tune.in: evaluation of an app to support adolescents with managing behavioural change.

This is an open, single arm trial aiming to test an app (tune.in) that has been co-designed with young people to support young people to make positive behavioural changes (i.e. goal attainment and emotional management). The tune.in app is an interactive app designed to support emotional and behavioural management in young people. Tune.in achieves this by facilitating goal attainment via reminders and rewards. Goals can be chosen from a variety of options preloaded into the tune.in app and which young people will then be coached to breakdown into “daily tasks” - specific behavioural strategies and activities that will help them achieve their ultimate goal. Tune.in sends a daily notification to the young person to remind them to engage in their “daily task” and on successful completion the young person will be rewarded with a song selected by a New Zealand celebrity and an encouraging message explaining how the song may inspire them to feel, think and act positively. Young people are able to use the tune.in app in conjunction with a health professional such as a mental health clinician. Goal planning is a key part of most psychological treatments and support, thus “goals” and “daily tasks” may be collaboratively decided upon and reviewed by the young person and health professionals in their sessions. The tune.in app used co-design sessions with young people to ensure that the final version of the app would appeal and be helpful to young people, services uses, health professionals and the Maori and Pasifika community. For this evaluation, the treatment period will be approximately four weeks. The app is based on goal setting; young people pick their overall goal (journey), the strategy they will use to achieve that goal, including the specific activity they will do as part of that strategy. The only information provided is about phone lines that they can call for support, and they can enter the number of their own support person into that list The app utilises important behaviour change elements of action planning and intentions. It enhances the opportunity for behaviour change by providing notifications each day (reminders) of the planned activity (steps) that the young person has chosen to help them achieve their goal. The app being highly customisable (young people choose their own goal and steps to achieve their goal). the app gives rewards for goal achievement in the form of songs young people can add to their play list that are accompanied by a message of encouragement from leading NZ artists, promoting a sense of connection to others who may have had similar experiences. Gamification to encourage and sustain behaviour change is provided via unlockable content (the next song on the playlist) that also includes an element of randomness via the name of the next song to be unlocked being hidden until is unlocked. The app is designed so that the support person of the young person (school counsellor, clinician etc…) can help the young person set up their goals etc…in the context of the therapeutic relationship they already have, and can check in regularly with how the young person is going with the app in their regular sessions Examples of journeys/goals are: Looking after myself; Accepting myself; Getting a job; Reduce substance use; Using substances safely; Managing my feelings; Reducing self-harm; Getting better marks; Planning my future; Keeping relationships. Choose the steps you will take – the things you choose to do (and how often you will do it). Get active 1) Go to the gym 2) Jog or walk 3) Go cycling or mtbiking 4) play a team sport 5) Get into/onto the water 6) Do yoga/pilates 7) Do chores/housework 8) Go dancing 9) Get outside and muck about 10) Do another activity Self care Appreciate myself Do something I love Pamper myself Do something creative Practice mindfulness Practice acceptance Do the opposite Turn off social media Enjoy time out for myself Be positive to myself Get connected Talk to someone Hang out with people Contact my supports Connect with Whanau / friends Join a team or group Try something new Explore/discover my culture Cut conflict and arguments Contribute and help others Connect to my community Sleep better Stick to the same bed time Avoid napping in the day Decrease screen time Reduce caffeine Keep bed as a 'sleepzone' Set an alarm and get up Do some exercise Turn off my phone Practice steady breathing Jot down worries Party safe Drink / use more slowly Avoid driving Be safe with sex Plan ahead Food and hydration Stay with friends Avoid mixing Know what I'm taking Use an alarm Call it quits Be calm Practice steading breathing Watch TV or movies or read Listen to positive music Talk to someone Tap into culture or spirituality Practice relaxation Be with Whanau or family Take a bath or shower Do something creative Be with nature and the land Get sorted Talk to my teacher Write a list of things to do Look for a job Volunteer Plan my time Have a study plan Problem solve Keep up to date with study Put my screen aside Get more sleep Cut down on substance use Delay my use See my non-using friends Monitor my use Avoid triggers to using Plan alternative activities Let cravings pass Go to a meeting Use less Save or spend money Contact my supports Be present Engage my senses Do something I love Practice gratitude Do something creative Take time out alone Schedule a quiet moment Fully enjoy the present Eat something delicious Read quietly or out loud Turn off my phone Manage distress Wait it (urge/distress) out Contact my support people Change my environment Hang with positive people Do intense physical exercise Listen to music Write about it Do alternative actions Be mindful of my triggers Be accepting There is no correspondance between clinician/support person and the young person via the app. The apps designed to be set up/customised by the young person according to what goal they want to set and the steps they want to take to achieve that goal. However, we are instructing support people to scaffold/support young people in this process and to check in with the young person at their regular sessions about how their app usage is going. The clinician can check the ‘activity log’ in the app, if the young person choses to show them this – this records achievement of steps. The young person spend up to ten minutes with their clinician/support person, in their regular session talking about their app usage during the week and showing the clinician/support person their activity log. There is no prescribed frequency or duration of sessions with a clinician/support person but we have suggested that for the period of time the young person is using the app (4 weeks) that there is a weekly check in. We are asking clinicians/support people to check in with the young person, preferably in their regular sessions, once a week about app usage.