1 or more of the characters, and 56.0% (84/150) reporting that their peers would relate a lot to 1 or more of the characters.
Participants with higher negative family support were more likely to experience Abigail’s issues (
Themes influencing the likelihood of app usage (N=150). R: respondent.
Theme | Definition | n (%) | Example |
Perceived need | The degree to which the young person has identified a need for relationship help and support | 74 (49.3) |
“...I would be able to have a better relationship with my potential girlfriend.” [R132] “I don’t feel I need it at this current stage.” [R2] |
Beliefs | The degree to which the young person believed in the effectiveness of mobile apps for providing genuine relationship support | 74 (49.3) |
“…if it does no harm then it is worth a shot.” [R26] “I’m open to the advice and possibly using such an app, but it also seems a bit silly to use an app for relationship advice.” [R102] |
Engagement and accessibility | The degree to which the young person valued the user experience aspects of the app, such as being easy to use, as well as engagement aspects such as being interesting and different | 50 (33.3) |
“If had useful things and was easily accessible, I would use it. If it was outdated, not useful, hard to interact with etc, I wouldn’t.” [R90] “...if it contains constructive advice and is designed in a way that targets my age group in a positive and welcoming way.” [R64] |
Participant responses to the vignettes (N=150).
Responses | Abigail, n (%) | Jasper, n (%) | Emily, n (%) | Angus, n (%) | |
Yes | 79 (52.7) | 49 (32.7) | 53 (35.3) | 27 (18.0) | |
No | 51 (34.0) | 68 (45.3) | 65 (43.3) | 96 (64.0) | |
Unsure | 20 (13.3) | 33 (22.0) | 32 (21.3) | 27 (18.0) | |
A lot | 51 (34.0) | 23 (15.3) | 32 (21.3) | 15 (10.0) | |
Moderately | 68 (45.3) | 58 (38.7) | 70 (46.7) | 53 (35.3) | |
A little | 27 (18.0) | 63 (42.0) | 42 (28.0) | 76 (50.7) | |
Not at all | 4 (2.7) | 6 (4.0) | 6 (4.0) | 6 (4.0) | |
Helpfulness, mean (SD) | 4.03 (0.81) | 4.12 (0.88) | 3.84 (0.89) | 3.95 (0.87) |
Themes influencing the acceptability of the proposed relationship-coping strategies (N=150). R: respondent.
Theme | Definition | n (%) | Example |
Nature | The degree to which a young person viewed the advice as appropriate, effective, feasible, or credible | 127 (84.7) |
“It’s very helpful useful information.” [R11] “The advice is theoretically perfect but in reality is very difficult to implement for someone in Emily’s shoes.” [R12] |
Scope | The degree to which a young person felt that the advice adequately addressed the full range of issues being faced | 38 (25.3) |
“There were many elements that I did not imagine, and the points were very comprehensive.” [R68] “You did not address the issue of Emily pressuring her to try marijuana.” [R116] |
Approach | The degree to which a young person felt that the advice was nonjudgmental, collaborative, empowering, or condescending | 11 (7.3) |
“I like that this suggestion understands his reluctance to talk to his parents, or anybody in general, but tries to find ways around that.” [R69] “I think it’s pretty good advice because it doesn’t place any blame on the person receiving it.” [R99] |
Personal experience | The degree to which a young person identified personal experience using the advice in the past | 10 (6.7) |
“I have been in a similar situation and those were pretty close to the steps I took.” [R98] “When I stopped going to school due to my anxiety I did try seeing the school counsellor and they did nothing.” [R10] |
Outlined in
When asked what participants would do themselves and recommend to a friend, 8 themes were identified. Outlined in
Participants’ recommendations for what they would do themselves and recommend to a friend when faced with a relationship issue (N=150). R: respondent.
