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Resilience is the capability, resources, and processes that are available to a person or system to adapt successfully in the face of stress or adversity. Given that resilience can be enhanced, using advances in technology to deliver and evaluate the impact of resilience interventions is warranted. Evidence supports the effectiveness of the resilience-building JoyPop app in improving resilience-related outcomes after use; however, experiential data from users is also needed to provide a more comprehensive account of its utility.
The aim of this study was to explore users’ experiences with the JoyPop app and their perspectives on its utility.
This qualitative description study involved a combination of group and one-on-one semistructured interviews with a subset of first-year undergraduate students who participated in a larger evaluation of the JoyPop app. Participants used the app for a 4-week period and were subsequently asked about their frequency of app use, most and least used features (and associated reasons), most and least helpful features (and associated reasons), barriers to use, facilitators of use and continuation, and recommendations for improvement. Data were coded and categorized through inductive content analysis.
The sample of 30 participants included 24 females and 6 males, with a mean age of 18.77 years (SD 2.30). App use ranged from 1 to 5 times daily (mean 2.11, SD 0.74), with the majority indicating that they used the app at least twice daily. The Rate My Mood, Journal, and SquareMoves features were reported to be used most often, while the Rate My Mood, Journal, and Breathing Exercises features were identified as the most helpful. A number of themes and subthemes pertaining to facilitators of app use (prompts, creating routine, self-monitoring opportunities, expressive opportunities), barriers to app use (editing, lack of variety, student lifestyle), outcomes of app use (increased awareness, checking in with oneself, helpful distraction, emotional control), and recommendations for app improvement (adding more features, enhancing existing features, enhancing tracking abilities, providing personalization) were identified.
This study provides insight into the aspects of the JoyPop app that motivated and benefitted users, as well as measures that can be taken to improve user experiences and promote longer-term uptake. Users were willing to engage with the app and incorporate it into their routine, and they valued the ability to self-monitor, express emotion, and engage in distraction.
Resilience is the multifaceted capability of an organism or system to adapt to challenging circumstances [
Because resilience is developed and shaped over time, the argument follows that resilience can be promoted [
Mobile health (mHealth) app use has greatly expanded in recent years, with the benefit of reaching a wider population than traditional health interventions [
Although there is promise in promoting resilience with apps, evaluating an app’s utility requires a multimethod approach that includes a quantitative examination of changes seen in target outcomes following app use, along with qualitative data exploring users’ perspectives on the app and its utility. Although establishing the effectiveness of an app via quantitative data is important and often lacking [
User acceptance and uptake of an app have often been measured through proxy metrics, such as utilization data and download rates; however, qualitative data can better reveal the features and functions that draw users in and keep them engaged [
The resilience-building JoyPop app (see
Features of the JoyPop app. LGBTQ: lesbian, gay, bisexual, transgender, queer.
The JoyPop app was designed with youth, who have demonstrated a willingness to use mHealth apps [
Research to date suggests that the JoyPop app contributes to positive changes in outcomes related to resilience among youth. In a sample of undergraduate students making the transition to university who were asked to use the app for 4 weeks, improvements in emotion regulation and depression symptoms were evidenced with each additional day a participant used the app [
Gathering qualitative evidence on users’ experiences with the app and perspectives of its utility is important for a comprehensive evaluation. For instance, because the JoyPop app contains numerous features that might differentially contribute to changes in outcomes, a qualitative assessment could elucidate which features and functions participants felt were most used and most helpful. Moreover, with the goal of promoting autonomous use of the app outside of a research context, a qualitative assessment would help gather feedback on factors facilitating continued long-term use.
The objective of this study was to describe users’ experiences with the JoyPop app and their perspectives on its utility. A priori hypotheses were not specified due to the nature of the qualitative research design.
This study was part of the larger program of research examining the outcomes associated with using the JoyPop app [
Undergraduate students who were enrolled in their first year at a mid-size Canadian university (ie, Lakehead University), were fluent in English, and had an iPhone were eligible for the larger study. As documented elsewhere [
Prior to their post-app session, participants were presented with the option of sharing their experiences using the app and perspectives on its utility by participating in this qualitative description study. Those who expressed interest were invited to participate and received CAD $10 (US $8.13) upon completion.
