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Accepted for/Published in: JMIR Pediatrics and Parenting

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  • Radhwan Hussein I, Marghoob Hussein Y, Mariwan Qadir H, Salwa Hazim A, Mohammed Faris A, Osama A
  • Adapting Cognitive Behavioral Therapy for Adolescents in Iraq via Mobile Apps: Qualitative Study of Usability and Outcomes
  • JMIR Pediatrics and Parenting
  • DOI: 10.2196/11848
  • PMID: 30303485
  • PMCID: 6352016
Preprints Accepted Manuscript

Adapting Cognitive Behavioral Therapy for Adolescents in Iraq via Mobile Apps: Qualitative Study of Usability and Outcomes

Abstract

background

Mental health challenges, including anxiety and depression, are increasingly common among adolescents. Mobile health (mHealth) apps offer a promising way to deliver accessible Cognitive Behavioral Therapy (CBT) interventions. However, research on the usability and effectiveness of apps explicitly tailored for adolescents is limited.

objective

This study aimed to explore the usability, engagement, and perceived effectiveness of a mobile CBT app designed for adolescents, focusing on user experiences and mental health outcomes.A qualitative study was conducted with 40 adolescents aged 13-19 (mean age = 15.8 ± 1.9 years; 45% male, 55% female) who engaged with a CBT app for four weeks. Mental health diagnoses included anxiety 20 (50%), depression (37.5%), and both (12.5%). Of these, 10 (25%) had previous CBT experience. Feedback was gathered through focus groups and individual interviews, and thematic analysis identified key themes related to usability, engagement, and perceived effectiveness. Quantitative data on mood and anxiety scores were analyzed with paired t-tests

methods

A qualitative study was conducted with 40 adolescents aged 13-19 (mean age = 15.8 ± 1.9 years; 45% male, 55% female) who engaged with a CBT app for four weeks. Mental health diagnoses included anxiety 20 (50%), depression (37.5%), and both (12.5%). Of these, 10 (25%) had previous CBT experience. Feedback was gathered through focus groups and individual interviews, and thematic analysis identified key themes related to usability, engagement, and perceived effectiveness. Quantitative data on mood and anxiety scores were analyzed with paired t-tests.

results

The mean usability score was 3.8 ± 0.6, and the mean effectiveness score was 3.9 ± 0.7. Older participants (16–19 years) reported significantly higher usability (4.1 ± 0.4) and effectiveness scores (4.3 ± 0.5) compared to younger participants (13–15 years) (P < 0.01). Females had higher mean usability (4.0 ± 0.6) and effectiveness scores (4.2 ± 0.7) than males (3.6 ± 0.7 and 3.5 ± 0.8, respectively) (P = 0.03). Participants with prior CBT experience had 2.8 times higher odds of reporting high usability scores (95% CI: 1.6–5.0; P = 0.002) and 3.1 times higher odds of reporting high effectiveness scores (95% CI: 1.7–5.6; P = 0.001). Usability challenges included complex navigation (42.9%), interface design issues (34.3%), and content overload (22.8%). Factors positively influencing engagement were motivation driven by personal relevance (38.5%) and gamification features (34.6%), while lack of personalization (35.9%) and external distractions (46.2%) were significant barriers. Mood improvement (43.9%) and learning new coping skills (38.6%) were the most reported outcomes

conclusions

The mobile CBT app shows potential for improving adolescent mental health, with initial improvements in mood and anxiety. Future app iterations should prioritize simplifying navigation, adding personalization features, and enhancing technical stability to support long-term engagement.

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Copyright

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it’s website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.

Citation

Please cite as:

Radhwan Hussein I, Marghoob Hussein Y, Mariwan Qadir H, Salwa Hazim A, Mohammed Faris A, Osama A

Adapting Cognitive Behavioral Therapy for Adolescents in Iraq via Mobile Apps: Qualitative Study of Usability and Outcomes

JMIR Pediatrics and Parenting

DOI: 10.2196/14886

URL: https://preprints.jmir.org/preprint/11848

PMID: 31789598

PMCID: 6352016

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