{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:10:48Z","timestamp":1788981048698,"version":"build-2803163510"},"reference-count":59,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self-injurious thoughts and behaviors, including suicidal ideation, planning, attempts, and nonsuicidal self-injury, are a significant public health concern among college students. Community college students face elevated mental health risks and persistent barriers to traditional services, particularly those from underserved and ethnoracially minoritized backgrounds, underscoring the need for scalable, accessible digital mental health interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study conducted a mixed methods evaluation of the initial reactions of college students to a novel technology-enhanced suicide prevention intervention (TE-SPI), with particular focus on feedback regarding a mobile app prototype (BRITE) designed to support coping skill use and mood monitoring, as well as proposed nondemanding caring contact text messages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A mixed methods approach using the technology acceptance model (TAM) was used to assess the TE-SPI among 20 ethnoracially diverse college students (\n                      <jats:sub\/>\n                      mean age 22.8, SD 3.9) from a community college (n=10) and a 4-year university (n=10). Participants were shown the BRITE app prototype on a study iPad and asked to provide feedback on its perceived ease of use, usefulness, and relevance to student needs. Quantitative measures assessed initial impressions of satisfaction and usability, while qualitative analyses examined participants\u2019 reactions to the app prototype and preferences regarding potential caring contact text messages.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants generally reported favorable initial impressions of the BRITE app prototype, with 90% (18\/20) describing it as helpful and 85% (17\/20) user-friendly; 90% (18\/20) also indicated that they would recommend it to peers in distress. Qualitative feedback supported these findings, highlighting the app\u2019s perceived accessibility, relevance to student life, and potential usefulness during moments of distress. Participants also offered concrete suggestions for app refinements (eg, mood scale customization, gamification, and language options) and for useful caring contact messages they would want to receive. In total, 55% (11\/20) of participants said that they would want to receive text messages as part of TE-SPI, while 25% (5\/20) reported maybe or possibly wanting to receive messages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings offer preliminary insight into how college students perceive the BRITE app prototype and proposed caring contact message, highlighting concrete feedback for app refinement prior to real-world testing. This study provides early user feedback that can inform further development of the TE-SPI model. Future research should examine actual use, acceptability, feasibility, and clinical impact among diverse college students.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/79537","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T09:05:07Z","timestamp":1779699907000},"page":"e79537-e79537","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary Support for a Technology-Enhanced Suicide Prevention Intervention for College Students: Mixed Methods Preimplementation Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8132-9099","authenticated-orcid":false,"given":"Jocelyn I","family":"Meza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1610-044X","authenticated-orcid":false,"given":"Joan R","family":"Asarnow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2397-5118","authenticated-orcid":false,"given":"Natalia","family":"Jaramillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9969-2244","authenticated-orcid":false,"given":"Juliane L","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0506-1438","authenticated-orcid":false,"given":"Candice","family":"Biernesser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7896-3697","authenticated-orcid":false,"given":"Brandie","family":"George-Milford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5756-2157","authenticated-orcid":false,"given":"David","family":"Brent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"R1","unstructured":"Web-based Injury Statistics Query and Reporting System (WISQARS). Centers for Disease Control and Prevention. 