The importance of user segmentation for designing digital therapy for adolescent mental health: Findings from scoping processes

© 2019 Journal of Medical Internet Research. All rights reserved. Background: New Zealand youth, especially those of Maori and Pacific descent, have high rates of depression, anxiety, and self-harm, but have low rates of help-seeking from mental health professionals. Apps, computerized therapy, and other digital tools can be effective, highly scalable treatments for anxiety and depression. Co-design processes are often used to foster engagement with end users, but this does not always lead to high levels of engagement. Objective: We aimed to carry out preliminary scoping to understand adolescents' current internet use and diversity of preferences to inform a planned co-design process for creating digital mental health tools for teenagers. Methods: Interactive workshops and focus groups were held with young people. Data were analyzed using a general inductive approach. Results: Participants (N=58) engaged in 2 whanau (extended family) focus groups (n=4 and n=5), 2 school- or community-based focus groups (n=9 each), and 2 workshops (n=11 and n=20). The authors identified 3 overarching themes: (1) Digital mental health tools are unlikely to be successful if they rely solely on youth help-seeking. (2) A single approach is unlikely to appeal to all. Participants had diverse, noncompatible preferences in terms of look or feel of an app or digital tool. The authors identified 4 user groups players or gamers, engagers, sceptics, and straight-talkers. These groups differed by age and degree of current mental health need and preferred gamified or fun approaches, were open to a range of approaches, were generally disinterested, or preferred direct-to-the-point, serious approaches, respectively. (3) Digital mental health tools should provide an immediate response to a range of different issues and challenges that a young person may face. Conclusions: Defining the preferences of different groups of users may be important for increasing engagement with digital therapies even within specific population and mental health-need groups. This study demonstrates the importance of scoping possible user needs to inform design processes.