Design, evaluation and implementation of an innovative digital health intervention to promote help-seeking and access to support for young people contacting Kids Helpline

Background: Kids Helpline offers Australia’s largest youth counselling service, which received 360,000 direct contact attempts in 2018 alone. While help seeking amongst young Australians, aged 5-25 years is on the rise, the helpline’s ability to address this demand is limited. Thus, 59% of all contact attempts to Kids Helpline remain unanswered. Meanwhile, the service has seen a significant shift of support-seekers from traditional phone counselling to online modalities such as chat, or email. This shift provides a great potential for the service to increase its accessibility via alternative media by implementing innovative digital health technologies.Methods: An end-user led engagement framework using a series of participatory design workshops (PDWs) following qualitative methodological guidelines was applied to inform the development of a new app aiming to increase highly-engaging and customisable access to support. The app was then trialled with a Randomised Controlled Trial (RCT) with young participants, aged 13-25 years comparing app access to no-access conditions combined with treatment as usual.Results: Qualitative analysis of the PDWs identified six states of the journey from 'being unwell' to 'wellbeing'. The new app provides support for overcoming the barriers related to each state. The RCT recruited over 600 young people and followed them up for three months, measuring mental health, wellbeing, resilience and perceived app quality, using the uMARS app rating scale. Preliminary analyses show promising results.Conclusions: Participatory design research is an integral component of the conceptualisation and development process, ensuring high quality and uptake of novel eHealth interventions. RCT, results provide further insight about the effectiveness of the app and its potential integration in Kids Helpline’s service provision. RCT results, strengths and limitations will be discussed