Understanding the uptake of a mobile phone application (app) to support youth wellbeing and resilience.

The intervention ("Quest - Te Whitianga") is an app available to study participants for download on their personal Android or iOS smart phone, or Chromebook, for self-directed use for the duration of the trial. App access is administered online and not facilitated face-to-face. For this uptake trial, the treatment period will be approximately eight weeks. The app consists of six modules, most of which contain at least three ‘levels’, which encourages the user to practise each skill at an increasing level of difficulty. Each module contains interactive activities (e.g. relaxation activity, entries in a gratitude journal, selecting activities to try out, interactive conversations). Module levels generally take less than 5 minutes to complete. The app is highly visual and requires minimum reading. The content is based on evidence-based strategies derived from Cognitive Behavioural Therapy, Interpersonal Therapy (IPT) and positive psychology approaches. The six modules cover the following core concepts: 1. Relaxation and mindfulness: brief slow and controlled breathing exercises 2. Structured problem solving: STEPS (Say what the problem is, Think of solutions, Examine each one, Pick one, See what happens) 3. Activity scheduling: an activity picker exercise designed to motivate the user to do fun, active and new activities to lift mood 4. Gratitude Journal: each time a user logs into the app s/he is asked to name three things they are grateful that day. 5. Interpersonal skills; Communication, assertiveness and staying in control of strong emotions 6. How thoughts influence emotions and how to deal with negative thoughts through ‘accept, distract, reframe’ methods. In the first instance, participants are introduced to the first level of each island (activity) sequentially (in the order: gratitude journal, relaxation, activity scheduling, thoughts and emotions, problem solving, interpersonal skills). Thereafter, participants are able to progress and continue at their discretion. Adherence to the intervention will be described using app usage metrics including duration and pattern of use as well as completion of modules and activities in the app. The app is linked through secure individual user accounts to the HABITs IT platform. The "Quest - Te Whitianga" app will be used in an open-label fashion by participants. App usage is entirely at participants discretion.