Evaluation of an app to support emotional wellbeing of adolescents.

The intervention ("Quest - Te Whitianga") is a self-administered 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. For this evaluation trial, the treatment period will be approximately two weeks. The app has been co-designed with Maori and Pasifika young people as part of the HABITs research group. 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. Examples include instant activities (e.g. smile, high 5) or fun activities (e.g. shopping, walking the dog, watching a movie, arts activities, relaxation activities). 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. There are no directions given to the participants regarding frequency or duration of use; use of the app is completely at the participants discretion. Adherence to the intervention will be assessed 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 in this open trial.