Background: There is growing interest in using mobile apps and online tools to support postsecondary student mental health, but most of these solutions have suboptimal user engagement in real-world settings. Poor engagement can limit long-term effectiveness and usefulness of these tools. Previous literature has proposed several theories that link factors such as low usability and poor user-centered design to app disengagement. However, few studies provide direct evidence showing what factors contribute to suboptimal user engagement in the context of mobile mental health apps for postsecondary students. Objective: This study focuses on understanding postsecondary students’ attitudes and behaviors when using Thought Spot, a co-designed mental health app and online platform, to understand factors related to engagement and user experience. Methods: Students who were given access to Thought Spot for 6 months during a randomized trial of the intervention were invited to participate in one-on-one semistructured interviews. The interviews explored participants’ overall experiences and perceptions of the app, along with factors that affected their usage of various features. All interviews were recorded, and template analysis was used to analyze transcripts. Results: User satisfaction was mixed among users of Thought Spot. The degree of engagement with the app appeared to be affected by factors that can be grouped 5 themes: (1) Students valued detailed, inclusive, and relevant content; (2) Technical glitches and a lack of integration with other apps affected overall user experience and satisfaction with the app; (3) Using the app to support peers or family can increase engagement; (4) Crowdsourced information from peers about mental health resources drove user engagement, but was difficult to obtain; and (5) Users often turned to the app when they had an immediate need for mental health information, rather than using it to track mental health information over time. Conclusions: Content, user experience, user-centeredness, and peer support are important determinants of user engagement with mobile mental health apps among postsecondary students. In this study, participants disengaged when the app did not meet their expectations on these determinants. Future studies on user engagement should further explore the effectiveness of different features and the relative importance of various criteria for high-quality apps. Doing so may inform the creation of interventions that best engage students and align with their mental health needs. Trial Registration: ClinicalTrials.gov NCT03412461; https://clinicaltrials.gov/ct2/show/NCT03412461

中文翻译：

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专上学生对心理健康应用程序和在线平台的参与（思想点）：评估与用户体验相关因素的定性研究


背景：人们越来越有兴趣使用移动应用程序和在线工具来支持专上学生的心理健康，但大多数解决方案在现实环境中的用户参与度并不理想。参与度低会限制这些工具的长期有效性和实用性。先前的文献提出了几种理论，将可用性低和以用户为中心的设计不佳等因素与应用程序脱离联系起来。然而，很少有研究提供直接证据来表明哪些因素导致专上学生移动心理健康应用程序中用户参与度不理想。目的：本研究的重点是了解专上学生在使用联合设计的心理健康应用程序和在线平台 Thought Spot 时的态度和行为，以了解与参与度和用户体验相关的因素。方法：在随机干预试验期间获得 Thought Spot 6 个月访问权的学生被邀请参加一对一的半结构化访谈。访谈探讨了参与者对应用程序的整体体验和看法，以及影响他们使用各种功能的因素。所有访谈均被记录，并使用模板分析来分析笔录。结果： Thought Spot 用户的满意度参差不齐。 对应用程序的参与程度似乎受到可分为 5 个主题的因素的影响：(1) 学生重视详细、包容性和相关的内容； (2) 技术故障以及缺乏与其他应用程序的集成影响了应用程序的整体用户体验和满意度； (3) 使用应用程序支持同伴或家人可以增加参与度； （4）来自同行的关于心理健康资源的众包信息提高了用户参与度，但获取困难； (5) 当用户迫切需要心理健康信息时，他们经常会转向应用程序，而不是使用它来跟踪一段时间内的心理健康信息。结论：内容、用户体验、以用户为中心和同伴支持是专上学生中用户使用移动心理健康应用程序的重要决定因素。在这项研究中，当应用程序未达到参与者对这些决定因素的期望时，参与者就会退出。未来关于用户参与度的研究应进一步探讨不同功能的有效性以及高质量应用程序的各种标准的相对重要性。这样做可能有助于制定最能吸引学生并符合他们心理健康需求的干预措施。试验注册： ClinicalTrials.gov NCT03412461； https://临床试验。政府/ct2/show/NCT03412461