2020. URL: https:\/\/wisqars.cdc.gov\/ [Accessed 13-09-2024]"},{"key":"R2","unstructured":"Stewart C . Past year suicidal and self-injurious behavior among U.S. college students 2024-2025. Statista; 2026. URL: https:\/\/www.statista.com\/statistics\/1126285\/college-students-with-suicidal-and-self -injurious-behavior-us\/ [Accessed 16-11-2023]"},{"issue":"10262","key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32226-1","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"GBD 2019 Disease and Injuries Collaborators","journal-title":"Lancet"},{"issue":"12","key":"R4","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1001\/jama.2023.1992","article-title":"Pediatric mental health hospitalizations at acute care hospitals in the US, 2009-2019","volume":"329","author":"Arakelyan","journal-title":"JAMA"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1146\/annurev-publhealth-051920-123206","article-title":"The recent rise of suicide mortality in the United States","volume":"43","author":"Mart\u00ednez-Al\u00e9s","journal-title":"Annu Rev Public Health"},{"issue":"Pt A","key":"R6","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.jad.2021.11.006","article-title":"The influence of diagnosed mental health conditions and symptoms of depression and\/or anxiety on suicide ideation, plan, and attempt among college students: findings from the Healthy Minds Study, 2018-2019","volume":"298","author":"Casey","journal-title":"J Affect Disord"},{"issue":"4","key":"R7","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1037\/per0000370","article-title":"Examining latent profiles of psychopathy in a mixed-gender sample of juvenile detainees","volume":"11","author":"Moffett","journal-title":"Personal Disord"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2019.11.013","article-title":"Suicide risk among gender and sexual minority college students: the roles of victimization, discrimination, connectedness, and identity affirmation","volume":"121","author":"Busby","journal-title":"J Psychiatr Res"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1177\/0091552114535466","article-title":"Community college student mental health: a comparative analysis","volume":"42","author":"Katz","journal-title":"Community Coll Rev"},{"issue":"156","key":"R10","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1002\/ss.20194","article-title":"Promoting resilience, retention, and mental health","volume":"2016","author":"Eisenberg","journal-title":"New Drctns for Student Srvcs"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.03.038","article-title":"Trends in college student mental health and help-seeking by race\/ethnicity: findings from the National Healthy Minds Study, 2013-2021","volume":"306","author":"Lipson","journal-title":"J Affect Disord"},{"key":"R12","unstructured":"Fry R Cilluffo A . A rising share of undergraduates are from poor families, especially at less selective colleges. Pew Research Center; 2019. URL: http:\/\/hdl.handle.net\/10919\/92670 [Accessed 30-08-2026]"},{"issue":"3","key":"R13","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1016\/j.jadohealth.2018.04.014","article-title":"Mental health disparities among college students of color","volume":"63","author":"Lipson","journal-title":"J Adolesc Health"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/45409","article-title":"Cultural responsivity in technology-enabled services: integrating culture into technology and service components","volume":"25","author":"Eustis","journal-title":"J Med Internet Res"},{"issue":"6","key":"R15","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1016\/j.beth.2024.04.004","article-title":"State of the science: using digital mental health interventions to extend the impact of psychological services","volume":"55","author":"Ramos","journal-title":"Behav Ther"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1080\/00221546.2018.1434280","article-title":"Are community college transfer students \u201ca Good Bet\u201d for 4-year admissions? Comparing academic and labor-market outcomes between transfer and native 4-year college students","volume":"89","author":"Xu","journal-title":"J Higher Educ"},{"issue":"3","key":"R17","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1177\/1521025119848754","article-title":"Transfer student resources: keeping students once they enroll","volume":"23","author":"Daddona","journal-title":"J Coll Stud Ret"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1080\/87568225.2016.1140996","article-title":"Examining mental health differences between transfer and nontransfer university students seeking counseling services","volume":"30","author":"Mehr","journal-title":"J College Stud Psychother"},{"issue":"4","key":"R19","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1177\/00915521221111460","article-title":"Basic needs insecurity and mental health: community college students\u2019 dual challenges and use of social support","volume":"50","author":"Broton","journal-title":"Community Coll Rev"},{"issue":"10","key":"R20","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1176\/appi.ps.202000437","article-title":"Mental health conditions among community college students: a national study of prevalence and use of treatment services","volume":"72","author":"Lipson","journal-title":"PS (Wash DC)"},{"issue":"7","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/12869","article-title":"Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: systematic review","volume":"21","author":"Lattie","journal-title":"J Med Internet Res"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00246","article-title":"Technology and college student mental health: challenges and opportunities","volume":"10","author":"Lattie","journal-title":"Front Psychiatry"},{"issue":"3","key":"R23","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s40501-019-00181-z","article-title":"Use