Data were collected from February to March 2019 through a combination of group and one-on-one semistructured interviews immediately following participants’ completion of their self-report measures during the post-app laboratory session. Because the nature of each laboratory session was group based, this same format was selected for the interviews in an effort to maximize involvement while minimizing scheduling challenges and participant burden. This structure also enabled questions to be asked systematically in a direct manner by the interviewer to each participant on an individual level (in contrast with a focus group, where participants interact more with one another) [
The interview guide (see
All transcripts were deidentified and analyzed by ESP and KW independently. The data analysts first read and reread the transcripts to become familiar with the data. Inductive content analysis, whereby themes are not predetermined but emerge organically, was then used to code and categorize the text [
To enhance the trustworthiness of the data and limit researcher biases [
A sample of 30 first-year undergraduate students was enrolled in the study. Participants were predominantly female (24/30, 80%) and 18.77 years old on average (SD 2.30). Their ages ranged from 16-29 years, with the majority of the sample being aged 19 years or younger (28/30, 93%). Most participants self-identified as White (21/30, 70%), Asian (6/30, 20%), or Black (2/30, 7%). Close to half (14/30, 47%) of the participants were pursuing degrees within the area of health and behavioral sciences (eg, kinesiology, psychology, nursing), while 5/30 (17%) were undeclared/undecided. The remaining participants were pursuing degrees in science and environmental studies (7/30, 23%; eg, biology, geography), business administration (2/30, 7%; eg, business), or social sciences and humanities (2/30, 7%; eg, social work, political science). We conducted 8 group-based (3 with n=2; 4 with n=3; 1 with n=5) and 7 one-on-one interviews. On average, the group interviews were 16.19 minutes long, and the one-on-one interviews were 8.79 minutes long.
At the outset of each interview, participants were asked how often they used the JoyPop app over the preceding 4 weeks. Use ranged from 1 to 5 times daily (mean 2.11, SD 0.74), with the majority indicating that they used the app at least twice daily. Some participants specifically reported that they used it first thing in the morning and again in the evening before going to sleep.
A summary of the use of specific features and their perceived helpfulness is presented in
Feature use and helpfulness (N=30).
Feature | Value, n (%)a | |||
|
Most used | Least used | Most helpful | Least helpful |
Rate My Mood | 16 (53) | 0 (0) | 8 (27) | 3 (10) |
Journal | 15 (50) | 8 (27) | 8 (27) | 5 (17) |
SquareMoves | 16 (53) | 5 (17) | 3 (10) | 3 (10) |
Breathing Exercises | 9 (30) | 5 (17) | 10 (33) | 1 (3) |
Art | 2 (7) | 13 (43) | 0 (0) | 8 (27) |
Helplines | 0 (0) | 1 (3) | 0 (0) | 2 (7) |
Circle of Trust | 0 (0) | 12 (40) | 0 (0) | 4 (13) |
aSome participants identified >1 feature when asked about the most/least used and most/least helpful features.
In addition to summarizing the reported use and helpfulness, analyses of the transcripts revealed a number of themes and subthemes pertaining to facilitators of app use, barriers to app use, outcomes of app use, and recommendations for app improvement. Each theme and its associated subthemes are described below along with illustrative quotes.
Participants described several positive attributes of the JoyPop app that facilitated their enjoyment and/or continued use. The most commonly discussed attributes included prompts; creating routine; self-monitoring opportunities; and expressive opportunities.
Many participants noted their appreciation for the two types of prompts associated with the study design or app itself. Specifically, receiving email reminders to use the app and the prompts built into the Journal feature (ie, meant to provide suggestions for topics to write about) were identified as helpful.
I like to write and like, get my expressions out. But sometimes I like, struggle to start. So, having the prompts was nice...
At first, I felt like I didn’t really need the app…when I got the reminder and I kept on using it, I felt like it was actually really helpful.
Participants discussed how over time, they developed a routine with using the JoyPop app. Many shared how they used it in the morning to start their day and in the evening to “decompress” and process the day’s events. Several participants also noted that the more they used the app, the easier and more enjoyable it became.
At first, it was just like “Oh, I have to use the app.” … And after a while, I just found myself just kind of using it on my own, not really thinking about having to do it, but wanting to do it.
Yeah it definitely got better with time. And like, incorporating the breathing exercises into like, your everyday routine. I found it really helpful.
