{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:28Z","timestamp":1785545008552,"version":"3.56.0"},"reference-count":50,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The global public health challenge of young people\u2019s mental health is particularly evident in Brazil, which is considered the most anxious and the fifth most depressed country globally. In response to this, a digital intervention, that takes the form of a storytelling chatbot named \u201cCad\u00ea o Kau\u00ea?\u201d (translation: \u201cWhere is Kau\u00ea?\u201d), was coproduced by an interdisciplinary team of researchers, young people, and narrative designers as part of a project titled Engajadamente. The intervention was designed to strengthen Brazilian adolescents\u2019 skills in promoting their peers\u2019 mental health through direct support and collective action for mental health. The intervention was rolled out in select schools in Brazil and online via social media, but it encountered challenges during the initial implementation phase in school settings.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This project\u2019s primary objective is to evaluate the implementation of \u201cCad\u00ea o Kau\u00ea\u201d in school settings in Brazil, assess current and potential complexities, and formulate recommendations to reduce or manage these complexities. The secondary objective of this project is to understand the current and potential sociotechnical change resulting from the implementation of the \u201cCad\u00ea o Kau\u00ea\u201d in a real-world setting.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The Non-adoption, Abandonment, Scale-up, Spread, Sustainability (NASSS) framework was selected as the theoretical framework to identify different areas of complexity across domains and further thinking of ways to reduce or manage these complexities. Data were gathered by conducting semistructured online interviews with the Engajadamente team members based in the United Kingdom and Brazil. The NASSS\u2013Complexity Assessment Tool was used as a sensemaking device to facilitate a collective understanding of the implementation, and narratives were mapped onto specific NASSS domains. Key themes were identified across overarching domains using thematic analysis to meet the objectives of this evaluation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The results mapped onto the NASSS domains generated a narrative about the initial implementation of \u201cCad\u00ea o Kau\u00ea?\u201d in schools. Existing and potential complexities across technology, organization, and wider system domains were characterized by interdependencies, unintended consequences, and uncertainties. The implementation of \u201cCad\u00ea o Kau\u00ea?\u201d highlighted challenges related to internet dependency, infrastructure limitations, and varying levels of organizational readiness, teacher preparedness, and school culture. Addressing these through offline solutions, additional teacher training, whole-school engagement strategies, and a value-informed complexity approach can enhance accessibility, alignment with school priorities, and adaptability within Brazil\u2019s dynamic sociopolitical context.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Using the NASSS framework, the evaluation captured both current and emerging complexities in implementing \u201cCad\u00ea o Kau\u00ea?\u201d in schools. By engaging with theory-informed approaches to technology implementation projects and deep-diving into discursive dynamic interactions between technology and its \u201ccontext\u201d of implementation, we have explored ways to manage these complexities and developed suitable recommendations to guide the Engadajamente team and support similar projects in the future.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/79106","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T17:15:06Z","timestamp":1776100506000},"page":"e79106-e79106","source":"Crossref","is-referenced-by-count":0,"title":["Using the NASSS\u2013Complexity Assessment Tool to Evaluate the Implementation of \u201cCad\u00ea O Kau\u00ea?\u201d: Chat-Story Intervention for Youth Participation in Mental Health Promotion in Brazil"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1484-3092","authenticated-orcid":false,"given":"Sakshi","family":"Setia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-4021","authenticated-orcid":false,"given":"Gabriela","family":"Pavarini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0831-8198","authenticated-orcid":false,"given":"Mona","family":"Koshkouei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5515-5219","authenticated-orcid":false,"given":"Sheila","family":"Giardini Murta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"R1","unstructured":"Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches. 1st ed. 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