Recommendation type and theme | Definition | n (%) | Example | |
Seek help | The degree to which a young person expressed that they would ask for help if faced with a similar issue | 64 (42.7) |
“Talk to my support teacher to help advise me in the situation.” [R43] “Gain help and advice from trusted friends.” [R66] |
|
Active coping | The degree to which a young person reported an action-orientated attempt to solve or cope with the problem if faced with a similar issue | 50 (33.3) |
“Ditch the smoking friend and find better friends.” [R37] “Just try to relax and make myself feel better by doing things I loved.” [R81] |
|
Perceived coping efficacy | The degree to which a young person felt that they would have the ability to cope if faced with a similar problem | 50 (33.3) |
“I would tell myself that things get better and try and focus on the positives in life.” [R141] “Not sure, probably withdraw.” [R120] |
|
General emotional support | This involved acting in a supportive, reassuring, comforting, empathetic, caring, nonjudgmental, and encouraging manner | 90 (60.0) |
“I would comfort them and make sure they feel loved.” [R117] “I would be there for them in the difficult time that they are going through.” [R110] |
|
Informational support | This involved providing advice, suggestions, or useful information | 61 (40.7) |
“Warn her about the effects of marijuana.” [R129] “Convince her to move on and that there are other guys better than Brendan.” [R150] |
|
Encourage help-seeking | This involved encouraging help-seeking from both formal and informal sources | 41 (27.3) |
“Encourage them to talk to as professional.” [R1] “I would urge them to see a therapist.” [R80] |
|
Shared activities | This involved spending time together and engaging in shared activities | 22 (14.7) |
“Get out and do some sport or hang out.” [R34] “Organize to do things with them to distract them.” [R145] |
|
Practical support | This involved providing doing something helpful for the friend | 19 (12.7) |
“I would offer to help her with homework.” [R13] |
This study aimed to examine young people’s attitudes toward using a mobile phone app for relationship problems and to determine the acceptability of the proposed content. In the current sample, technology ownership was high, with only 1 participant not owning a smartphone or tablet. Almost half of the sample accessed the Internet from their mobile phone. Importantly, two-thirds of the sample indicated that they would be open to using a mobile help-seeking intervention for relationships, irrespective of background factors or levels of social support. These findings suggest that delivering relationship support via a mobile phone app is likely to be accessible to a general youth population and confirms a degree of acceptability for a mobile help-seeking intervention. In terms of future development, several key factors were found to influence the likely use of a mobile app for relationships including perceived need, personal beliefs, engagement, and accessibility. The acceptability of the help-seeking information was influenced by the nature, scope, and approach of the content as well as users’ personal experience of the suggestions. These aspects are likely to be relevant to a range of other youth help-seeking interventions and must be systematically addressed if a mobile intervention is to have broad uptake and appeal.
Notably, likelihood of seeking help from an app was influenced by whether a young person identified a need for relationship support and whether they believed an app would be beneficial. In this study, when asked what they would do when faced with relationship issues, only one-third of the participants reported that they would seek help. Fewer suggested seeking help from a friend. The low level of help-seeking reported by participants aligns with past research on mental health issues, in which youths prefer self-management [
Unsurprisingly, young people identified that accessibility and engagement issues, including user experience, influenced their likelihood of using a mobile help-seeking intervention. This is consistent with mobile health app ratings in which users report to value apps that are easy to use, deliver a clear outline of the steps involved to reach a desired goal, and provide personalized information and education tailored to a user’s needs [
The current findings must be considered within the study’s limitations. First, this study examined young people’s help-seeking intentions, rather than actual behavior, and may therefore not be a true indication of how young people respond when faced with a relationship problem. Although this is appropriate for acceptability research, future trials would benefit from assessing other objective measures of acceptability, including app usage. Second, the use of an online survey restricted participation only to those who had access to the Internet, and the sample may not have been representative across a range of characteristics. In addition, the sample was recruited primarily from Facebook and Black Dog Institute social media sites. Future studies would benefit from targeting a more diverse sample as this study may have reached a more mental health literate subgroup of youths and those with an interest in mobile apps. Third, it is possible that the suggestions provided in the survey influenced participants’ free responses, thereby creating a learning effect. However, visual inspection of the qualitative data did not indicate participants’ reported help-seeking, coping strategies, or suggestions differed across characters. Finally, a strength of this study is the representativeness of youths who identified as LGBTI, being twice as many than the general population, which is approximately 10% to 11% [
Existing evidence has outlined that young people frequently experience relationship problems and associated distress. The findings of this study substantiate the need for additional relationship support and echo previous research that highlighted young people’s reluctance to seek help from formal services [
Online survey including the questionnaire, character vignettes, and the app suggestions.
Aboriginal and/or Torres Strait Islander
cognitive behavioral therapy
Interpersonal therapy
lesbian, gay, bisexual, trans, intersex
This project was funded by Brain Sciences, University of New South Wales. The authors would like to acknowledge the support of fellow researchers Dr Elizabeth Mason, Dr Jill Newby, Dr Angela Nickerson, and Erin Kelly in achieving funding. PJB and ALC are supported by National Health and Medical Research Centre Fellowships 1083311 and 1122544, respectively.
BOD and PJB are on the editorial boards for