Many participants commented about appreciating the ability to look back at their calendar and journal entries over time, which enabled them to review and reflect on previous feelings and circumstances. This act of self-monitoring was deemed to be helpful in gaining perspective on one’s feelings and current state and also facilitated continued use of the JoyPop app. Some participants also reported using various app features in tandem, such as journaling following their mood rating, which likely contributed to ongoing self-monitoring.
Look[ing] back, even if I was like, having a bad day I’d be like, “Oh, I was really happy on this day.” And if like, I’m feeling bad one day I could look back and see like, “Oh, this week I was really, really happy” kind of thing.
I liked being able to rate my mood and then go into the journal setting and be able to like, write down things that were happening that day, so I could go and look back.
Some participants shared how using the JoyPop app enabled them to express themselves and that this was a positive feature that encouraged future use. Some noted prior difficulty communicating their feelings verbally and stated that through the app, they were able to express their emotions more readily via the Journal or Rate My Mood features.
It helps give students like, the opportunity to have a way to express themselves... the journal [feature] for example. But also, like keeping track of how they’re feeling and keeping themselves in check by having like, that visual… showing them where they’re at with their emotions.
[I found that journaling] was really helpful at the end of the day, just to kind of unload everything…[it] unpacked my day so I found that was really helpful.
In addition to factors that facilitated enjoyment and ongoing use of the JoyPop app, participants noted some factors that they felt interfered with their use. The primary barriers were related to editing, lack of variety, and student lifestyle.
Some participants discussed the inability to make changes to their data in some of the features. For example, a few expressed that they did not feel comfortable writing in the Journal if they were not able to later edit or retract their entry. Similar sentiments were expressed by some participants regarding not being able to save their drawings in the Art feature. Participants expressed that the option to edit or save their data would have motivated them to use certain features more often.
I didn’t like how you couldn’t edit [the journal entries] because, [I’m] someone who can get anxious about making mistakes…
It didn’t save my mood and stuff, you know?… I also didn’t like that I couldn’t save my drawings. Like, or attach a drawing to a mood or something like that.
Some participants commented on the limited prompt variety in the Journal feature, indicating that once they had responded to all the available prompts, they felt less inclined to continue to use the feature. Some participants similarly noted that because the Rate My Mood feature included a limited number of emotions, they felt that their true feelings may not have been captured.
I think the quotes being the same every time when you fill out the [journal] got kind of [frustrating].
I liked the rate my mood the least… it was just like, a happy or sad thing. Would’ve been nice be able to have something that it’s like, there’s different moods to rate. So like maybe I was feeling very happy but there would have been one to track, like how nervous I was feeling or how distressed like I feel. Like, more options would have been nice.
Some participants commented that, at times, the busy lifestyle and fatigue associated with being a student interfered with using the app. These participants indicated that “life” affected their use of the JoyPop app, and they mentioned feeling that there was not enough time to use it due to competing priorities and responsibilities.
[If] I was like, really busy studying, like during midterms [I would use it less].
If I was busy at the moment…if I was working on schoolwork or something…it wouldn’t happen.
During the interviews, participants expressed several positive outcomes related to their use of the JoyPop app. These were categorized into four main subthemes: increased awareness; checking in with oneself; helpful distraction; and emotional control
Many participants expressed how the JoyPop app enhanced their self-awareness in terms of being better able to recognize and differentiate their emotions. In addition, a few participants shared that after using the app, they began thinking more about the “why” behind their emotions, and how their feelings were related to mental and physical health.
It kinda gave me some time to reflect back on…certain things…After a point, I started noticing a pattern of why this one emotion I kept linking with a certain event, and then it kinda made me internalize like, “Am I depending too much on this event to make me feel a certain way?”
I was really impressed with the fact that it brought my attention more to how I was feeling. So, instead of just acknowledging that I was stressed and then managing with that, it really brought attention to why I was feeling that and just acknowledging that, which I thought was really cool.
The notion of taking or making time to check in with oneself was discussed frequently. In particular, participants mentioned benefits associated with pausing and reflecting on how they were feeling and what they might need in the moment (eg, to focus on their breathing). Related to their increased awareness, participants also expressed that because they were more aware of how they were feeling, they were able to “reset” and get things “back in check.”
It’s just nice to start your day off or end your day off with…taking a moment for yourself and like…getting your breathing in check and your emotions back in check.
