Effects of a Mobile and web app (thought spot) on mental health help-seeking among college and university students: randomized controlled trial
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Abstract
BACKGROUND: Mental health disorders are the most prevalent health issues among postsecondary students, yet few solutions to this emerging crisis exist. While mobile health technologies are touted as promising solutions for the unmet mental health needs of these students, the efficacy of these tools remains unclear. In response to these gaps, this study evaluates Thought Spot, a mobile and web app created through participatory design research. OBJECTIVE: The goal of the research is to examine the impact of Thought Spot on mental health and wellness help-seeking intentions, behaviors, attitudes, self-stigma, and self-efficacy among postsecondary students in Canada. METHODS: A 2-armed randomized controlled trial involving students from three postsecondary institutions was conducted. Students were eligible if they were aged 17 to 29 years, enrolled in full-time or part-time studies, functionally competent in English, and had access to a compatible digital device. The usual care group received a mental health services information pamphlet. The intervention group received the Thought Spot app on their digital device. Thought Spot is a standalone app that allows users to add, review, and search crowdsourced information about nearby mental health and wellness services. Users can also track their mood on the app. Outcomes were self-assessed through questionnaires collected at baseline and 3 and 6 months. The primary outcome was change in formal help-seeking intentions from baseline to 6 months, measured by the General Help-Seeking Questionnaire. A mixed-effects model was used to compare the impact of usual care and intervention on the primary outcome (formal help-seeking intentions). Secondary outcomes included changes in informal help-seeking intentions and help-seeking behaviors, help-seeking attitudes, self-stigma, and self-efficacy. RESULTS: =23.52; P<.001, f=0.21). Compared with males, females sought more help from formal resources (OR 1.86; 95% CI 1.22 to 2.83, P=.001). Females were less likely to seek help from informal sources than males (OR 0.80; 95% CI 0.22 to 0.73, P<.001). CONCLUSIONS: Prompting postsecondary students about mental health and help-seeking appears to increase help-seeking intentions. mHealth interventions may be as effective as information pamphlets in increasing formal help-seeking but may confer a small advantage in driving help-seeking from informal sources. Although there is enthusiasm, developers and health policy experts should exercise caution and thoroughly evaluate these types of digital tools. Future studies should explore the cost-effectiveness of digital interventions and develop strategies for improving their efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT03412461; https://clinicaltrials.gov/ct2/show/NCT03412461. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/resprot.6446.
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The Thought Spot app did not change help-seeking intentions.
“Although this app, did not change help-seeking intentions”
From The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review (2022) · cites this paper as [29]
The Results (Primary Outcome: Change in Formal Help-Seeking Intentions) found no significant difference in change between the Thought Spot and pamphlet groups. But intentions increased significantly in both groups, including the Thought Spot group. The claim is supported as a statement about no additional effect relative to the comparator, not as a statement that intentions did not change. (LLM, conf=0.84)
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- Authors
- Wiljer, D., Shi, J., Lo, B., Sanches, M., Hollenberg, E., Johnson, A., Abi-Jaoudé, A., Chaim, G., Cleverley, K., Henderson, J., Isaranuwatchai, W., Levinson, A., Robb, J., Wong, H. W., & Voineskos, A.
- Affiliations
- University Health Network (CA)
- Centre for Addiction and Mental Health (CA)
- St. Michael's Hospital (CA)
- University of Toronto (CA)
- Corresponding author
- Wiljer, David
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2020-10-30
- Volume
- 22
- Issue
- 10
- Pages
- e20790
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC7665949
- OpenAlex
- W3094654492
- Cited by
- 78
- References
- 53
- Citations by year
- 2026: 10 · 2025: 25 · 2024: 14 · 2023: 10 · 2022: 8 · 2021: 11
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Canadian Institutes of Health Research (143558_1)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- mental health help-seeking, university students, mobile health apps, help-seeking intentions, help-seeking attitudes, self-stigma, self-efficacy, mood tracking, gender differences in help-seeking, participatory design, mental health promotion, wellness services, postsecondary students, information booklet, digital mental health interventions, Canada
- MeSH terms
- Help-Seeking Behavior, Adolescent, Adult, Mental Disorders, Female, Humans, Male, Mental Health, Surveys and Questionnaires, Students, Universities, Telemedicine, Young Adult, Mobile Applications
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