{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:34:03Z","timestamp":1790710443853,"version":"4.1.0"},"reference-count":81,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Smartphone apps may provide an opportunity to deliver mental health resources and interventions in a scalable and cost-effective manner. However, young people from marginalized and underserved groups face numerous and unique challenges to accessing, engaging with, and benefiting from these apps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to better understand the acceptability (ie, perceived usefulness and satisfaction with an app) and feasibility (ie, the extent to which an app was successfully used) of mental health apps for underserved young people. A secondary aim was to establish whether adaptations can be made to increase the accessibility and inclusivity of apps for these groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted 2 sequential studies, consisting of a systematic literature review of mental health apps for underserved populations followed by a qualitative study with underserved young male participants (n=20; age: mean 19). Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 5 databases was conducted in 2021. The search yielded 18,687 results, of which 14 articles met the eligibility criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The included studies comprised a range of groups, including those affected by homelessness, having physical health conditions, living in low- and middle-income countries, and those with sexual and gender minority identities. Establishing and maintaining user engagement was a pervasive challenge across mental health apps and populations, and dropout was a reported problem among nearly all the included studies. Positive subjective reports of usability, satisfaction, and acceptability were insufficient to determine users\u2019 objective engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the significant amount of funding directed to the development of mental health apps, juxtaposed with only limited empirical evidence to support their effectiveness, few apps have been deliberately developed or adapted to meet the heterogeneous needs of marginalized and underserved young people. Before mental health apps are scaled up, a greater understanding is needed of the types of services that more at-risk young people and those in limited-resource settings prefer (eg, standard vs digital) followed by more rigorous and consistent demonstrations of acceptability, effectiveness, and cost-effectiveness. Adopting an iterative participatory approach by involving young people in the development and evaluation process is an essential step in enhancing the adoption of any intervention, including apps, in \u201creal-world\u201d settings and will support future implementation and sustainability efforts to ensure that marginalized and underserved groups are reached.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO CRD42021254241; https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=254241<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/48964","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T11:08:25Z","timestamp":1722337705000},"page":"e48964","source":"Crossref","is-referenced-by-count":68,"title":["The Acceptability, Engagement, and Feasibility of Mental Health Apps for Marginalized and Underserved Young People: Systematic Review and Qualitative Study"],"prefix":"10.2196","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6737-6120","authenticated-orcid":false,"given":"Holly Alice","family":"Bear","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5070-7731","authenticated-orcid":false,"given":"Lara","family":"Ayala Nunes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5445-5180","authenticated-orcid":false,"given":"Giovanni","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7921-345X","authenticated-orcid":false,"given":"Tanya","family":"Manchanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2443-4391","authenticated-orcid":false,"given":"Blossom","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6569-5489","authenticated-orcid":false,"given":"Sophia","family":"Chabursky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6212-5242","authenticated-orcid":false,"given":"Sabine","family":"Walper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2432-5577","authenticated-orcid":false,"given":"Edward","family":"Watkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9342-2365","authenticated-orcid":false,"given":"Mina","family":"Fazel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-021-01161-7"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/appy.12199"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/0020731416662736"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201500453"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1027\/0227-5910\/a000527"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.04.026"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.2006.102525"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-019-00181-z"},{"key":"ref10","unstructured":"Introduction: NIH minority health and health disparities strategic plan 2021-2025National Institutes of Health National Institute on Minority Health and Health Disparities2024-06-29https:\/\/www.nimhd.nih.gov\/about\/strategic-plan\/nih-strategic-plan-directors-foreword.html"},{"key":"ref11","unstructured":"Improving inclusion of under-served groups in clinical research: Guidance from INCLUDE projectNational Institute for Health and Care Excellence2020872024-06-29https:\/\/www.nihr.ac.uk\/documents\/improving-inclusion-of-under-served-groups-in-clinical-research-guidance-from-include-project\/25435"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291717003336"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12663"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.2196\/25456"},{"key":"ref15","unstructured":"Mobile fact sheetPew Research Center20241312024-07-12https:\/\/www.pewresearch.org\/internet\/fact-sheet\/mobile\/"},{"key":"ref16","unstructured":"SilverL2. 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