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Deriving Information Requirements for College Student Mental Health Self-Management Mobile Applications
Event Type
Poster Presentation
TimeThursday, April 152:12pm - 2:13pm EDT
LocationDigital Health
DescriptionKeywords: Mental Health, mHealth, College Student, Interview, Information Requirement
Background
About 1 in 3 first year college students screen positive for at least one mental health disorder, with little difference across countries and demographics (Auerbach et al., 2018). Despite 20% increased spending in university mental health services across a decade (Desrochers & Hurlburt, 2016) and increased intention and utilization of mental health services by students, college student mental health has continued to decline (Oswalt et al., 2018). The Association for University and College Counseling Center Directors Annual Survey has consistently reported that anxiety, stress, and depression are the most frequent concerns for student clients (LeViness et al., 2019). Improving student mental health is needed to save lives, improve student wellbeing, and to get better returns on the monetary and temporal investments stakeholders make.
While in person counseling is generally preferred by students, it has many disadvantages. Counseling is associated with higher financial costs and is of lesser preference to those with self-stigma regarding mental health (Wang, Fagan, & Yu, 2020). This is particularly salient when considering that 20% of those students who committed suicide never contacted their institutions’ counseling center (Shuchman, 2007). Furthermore, long wait times are the reality in many colleges with an average wait of 6 business days for a triage session and 9 business days for their first session after triage (LeViness et al., 2019).
In contrast, digital interventions such as a mobile application can be accessed almost instantaneously and as frequently as a user desires. Students are more capable of communicating across virtual platforms (Weisel et al., 2019) which may help in managing their mental health more easily through apps. Other research has also found that asking student patients to use a mental health app in the period between setting up an appointment with a counselor and meeting with the counselor led to moderate app usage and better mental health outcomes (Levin et al., 2020). In spite of these promising findings, there has been little investigation into the design preferences or key features that students would like to see in a mental health app which may encourage prolonged use and adoption (Baumel et al., 2019).
To address this gap, this study presents the findings from a qualitative study to identify information requirements for the design of a student-centered, mHealth intervention. We first conducted semi-structured interviews with 153 university students to understand user needs and preferences. Then, the themes identified from the interviews were translated into information requirements using the Functional Information Requirement Analysis method (Khanade et al., 2018). The information requirements gathered and analyzed can be used as design input to develop and deploy a mHealth application for helping students manage their mental health, stress and anxiety.
Part I Interview Study to Understand User Needs and Preferences
Methods
One hundred and fifty-five students were recruited as participants in the semi-structured interview. The majority (n=95) were female (62%), with a mean age of 20.25 (SD=1.21) years. Interviews were conducted by 21 undergraduate students trained in interviewing. The interviews were all conducted virtually during the Spring 2020 semester, with questions about the effects of stress and anxiety and type of technological tools, more specifically within an app, they would prefer for managing their stress and anxiety. Participants were asked the following questions, among others: ‘Imagine you have a tool that helps you self-manage your stress/anxiety’; and as follow ups: ‘What would this tool look like?’ and ‘What specific features would you like to see and why?’.
Due to the nature of semi-structured interviews, not every question was asked and not every question received a response.
Three coders with previous knowledge of qualitative analysis conducted the data analysis. The transcribed interviews were analyzed using thematic analysis (Guest et al., 2012).
Results
Seven themes emerged from the thematic analysis. Five themes were related to user needs on app functions, including Coping Techniques, AI, Tracking, Time Management, and Communication. The rest two themes were related to user preferences, including Privacy and App Design.
Each theme has its definition, subthemes, number of participants who mentioned the subtheme, and example quotes from participants. One example is shown below:
• Theme: Time Management
• Definition: Participants wanted a feature that can help them manage their time in the form of reminders, scheduling, and planning their day, week or month.
• Subthemes: Reminders, Calendar, Time Planning
• Reminders: Some participants (24/153; 15.7%) stated that they felt stressed out whenever they were overwhelmed with tasks and could not keep up with them and wanted a reminder to help them. Several participants wanted an option within the tool to set reminders for their daily tasks to stay on track with their lives. Some of the specific cases they brought up included phone usage, taking breaks, walking, finishing assignments or staying motivated.
• Example Quote on Reminders: “...feature that says like, you've been scrolling for far too long. Go get some water, take a walk, and then come back later.”
(Further details omitted here due to the limitation of word counts and formatting.)
Part II Functional Information Requirement Analysis on the Interview Results
Methods
Nine analysts including postdocs, graduate students and undergraduate students conducted Functional Information Requirement analysis based on the five themes related to user needs on app functions. The purpose is to translate the user needs on functions and features into information requirements that can be used as design inputs. Information requirements describe what information the app needs to display to users, to gain from users to ensure that all required information that is expected by the users is captured in the design (Khanade et al., 2018). They are design-independent requirements that can be used as objective assessment of needs for design, or inputs for design that do not restrict the designer to use any particular design form. There were three phases in the analysis process.
In the first phase, all nine analysts met. The lead coder of the interview (in Part I) introduced the themes and subthemes to the whole team. Then the team trained themselves on the method by analyzing theme Time Management together.
In the second phase, nine analysts were randomly assigned to five different groups, each with four to five people to analyze each theme. Each person first conducted the analysis independently, then the group discussed to merge them into a final list of information requirements.
In the third phase, all nine analysts met together to review the results. Each group presented the results they had, while members from the other groups asked for clarification, and suggested changes where appropriate.
Results
Functional information requirements were listed for each subtheme to be used as design input to develop and deploy a mHealth application for helping students manage their mental health, stress and anxiety.
One example is shown below:
• Theme: Time Management – Calendar
• Information Requirements: Current Date; Planned Date; User Activity; Time Requirement/Duration for Activity; Time Zone;
(Further details omitted here due to the limitation of word counts and formatting.)

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