of digital mental health for marginalized and underserved populations","volume":"6","author":"Schueller","journal-title":"Curr Treat Options Psych"},{"key":"R24","unstructured":"Kodish TA . Digital Mental Health Interventions for College Students of Color: Understanding Uptake and Enhancing Engagement [UCLA electronic theses and dissertations]. eScholorship Publishing; URL: https:\/\/escholarship.org\/uc\/item\/7p773792 [Accessed 20-08-2026]"},{"issue":"9","key":"R25","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1176\/appi.ajp.2018.17101151","article-title":"As Safe as Possible (ASAP): a brief app-supported inpatient intervention to prevent postdischarge suicidal behavior in hospitalized, suicidal adolescents","volume":"175","author":"Kennard","journal-title":"AJP"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.8917","article-title":"A smartphone app (BlueIce) for young people who self-harm: open phase 1 pre-post trial","volume":"6","author":"Stallard","journal-title":"JMIR Mhealth Uhealth"},{"issue":"12","key":"R27","doi-asserted-by":"publisher","DOI":"10.2196\/14296","article-title":"Usage and acceptability of the iBobbly app: pilot trial for suicide prevention in Aboriginal and Torres Strait Islander youth","volume":"7","author":"Tighe","journal-title":"JMIR Ment Health"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084323","article-title":"Qualitative meta-synthesis of user experience of computerised therapy for depression and anxiety","volume":"9","author":"Knowles","journal-title":"PLoS One"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.2196\/21636","article-title":"Factors associated with dropout of participants in an app-based child injury prevention study: secondary data analysis of a cluster randomized controlled trial","volume":"23","author":"Li","journal-title":"J Med Internet Res"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.11.167","article-title":"Dropout rates in clinical trials of smartphone apps for depressive symptoms: a systematic review and meta-analysis","volume":"263","author":"Torous","journal-title":"J Affect Disord"},{"issue":"10","key":"R31","doi-asserted-by":"publisher","DOI":"10.2196\/10893","article-title":"Effect of a mobile phone intervention on quitting smoking in a young adult population of smokers: randomized controlled trial","volume":"6","author":"Baskerville","journal-title":"JMIR Mhealth Uhealth"},{"issue":"8","key":"R32","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1007\/s10896-022-00453-y","article-title":"Patterns of interpersonal violence experience and their association with mental health and substance use problems among women with incarceration histories: a multidimensional longitudinal study","volume":"38","author":"Zhao","journal-title":"J Fam Viol"},{"issue":"4","key":"R33","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1080\/15228835.2015.1106384","article-title":"Developing a brief suicide prevention intervention and mobile phone application: a qualitative report","volume":"33","author":"Kennard","journal-title":"J Technol Hum Serv"},{"issue":"5","key":"R34","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1016\/j.jaac.2024.06.008","article-title":"Bridging gaps in care following hospitalization for suicidal adolescents: As Safe As Possible (ASAP) and BRITE app","volume":"64","author":"Goldstein","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"R35","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1016\/j.jaacop.2024.10.006","article-title":"Treatment outcomes of an adolescent intensive outpatient program for depressed and suicidal youth","volume":"3","author":"Bero","journal-title":"JAACAP Open"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1111\/j.1943-278X.1976.tb00880.x","article-title":"Suicide prevention for high-risk persons who refuse treatment","volume":"6","author":"Motto","journal-title":"Suicide Life Threat Behav"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1037\/ser0000645","article-title":"Caring contacts for suicide prevention: a systematic review and meta-analysis","volume":"20","author":"Skopp","journal-title":"Psychol Serv"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.03.029","article-title":"Comparative effectiveness of two versions of a caring contacts intervention in healthcare providers, staff, and patients for reducing loneliness and mental distress: a randomized controlled trial","volume":"331","author":"Radin","journal-title":"J Affect Disord"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2022.106966","article-title":"Caring Texts, a strength-based, suicide prevention trial in 5 native communities: research design and methods","volume":"123","author":"Hebert","journal-title":"Contemp Clin Trials"},{"issue":"10","key":"R40","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1001\/jamapsychiatry.2020.1586","article-title":"Association of suicide prevention interventions with subsequent suicide attempts, linkage to follow-up care, and depression symptoms for acute care settings: a systematic review and meta-analysis","volume":"77","author":"Doupnik","journal-title":"JAMA Psychiatry"},{"issue":"4","key":"R41","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1089\/tmj.2021.0106","article-title":"Assessing college students\u2019 perceptions of and intentions to use a mobile app for mental health","volume":"28","author":"Mitchell","journal-title":"Telemed J E Health"},{"key":"R42","unstructured":"Davis FD . Technology acceptance model: TAM. In: Al-Suqri MN Al-Aufi AS , editors. Information Seeking Behavior and Technology Adoption. IGI Global; 1989:205-219."