Co-design and feasibility of a chatbot based coaching intervention for adolescents to promote life skills (Preprint)

BACKGROUND Adolescence is a challenging period, facing rapid changes, increasing socio-emotional demands and threats, such as (cyber)bullying. Adolescent mental health and well-being can best be ensured by providing effective coaching on life skills, as coping strategies and protective factors. Interventions that take advantage of online coaching by means of chatbots, deployed on web or mobile technology, may be a novel and more appealing way to support mental health prevention for adolescents. OBJECTIVE In this pilot study, we co-designed and conducted a formative evaluation of an online life skills coaching chatbot intervention, inspired by the positive technology approach, to promote mental well-being in adolescence. METHODS We co-designed the first life-skills coaching session of the “CRI(S)” chatbot with 20 secondary school students in a participatory design workshop. We then conducted a formative evaluation of whole intervention (8 sessions) with a convenience sample of 21 adolescents of both genders (average age 14.52 years), who engaged with the chatbot sessions over 4 weeks, filling in a user experience anonymous questionnaire (5-point Likert scale) at the end of each session. RESULTS A majority of the adolescents found the intervention was useful (16/21, 76.1%), easy to use (19/21, 90.4%) and innovative (17/21, 80.9%). Most of participants (15/21, 71.4%) liked in particular the video cartoons provided by the chatbot in the coaching sessions, thought that a session should last 5-10 minutes (14/21, 66%) and they said they would recommend the intervention to a friend (20/21, 95.2%). CONCLUSIONS We have presented a novel and scalable self-help intervention to deliver life skills coaching to adolescents that is appealing to them and can support the promotion of coping skills and mental well-being in youth.

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A Chatbot-Based Coaching Intervention for Adolescents to Promote Life Skills: Pilot Study

JMIR Human Factors ◽

10.2196/16762 ◽

2020 ◽

Vol 7 (1) ◽

pp. e16762 ◽

Cited By ~ 3

Author(s):

Silvia Gabrielli ◽

Silvia Rizzi ◽

Sara Carbone ◽

Valeria Donisi

Keyword(s):

Mental Health ◽

Pilot Study ◽

Life Skills ◽

Participatory Design ◽

Formative Evaluation ◽

Well Being ◽

School Students ◽

Convenience Sample ◽

Coaching Intervention ◽

Mental Well Being

Background Adolescence is a challenging period, where youth face rapid changes as well as increasing socioemotional demands and threats, such as bullying and cyberbullying. Adolescent mental health and well-being can be best supported by providing effective coaching on life skills, such as coping strategies and protective factors. Interventions that take advantage of online coaching by means of chatbots, deployed on Web or mobile technology, may be a novel and more appealing way to support positive mental health for adolescents. Objective In this pilot study, we co-designed and conducted a formative evaluation of an online, life skills coaching, chatbot intervention, inspired by the positive technology approach, to promote mental well-being in adolescence. Methods We co-designed the first life skills coaching session of the CRI (for girls) and CRIS (for boys) chatbot with 20 secondary school students in a participatory design workshop. We then conducted a formative evaluation of the entire intervention—eight sessions—with a convenience sample of 21 adolescents of both genders (mean age 14.52 years). Participants engaged with the chatbot sessions over 4 weeks and filled in an anonymous user experience questionnaire at the end of each session; responses were based on a 5-point Likert scale. Results A majority of the adolescents found the intervention useful (16/21, 76%), easy to use (19/21, 90%), and innovative (17/21, 81%). Most of the participants (15/21, 71%) liked, in particular, the video cartoons provided by the chatbot in the coaching sessions. They also thought that a session should last only 5-10 minutes (14/21, 66%) and said they would recommend the intervention to a friend (20/21, 95%). Conclusions We have presented a novel and scalable self-help intervention to deliver life skills coaching to adolescents online that is appealing to this population. This intervention can support the promotion of coping skills and mental well-being among youth.