[It] kind of like, forced me to take time throughout the day to reflect upon how I was feeling.
Many participants expressed that some features of the JoyPop app helped them to “take their mind off of” negative feelings or stressors they were experiencing. The distraction provided by the Journal and SquareMoves were deemed particularly useful and enabled the participants to focus on “something else.”
I liked the journal one the most I think, ’cause it was like, different. It was kind of like, distracting to take your mind off of whatever you might have been feeling at the time.
There were times when I’d be like on my phone and like, bored and stressed out, and just looking for a distraction and then I was like, “Ok, this was something I could do right now.”
I think the [SquareMoves feature] was probably the most helpful in terms of like, turning off my thoughts and focusing on something else.
Related to their increased awareness, many participants shared how the JoyPop app helped them to have more active control over their emotions. Using specific features (eg, Journal, Breathing Exercises) was discussed often as a means of managing emotions directly, especially in relation to school-specific situations (eg, midterm examinations, studying).
Take a couple more minutes and like, go through the events of my day… I kinda found that…as a good way to kinda, balance my emotions.
It really helps to calm down: the breathing exercises. It really helps like when I’m…angry… it helped a lot.
It definitely helped me figure [my feelings] out… actually helped me to relate my mood… Often I would feel better afterwards because I’d be like, “Ok. I know how to deal with this now”… rather than just sitting there and stewing not knowing what to do.
A few participants believed that the app or specific features of the app contributed to increased stress. For example, one participant explained that they felt there were too many buttons popping up which distracted them while using the app.
Too many buttons to hit or same quotes popping up or it was just…Even though it wasn’t the app causing the stress, I found that in this situation it couldn’t get me out of it… [It] was too many buttons and distracting colors to help.
[Using the breathing feature] …I feel stressed and stuff when I use this.
Suggestions for improving the JoyPop app involved four main subthemes: adding more features; enhancing existing features; enhancing tracking abilities; and providing personalization.
Many participants suggested adding more features for future app users. Specifically, participants recommended adding more activities (eg, games and varied breathing exercises or strategies for relaxation). The notion of incorporating accountability was also discussed by a few participants, with suggestions to increase social connectedness through the app and adding a reward system tied to use patterns. Finally, a few participants felt that reminders sent through their phone (eg, via pop-up notifications) would lead to increased app use.
Some apps use like, this notification. Like, they notify you after not using [it] for an hour. So, maybe adding [more notifications on the app].
I think having more activities on it…or being able to connect with people through the app rather than having to call them…getting their opinion on coping strategies, or… maybe having them to… check in on you every once in a while… like have accountability.
Some participants noted that more mood options would be beneficial in the Rate My Mood feature. Because only four emotions were included, the participants felt that their true feelings may not have been captured. Another common suggestion by participants was to include more prompts in the Journal feature. One participant suggested adding prompts to the Art feature as well.
[Adding] sound for the breathing so I can like, close my eyes or not like, stare down at my phone.
I like the idea of like the prompts for drawing or like a coloring book idea.
Um, definitely the rate the mood thing: adding more moods so then people can kinda have more options.
Having the ability to track emotions over time was also discussed by several participants. For instance, participants suggested that having a chart or graph within the app would be helpful to look back at and compare their emotions over time.
Some means of actually being able to properly like… track all of my moods and how I’m feeling… it would be a good way of like, expressing myself and then being able to reflect on it if I wanted to.
A few participants suggested offering users the ability to personalize the app based on their personality or preferences. Others thought personalization based on locations might be beneficial.
Having different versions of it for your personality types. Like certain things that are geared more towards your personality than others… there are a lot more creative and artistic people that would gear from the creative parts, but then there are the people who are less creative that will not use it at all or can’t draw. So…different versions of it too for each personality type would definitely… help it.
Like, you could put your location in [the app] and then it will bring up the local places around you [helplines, resources].
