Predictors of adolescent engagement and outcomes - A cross-sectional study using the togetherall (formerly Big White Wall) digital mental health platform

J Affect Disord. 2022 Aug 15:311:284-293. doi: 10.1016/j.jad.2022.05.058. Epub 2022 May 16.

Abstract

Background: Online mental health platforms can improve access to, and use of, mental health support for young people who may find it difficult to engage with face-to-face delivery.

Objective: We modelled predictors of engagement and symptom change in adolescent users of the Togetherall (formerly "Big White Wall") anonymous digital mental health peer-support platform.

Methods: We report a retrospective analysis of longitudinal user data from UK 16-18 year Togetherall users, referred from mental health services (N = 606). Baseline demographics were reported for participants who logged anxiety and depression measures. Number of log-ins, mean session duration, total usage time, number of guided support courses and self-help materials accessed were our usage metrics. Participant characteristics and symptoms were used to predict engagement. For n = 245 users with symptom measures at >1 timepoint we modelled the effect of predictors on symptom scores.

Results: Mean logins was 5.11 and mean usage time was 64.22 mins. Participants with one log-in represented 33.5% of the sample. Total time accessing Togetherall predicated greater usage of self-help materials and courses. Females made greater use of materials and courses than males. In a subsample, higher baseline depression and anxiety, longer total usage time and mean session duration predicted final depression scores, whereas higher baseline depression and anxiety and greater accessed self-help materials predicted lower final anxiety scores.

Limitations: A naturalistic design was used and symptom modelling should be interpreted with caution.

Conclusions: Findings suggest adolescents can engage with the Togetherall platform. Baseline symptoms and characteristics can inform user engagement with digital platforms.

Keywords: Adolescents; Anxiety; Depression; E-mental health; Engagement; Internet; Outcome.

MeSH terms

  • Adolescent
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression* / epidemiology
  • Depression* / psychology
  • Female
  • Humans
  • Male
  • Mental Health*
  • Retrospective Studies