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Study of correlation between social determinants on mental health status of adolescent school students of Patna, Bihar, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202617 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1561

Author(s):

Anil Kumar Tiwari ◽

Anil Kumar Jaiswal

Keyword(s):

Mental Health ◽

Social Determinants ◽

Mental Health Problems ◽

Well Being ◽

Health Problems ◽

School Students ◽

Cross Sectional ◽

The Status ◽

Teachers And Parents ◽

Mental Well Being

Background: The status of mental well-being is a function of emotional well-being, psychological well-being and social well-being, and includes aspects like cognitive and social skills, emotional capacity, empathy, ability to cope with adverse events, and capability to function within a society. Various studies have found strong correlations between a person’s immediate surroundings to how they perceive their well-being as well as their actual status of mental health. On one hand, social determinants affect the causation, severity and outcome of mental well-being, on the other hand the state of mental well-being affects the social determinants by affecting personal freedom, ability to make healthy life choices etc. This makes the study of social determinants of mental health very significant.Methods: A cross-sectional, exploratory study of qualitative nature was undertaken in Patna among School going students between the ages 13-17. A self-administered peer reviewed questionnaire was used for data collection.Results: Of 400 participants 19% have features of depression and other mental health problems. Females were more affected. Students of low socioeconomic group (41.6%) and of single parent family (40%) were affected.Conclusions: Mental health problems are very common in adolescent school students. Active steps must be taken to increase awareness about depression among teachers and parents. Early intervention can help prevent worsening of depression and its impact on life.

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Assessing mental well-being in family carers of people with dementia using the Warwick–Edinburgh Mental Well-Being Scale

International Psychogeriatrics ◽

10.1017/s1041610213000835 ◽

2013 ◽

Vol 25 (9) ◽

pp. 1443-1451 ◽

Cited By ~ 13

Author(s):

Vasiliki Orgeta ◽

Elena Lo Sterzo ◽

Martin Orrell

Keyword(s):

Mental Health ◽

Physical Health ◽

Preliminary Data ◽

Well Being ◽

Positive Mental Health ◽

Family Carers ◽

Convenience Sample ◽

People With Dementia ◽

Mental Well Being ◽

Health And Well Being

ABSTRACTBackground:Understanding and measuring mental health and well-being among carers of people with dementia has become an important public health issue.Methods:In the present study we used the Warwick–Edinburgh Mental Well-Being Scale (WEMWBS) to identify predictors of positive mental health in a convenience sample of family carers of people with dementia using a cross-sectional design.Results:WEMWBS showed a negative correlation with anxiety and depressive symptoms, and a positive correlation with physical health status. Regression analyses indicated that overall nearly 70% of the variance in mental well-being in carers could be attributed to caregiver's age, physical health, stress specific to caregiving, and social support. Preliminary data show that the WEMWBS demonstrates strong internal consistency. Confirmatory factor analysis demonstrated one underlying factor of positive mental well-being.Conclusions:WEMWBS is a psychometrically strong measure of mental well-being, and can be used to identify factors that promote positive mental health in family carers of people with dementia. Current results provide preliminary data supporting the usefulness of the scale as an overall indicator of population mental health and well-being for carers of people with dementia.

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Physical Activity, Sedentary Behaviours and Duration of Sleep as Factors Affecting the Well-Being of Young People against the Background of Environmental Moderators

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16060915 ◽

2019 ◽

Vol 16 (6) ◽

pp. 915 ◽

Cited By ~ 6

Author(s):

Dorota Kleszczewska ◽

Agnieszka Szkutnik ◽

Jadwiga Siedlecka ◽

Joanna Mazur

Keyword(s):

Mental Health ◽

Physical Activity ◽

Young People ◽

Social Relations ◽

Satisfaction With Life ◽

Mental Health Problems ◽

Well Being ◽

School Students ◽

Sedentary Behaviours ◽

Mental Well Being

Mental health problems during adolescence are becoming increasingly frequent. The purpose of this study was to evaluate the total impact of selected behavioural and environmental factors on the variability of mental well-being indexes of young people aged 15 to 17 years. The survey, conducted as part of the last round of the Health Behaviour in School-Aged Children (HBSC) 2017/18 study, covered 3693 secondary school students in Poland at the average age of 16.53 years (SD = 1.09). Dependent variables: depression (CES-DC), stress (Cohen scale), satisfaction with life (Cantril’s Ladder), and self-efficacy in social relations (Smith and Betz scale). Independent variables included: physical activity; sedentary behaviours; length of sleep; and perception of the environment in which the respondent was raised. The analyses were adjusted by gender, age, and occurrence of chronic disease. It was demonstrated that gender, duration of sleep, and perception of the surrounding environment proved to be significant predictors of all four mental health indicators. The protective influence of physical activity appeared to be a particular advantage in a less-supportive environment. The intervention programmes aimed at improving the mental well-being of young people should include promoting physical activity and sufficient sleep; furthermore, environmental moderators should be taken into consideration.