Consistent with recent recommendations to evaluate the utility and usability of mHealth apps [
Certain aspects of participants’ experience with the JoyPop app emerged as key facilitators of continued use. First, one major subtheme was the creation of routine, whereby the drive to use the app seemed to progress from wanting to adhere to study requirements to eventually desiring to use the JoyPop app and feeling it had become a habitual part of one’s day. This idea of habit formation is intriguing, as it is consistent with prior work on the factors associated with technology uptake [
Other facilitators of app use endorsed by participants were the self-monitoring and expressive opportunities provided by the JoyPop app. Consistent with this, the features that most clearly support these functions were among the most used and most helpful features according to participants, such as the Rate My Mood and Journal features. Prior studies have consistently indicated that self-monitoring and tracking of one’s mood is a highly desired feature of mental health–related apps [
Related to the self-monitoring and expressive opportunities that facilitated app use were the perceived outcomes described by participants of checking in with oneself, increased awareness, and emotional control. The JoyPop app appeared to serve as a signal to participants to pause their day to check in on how they were doing and assess how they might improve their mood if needed. By engaging in this self-monitoring and expression of emotion, the participants seemed to gain awareness and understanding of their emotions to better regulate them. Specifically, they indicated that the Journal and Rate My Mood features helped them learn to label and communicate their feelings, while the Breathing Exercises also provided a more direct form of emotion regulation. These findings are in line with general theories of self-regulation, which emphasize a connection between self-reflection, understanding, and regulation [
Another outcome of app use was that participants found it acted as a helpful distraction. Both SquareMoves and the Journal feature were mentioned within this subtheme, such that participants reported they felt these activities helped them take their mind off negative emotions and thoughts and focus on something else. Interestingly, in our tally of feature use and helpfulness, SquareMoves was indicated as one of the most used features; however, it was rarely mentioned as the most helpful feature. This finding suggests that it was the entertainment or distraction value of the feature that fostered continued use. Models of technology acceptance highlight entertainment factors as an important motive to using mHealth apps [
In terms of constructive criticism, participants described barriers to app use and recommendations for app improvements. They desired enhanced functionality of certain features, such as the Journal (more prompts, the ability to edit entries) and the Rate My Mood feature (greater variety of mood states). They also desired more features overall and were forthcoming with suggestions about features that should be added. This is in line with prior research on mHealth apps, which suggests that app users desire a sufficient number and diverse array of features that are also flexible enough to accommodate various needs [
Certain features did not appear instrumental to the uptake and perceived helpfulness of the JoyPop app. These included the Circle of Trust and Art features, which were either rarely mentioned or mentioned as the least used and least helpful features. With respect to the Circle of Trust feature, this finding is somewhat surprising, as having some aspect of social support and feeling part of a community have been cited as important to app users in prior research [
This study had many strengths. Obtaining user input on experiences with the JoyPop app and their perspectives on its utility aligns with recommendations of the value of user involvement in the design of digital health interventions [
A limitation to the current study is that participants were predominantly female, which reflects the composition of the larger sample of participants who used the app from which this subsample was drawn [
A further limitation is the variation in the number of participants who attended each interview session, which ranged from 1 to 5. A larger group may have resulted in some participants sharing more than others, which may have created differences in how much certain perspectives were amplified. In addition, participants may have been less willing to share negative feedback about the JoyPop app in the presence of the interviewers; however, certain questions were meant to specifically elicit negative or constructive feedback (eg, least used/least helpful features, barriers to use, recommendations for improvement), which should have encouraged participants to provide honest feedback about the app.
Continuing to seek and incorporate feedback from users into evolving versions of the JoyPop app is an important future direction. Understanding user perspectives on the utility, features, and design of the app will aid in ensuring its continued use and engagement [
Although the JoyPop app was designed specifically to draw attention toward positive mood states, consistent with consumer desire for positivity in mHealth apps [
In sum, this qualitative study of users’ experiences with the JoyPop app provides insight into aspects of the app that motivated and benefitted users, as well as actions that can be taken to improve user experiences and promote longer-term uptake. Students in our study demonstrated a willingness to engage with the app and incorporate it into their routine, while valuing the ability to self-monitor, express emotion, and engage in distraction. They preferred and used some features over others and were forthcoming with various suggestions for improvement. Their feedback underscores the value of considering user input in the continual development and evolution of apps, and it will be instrumental in ensuring the JoyPop app meets the needs of its users.
Interview guide.
mobile health
The majority of the authors have no conflicts of interest to declare. CW is the creator of the JoyPop app. To mitigate any risk related to conflict of interest, CW was not involved in collecting or analyzing the data. CW’s main role was to support the team in evaluating the JoyPop app, and to liaise between the research team and app developers. CW also reviewed the manuscript prior to submission.