Development of a mobile healthy lifestyle intervention for promoting mental health in adolescence: #LIFEGOALS

Background: This paper describes the development process of the mobile health (mHealth) intervention #LIFEGOALS, using the CeHRes Roadmap (van Gemert-Pijnen et al., 2011) as framework. #LIFEGOALS is directed to the general population of young adolescents (12-15y) in Flanders, Belgium, with the aim to improve their lifestyle behaviors for promoting mental health. Objectives: The objectives were to provide an overview of the different activities that formed part of the development process, and to detect its strengths and shortcomings. Methods: #LIFEGOALS was developed using an iterative, multidisciplinary and participatory approach, and by building on behavior change and persuasion theories, and other evidence regarding mHealth effectiveness and engagement. Results: The development activities are described according to the five phases outlined by the CeHRes Roadmap. Part of the contextual inquiry were a literature review, analysis of youth helpline conversations, stakeholder identification, and focus groups with end-users. For value specification, various expert organizations and end-users were consulted. The design phase consisted of the active involvement of the end-users via think-aloud interviews, test-trials, an end-user steering group, and usability testing. Design of the different components took further place within an interdisciplinary team of researchers, graphic designer, programmer, script writers, cinematographer and psychologists. Activities within the operationalization phase were pilot testing, stakeholder consultation, and operationalization planning. Finally, the summative evaluation consisted of a cluster-controlled trial and process evaluation interviews for evaluating effectiveness, engagement and success components. Discussion: eHealth development is an iterative process that is not straightforward to capture in one overview. Nevertheless, the CeHRes Roadmap proved a workable and holistic framework for describing and evaluating the development process. Main challenges of the development of #LIFEGOALS were related to the adoption and implementation of the intervention. The in-detail description of the development process with its strengths and shortcomings can provide guidance for the development of future e- and m-health interventions