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Social Disconnectedness, Loneliness, and Mental Health Among Adolescents in Danish High Schools: A Nationwide Cross-Sectional Study

Frontiers in Behavioral Neuroscience ◽

10.3389/fnbeh.2021.632906 ◽

2021 ◽

Vol 15 ◽

Author(s):

Ziggi Ivan Santini ◽

Veronica S. C. Pisinger ◽

Line Nielsen ◽

Katrine Rich Madsen ◽

Malene Kubstrup Nelausen ◽

...

Keyword(s):

Mental Health ◽

High School ◽

High School Students ◽

Social Connectedness ◽

Mental Health Problems ◽

Well Being ◽

Health Problems ◽

School Students ◽

Cross Sectional ◽

Mental Well Being

Background: Previous research has suggested that social disconnectedness experienced at school is linked to mental health problems, however, more research is needed to investigate (1) whether the accumulation of various types of social disconnectedness is associated with risk for mental health problems, and (2) whether loneliness is a mechanism that explains these associations.Methods: Using data from the Danish National Youth Study 2019 (UNG19), nation-wide cross-sectional data from 29,086 high school students in Denmark were analyzed to assess associations between social disconnectedness experienced at school (lack of classmate support, lack of teacher support, lack of class social cohesion, and not being part of the school community) and various mental health outcomes, as well as the mediating role of loneliness for each type of disconnectedness. Multilevel regression analyses were conducted to assess the associations.Results: Descriptive analyses suggest that 27.5% of Danish high school students experience at least one type of social disconnectedness at school. Each type of social disconnectedness was positively associated with mental health problems (depression symptoms, anxiety symptoms, stress, sleep problems, suicidal ideation, non-suicidal self-injury, eating disorder, body dissatisfaction, and low self-esteem) and negatively associated with mental well-being. In all cases, loneliness significantly mediated the associations. We found a clear dose-response pattern, where each addition in types of social disconnectedness was associated with (1) stronger negative coefficients with mental well-being and (2) stronger positive coefficients with mental health problems.Conclusion: Our results add to a large evidence-base suggesting that mental health problems among adolescents may be prevented by promoting social connectedness at school. More specifically, fostering social connectedness at school may prevent loneliness, which in turn may promote mental well-being and prevent mental health problems during the developmental stages of adolescence. It is important to note that focusing on single indicators of school social connectedness/disconnectedness would appear to be insufficient. Implications for practices within school settings to enhance social connectedness are discussed.

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Cognitive Flexibility and Mental Well-Being in Turkish Adolescents: The Mediating Role of Academic, Social and Emotional Self-Efficacy

Anales de Psicología ◽

10.6018/analesps.336681 ◽

2019 ◽

Vol 36 (1) ◽

pp. 111-121 ◽

Cited By ~ 1

Author(s):

Ayşe Sibel Demirtaş

Keyword(s):