},{"key":"R43","unstructured":"Masrom M . Technology acceptance model and e-learning. Presented at: 12th International Conference on Education; May 21-24, 2007; Bandar Seri Begawan, Brunei Darussalam."},{"issue":"5","key":"R44","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1111\/jcal.12678","article-title":"Students\u2019 use of technology and their perceptions of its usefulness in higher education: international comparison","volume":"38","author":"Cohen","journal-title":"Comput Assist Learn"},{"key":"R45","unstructured":"STAND: screening & treatment for anxiety & depression. UCLA Depression Grand Challenge | STAND. URL: https:\/\/stand.ucla.edu\/ [Accessed 30-08-2026]"},{"issue":"6","key":"R46","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1176\/appi.ps.52.6.828","article-title":"A randomized controlled trial of postcrisis suicide prevention","volume":"52","author":"Motto","journal-title":"PS (Wash DC)"},{"issue":"sup1","key":"R47","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1080\/13811118.2018.1531797","article-title":"Dissemination of the safety planning intervention (SPI) to university counseling center clinicians to reduce suicide risk among college students","volume":"24","author":"Stewart","journal-title":"Arch Suicide Res"},{"issue":"11","key":"R48","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1097\/01.MLR.0000093487.78664.3C","article-title":"The Patient Health Questionnaire-2: validity of a two-item depression screener","volume":"41","author":"Kroenke","journal-title":"Med Care"},{"issue":"5","key":"R49","doi-asserted-by":"publisher","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","article-title":"Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection","volume":"146","author":"Kroenke","journal-title":"Ann Intern Med"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2018.11.003","article-title":"Psychometric properties and clinical utility of brief measures of depression, anxiety, and general distress: the PHQ-2, GAD-2, and K-6","volume":"56","author":"Staples","journal-title":"Gen Hosp Psychiatry"},{"issue":"7","key":"R51","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1080\/10447318.2018.1455307","article-title":"The System Usability Scale: past, present, and future","volume":"34","author":"Lewis","journal-title":"Int J Hum-Comput Interact"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.2196\/40509","article-title":"Digital Intervention Barriers Scale-7 (DIBS-7): development, evaluation, and preliminary validation","volume":"7","author":"Ramos","journal-title":"JMIR Form Res"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.112516","article-title":"Qualitative methods in implementation research: an introduction","volume":"280","author":"Hamilton","journal-title":"Psychiatry Res"},{"issue":"17","key":"R54","doi-asserted-by":"publisher","first-page":"12954","DOI":"10.3390\/su151712954","article-title":"Perceived usability evaluation of educational technology using the Post-Study System Usability Questionnaire (PSSUQ): a systematic review","volume":"15","author":"Vlachogianni","journal-title":"Sustainability"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01111-5","article-title":"Rapid versus traditional qualitative analysis using the Consolidated Framework for Implementation Research (CFIR)","volume":"16","author":"Nevedal","journal-title":"Implement Sci"},{"issue":"8","key":"R56","doi-asserted-by":"publisher","DOI":"10.2196\/29368","article-title":"Understanding people\u2019s use of and perspectives on mood-tracking apps: interview study","volume":"8","author":"Schueller","journal-title":"JMIR Ment Health"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.2196\/43942","article-title":"Understanding the adoption and use of digital mental health apps among college students: secondary analysis of a national survey","volume":"10","author":"Bautista","journal-title":"JMIR Ment Health"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.2196\/64715","article-title":"Users\u2019 perceptions and trust in AI in direct-to-consumer mHealth: qualitative interview study","volume":"13","author":"Ryan","journal-title":"JMIR Mhealth Uhealth"},{"issue":"4","key":"R59","doi-asserted-by":"publisher","DOI":"10.2196\/16518","article-title":"Smartphone users\u2019 persuasion knowledge in the context of consumer mHealth apps: qualitative study","volume":"9","author":"Joo","journal-title":"JMIR Mhealth Uhealth"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:44:13Z","timestamp":1788979453000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e79537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":59,"URL":"https:\/\/doi.org\/10.2196\/79537","relation":{},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"v13i10262e79537"}}