Mental Health ◽

High School Students ◽

Cognitive Flexibility ◽

Adult Development ◽

Self Efficacy ◽

Well Being ◽

School Students ◽

Social And Emotional ◽

Salud Mental ◽

Mental Well Being

La adolescencia es una etapa crítica de crecimiento y desarrollo en el ciclo de vida de un individuo. Debido a la importancia del éxito en el desarrollo durante esta etapa, con implicaciones del desarrollo adulto y la salud mental positiva, el presente estudio tiene como objetivo examinar los roles predictores de la flexibilidad cognitiva y la autoeficacia en el bienestar mental de los adolescentes turcos. Además, dado que se considera que la asociación entre la flexibilidad cognitiva y la autoeficacia tiene efectos cru-ciales en el bienestar mental de los adolescentes, se suponía que la autoefi-cacia académica, social y emocional podría mediar la relación entre la flexi-bilidad cognitiva y el bienestar mental. . Los participantes de la investiga-ción están compuestos por 192 mujeres (49 %) y 200 hombres (51 %), Un total de 392 estudiantes de secundaria que asistían a cuatro escuelas secun-darias diferentes se inscribieron en los grados 9-12, en una ciudad de Tur-quía. El Inventario de Flexibilidad Cognitiva, la Escala de Autoeficacia para Niños y la Escala de Bienestar Mental Warwick-Edinburgh se aplicaron en la recolección de datos. Los resultados mostraron que la flexibilidad cogni-tiva se correlacionó positivamente con las subdimensiones de autoeficacia y bienestar mental. Además, las subdimensiones de autoeficacia se correla-cionan positivamente con el bienestar mental. Los resultados del modelo mediacional indicaron que la autoeficacia académica, social y emocional sirvió para mediar la relación entre la flexibilidad cognitiva y el bienestar mental. Los resultados de la investigación se discutieron a la luz de la litera-tura y se propusieron algunas sugerencias para expertos e investigadores en salud mental. El Inventario de Flexibilidad Cognitiva, la Escala de Autoefi-cacia para Niños y la Escala de Bienestar Mental Warwick-Edinburgh se aplicaron en la recolección de datos. Los resultados mostraron que la flexi-bilidad cognitiva se correlacionó positivamente con las subdimensiones de autoeficacia y bienestar mental. Además, las subdimensiones de autoefica-cia se correlacionan positivamente con el bienestar mental. Los resultados del modelo mediacional indicaron que la autoeficacia académica, social y emocional sirvió para mediar la relación entre la flexibilidad cognitiva y el bienestar mental. Los resultados de la investigación se discutieron a la luz de la literatura y se propusieron algunas sugerencias para expertos e inves-tigadores en salud mental. Adolescence is a critical period of growth and development in an individual’s life cycle. Because of the importance of developmental success during this stage, with implications of adult development and positive mental health, the current study aims to investigate the predictor roles of cognitive flexibility and self-efficacy on mental well-being of Turkish adolescents. Moreover, as the association between cognitive flexibility and self-efficacy are considered to have crucial effects on adolescents’ mental well-being, it was supposed that academic, social and emotional self-efficacy could mediate the relation between cognitive flexibility and mental well-being. The participants of the research are comprised of 192 females (%49) and 200 males (%51), a total of 392 high school students who were attending four different high schools enrolled in grades 9–12, in a city of Turkey. Cognitive Flexibility Inventory, The Self-Efficacy Scale for Children and Warwick-Edinburgh Mental Well-Being Scale were applied in data collection. The results showed that cognitive flexibility positively correlated with sub-dimensions of self-efficacy and mental well-being. Also, sub-dimensions of self-efficacy positively correlated with mental well-being. Findings from the mediational model indicated that academic, social and emotional self-efficacy served to mediate the relationship between cognitive flexibility and mental well-being. Research findings were discussed in the light of the literature and some suggestions were proposed for mental health experts and researchers.

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Furloughs, Teleworking and Other Work Situations during the COVID-19 Lockdown: Impact on Mental Well-Being

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062898 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2898

Author(s):

Israel Escudero-Castillo ◽

Fco. Javier Mato-Díaz ◽

Ana Rodriguez-Alvarez

Keyword(s):

Mental Health ◽

Ad Hoc ◽

Well Being ◽

The Self ◽

Exogenous Shock ◽

Work Location ◽

Negative Effect ◽

Market Status ◽

Mental Well Being ◽

Labour Market Status

As a consequence of the Spring 2020 lockdown that occurred in Spain due to the COVID-19 pandemic, many people lost their jobs or had to be furloughed. The objective of this study is to analyse the influence of the latter changes in labour market status on psychological well-being. For this purpose, an ad-hoc questionnaire featuring socio-demographic and mental health criteria was created. Granted that the pandemic can be viewed as an exogenous shock, the bias caused by the bidirectional problems between the work situation and mental well-being can be tackled. Results indicate that the lockdown exerted a greater negative effect on the self-perceived well-being of unemployed and furloughed persons than on those in employment. Moreover, among those in continuous employment, teleworkers experienced a lesser degree of self-perceived well-being post lockdown as compared to those people remaining in the same work location throughout the COVID-19 crisis. Finally, the lockdown provoked worse effects on the self-perceived well-being of women as compared to men, a result that appears to be related to gender differences in household production. In conclusion, these results could be especially relevant given that the evolution of the pandemic is having ongoing effects on employment and, therefore, on the mental health of workers.

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COVID-19 is having a destructive impact on health-care workers’ mental well-being

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzaa158 ◽

2020 ◽

Author(s):

Kris Vanhaecht ◽

Deborah Seys ◽

Luk Bruyneel ◽

Bianca Cox ◽

Gorik Kaesemans ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Residential Care ◽

Health Care Workers ◽

Well Being ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Care Workers ◽

Sources Of Support ◽

Mental Well Being

Abstract Background The coronavirus disease 2019 (COVID-19) may aggravate workplace conditions that impact health-care workers’ mental health. However, it can also place other stresses on workers outside of their work. This study determines the effect of COVID-19 on symptoms of negative and positive mental health and the workforce’s experience with various sources of support. Effect modification by demographic variables was also studied. Methods A cross-sectional survey study, conducted between 2 April and 4 May 2020 (two waves), led to a convenience sample of 4509 health-care workers in Flanders (Belgium), including paramedics (40.6%), nurses (33.4%), doctors (13.4%) and management staff (12.2%). About three in four were employed in university and acute hospitals (29.6%), primary care practices (25.7%), residential care centers (21.3%) or care sites for disabled and mental health care. In each of the two waves, participants were asked how frequently (on a scale of 0–10) they experienced positive and negative mental health symptoms during normal circumstances and during last week, referred to as before and during COVID-19, respectively. These symptoms were stress, hypervigilance, fatigue, difficulty sleeping, unable to relax, fear, irregular lifestyle, flashback, difficulty concentrating, feeling unhappy and dejected, failing to recognize their own emotional response, doubting knowledge and skills and feeling uncomfortable within the team. Associations between COVID-19 and mental health symptoms were estimated by cumulative logit models and reported as odds ratios. The needed support was our secondary outcome and was reported as the degree to which health-care workers relied on sources of support and how they experienced them. Results All symptoms were significantly more pronounced during versus before COVID-19. For hypervigilance, there was a 12-fold odds (odds ratio 12.24, 95% confidence interval 11.11–13.49) during versus before COVID-19. Positive professional symptoms such as the feeling that one can make a difference were less frequently experienced. The association between COVID-19 and mental health was generally strongest for the age group 30–49 years, females, nurses and residential care centers. Health-care workers reported to rely on support from relatives and peers. A considerable proportion, respectively, 18 and 27%, reported the need for professional guidance from psychologists and more support from their leadership. Conclusions The toll of the crisis has been heavy on health-care workers. Those who carry leadership positions at an organizational or system level should take this opportunity to develop targeted strategies to mitigate key stressors of health-care workers’ mental well-being.

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Mental health and wellbeing implications of the COVID-19 quarantine for disabled and disadvantaged children and young people: evidence from a cross-cultural study in Zambia and Sierra Leone

BMC Psychology ◽

10.1186/s40359-021-00583-w ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Darren Sharpe ◽

Mohsen Rajabi ◽

Clement Chileshe ◽

Sitali Mayamba Joseph ◽

Ibrahim Sesay ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Sierra Leone ◽

Peer Relationships ◽

Well Being ◽

Mental Wellbeing ◽

Planning Tool ◽

Income Loss ◽

Convenience Sample ◽

Children And Young People

Abstract Background The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone. Method A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool. Results The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12–14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating. Conclusion The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.

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Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

10.2196/preprints.30976 ◽

2021 ◽

Author(s):

Silvina Catuara-Solarz ◽

Bartlomiej Skorulski ◽

Inaki Estella ◽

Claudia Avella-Garcia ◽

Sarah Shepherd ◽

...

Keyword(s):

Mental Health ◽

Perceived Stress ◽

Intervention Group ◽

Well Being ◽

Self Report ◽

World Health ◽

Randomised Control Trial ◽

Control Group ◽

Mental Well Being ◽

Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

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