{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:52Z","timestamp":1785545032968,"version":"3.56.0"},"reference-count":61,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Adolescent anxiety is a growing public health concern associated with significant social and emotional impairment. Mindfulness-based interventions (MBIs) have shown promise in reducing anxiety and improving well-being; however, engagement remains challenging. Virtual reality (VR)\u2013based delivery may enhance immersion and attention, potentially addressing barriers of traditional mindfulness formats. Evidence on VR-based mindfulness interventions for adolescents, particularly in Hong Kong, remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the feasibility and acceptability of a VR-MBI delivered via a CAVE, an enclosed VR environment with three projected walls displaying immersive natural scenes and ambient sounds, for adolescents with mild-to-moderate anxiety symptoms in Hong Kong. Secondary aims were to explore preliminary effects on psychological outcomes and physiological stress regulation and to identify facilitators and barriers to engagement.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A mixed methods, single-group pre-post study was conducted with adolescents experiencing mild-to-moderate anxiety symptoms, recruited from secondary schools and youth service organizations in Hong Kong. Participants completed an 8-week group-based VR-MBI. Feasibility and acceptability were assessed using recruitment, attendance, retention, homework practice frequency, dropouts, and adverse events. Psychological outcomes were measured using the Depression Anxiety Stress Scale\u201321 and the Mindful Attention Awareness Scale. Heart rate variability indices, including the standard deviation of normal-to-normal intervals and root-mean-square of successive differences, were collected at baseline and postintervention using a wearable device. Focus group interviews explored participants\u2019 experiences. Paired-sample\n t<\/jats:italic>\n tests and Wilcoxon signed rank tests examined pre-post changes, and qualitative data were analyzed using thematic analysis, with findings integrated through triangulation.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 42 participants (mean age 14.88, SD 1.90 years; 20\/42, 47.6% female; 22\/42, 52.4% male) enrolled and completed both assessments. Attendance was high, with 73.8% (31\/42) of participants attending at least 80% (8\/10) sessions, and participants engaged in regular homework practice. No dropouts or adverse events were reported. No significant pre-post changes were observed in self-reported distress, anxiety, depression, stress, or trait mindfulness (all\n P<\/jats:italic>\n >.05). However, significant improvements were observed in both heart rate variability indices, standard deviation of normal-to-normal intervals (mean difference 17.6 ms, 95% CI \u221233.88 to \u22121.32;\n P<\/jats:italic>\n =.04; Cohen\n d<\/jats:italic>\n =0.38) and root-mean-square of successive differences (mean difference 20.20 ms, 95% CI \u221238.76 to \u22121.65;\n P<\/jats:italic>\n =.03; Cohen\n d<\/jats:italic>\n =0.39), which may suggest preliminary enhancements in physiological stress regulation. Qualitative findings suggested perceived benefits in emotional regulation, stress reduction, focus, and sleep, with the immersive environment and group-based format identified as key facilitators.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The CAVE-based VR-MBI was feasible and acceptable for adolescents with mild-to-moderate anxiety symptoms in Hong Kong. Despite no significant changes in self-reported outcomes, physiological improvements and positive qualitative feedback suggest early benefits not captured by self-report measures. These findings support further investigation of using controlled designs and longer follow-up periods.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/91819","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T21:05:07Z","timestamp":1775509507000},"page":"e91819-e91819","source":"Crossref","is-referenced-by-count":0,"title":["Using a Virtual Reality CAVE\u2013Based Mindfulness Intervention to Promote Mental Well-Being in Adolescents With Anxiety Symptoms: Pre-Post Mixed Methods Pilot Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7771-5838","authenticated-orcid":false,"given":"Clare Tsz Kiu","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2919-1587","authenticated-orcid":false,"given":"Alex Pak Lik","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9107-6763","authenticated-orcid":false,"given":"Kelly Ka Yu","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2755-7196","authenticated-orcid":false,"given":"Irene Oi Chiu","family":"Fung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8385-9040","authenticated-orcid":false,"given":"Zoe Suk Yi","family":"Ngai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0751-0708","authenticated-orcid":false,"given":"Lester Yin Cho","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0611-9442","authenticated-orcid":false,"given":"Sam Kam San","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7499-2732","authenticated-orcid":false,"given":"Gary Tsun Fung","family":"Fung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1777-8854","authenticated-orcid":false,"given":"Sammy Law Sun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3477-3143","authenticated-orcid":false,"given":"Victor Wai Keung","family":"Ching","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9785-973X","authenticated-orcid":false,"given":"Patrick Pui Kin","family":"Kor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2025.101533","article-title":"Twelve-month prevalence of DSM-5 mental disorders and the psychosocial correlates- a child and adolescent psychiatric epidemiologic survey in Hong Kong SAR","volume":"57","author":"Chan","journal-title":"Lancet Reg Health West Pac"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1111\/camh.12322","article-title":"Review: the association between anxiety and poor attendance at school - a systematic review","volume":"24","author":"Finning","journal-title":"Child Adolesc Ment Health"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","DOI":"10.1186\/1744-859X-12-25","article-title":"Anxiety as a risk factor for school absenteeism: what differentiates anxious school attenders from non-attenders?","volume":"12","author":"Ingul","journal-title":"Ann Gen Psychiatry"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.01.008","article-title":"Social and academic functioning in adolescents with anxiety disorders: a systematic review","volume":"230","author":"de Lijster","journal-title":"J Affect Disord"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00698","article-title":"Low self-esteem and its association with anxiety, depression, and suicidal ideation in Vietnamese secondary school students: a cross-sectional study","volume":"10","author":"Nguyen","journal-title":"Front Psychiatry"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jaac.2013.09.017","article-title":"Longitudinal patterns of anxiety from childhood to adulthood: the Great Smoky Mountains Study","volume":"53","author":"Copeland","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"5","key":"R7","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1192\/bjp.2023.23","article-title":"Impact of anxiety and depression across childhood and adolescence on adverse outcomes in young adulthood: a UK birth cohort study","volume":"222","author":"Morales-Mu\u00f1oz","journal-title":"Br J Psychiatry"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1037\/0022-006X.72.2.276","article-title":"Child anxiety treatment: outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up","volume":"72","author":"Kendall","journal-title":"J Consult Clin Psychol"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/0163-8343(82)90026-3","article-title":"An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results","volume":"4","author":"Kabat-Zinn","journal-title":"Gen Hosp Psychiatry"},{"issue":"2","key":"R10","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1093\/clipsy.bpg016","article-title":"Mindfulness-based interventions in context: past, present, and future","volume":"10","author":"Kabat-Zinn","journal-title":"Clin Psychol (New York)"},{"issue":"2","key":"R11","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1177\/1049731516684961","article-title":"Mindfulness-based interventions for youth with anxiety: a systematic review and meta-analysis","volume":"29","author":"Borquist-Conlon","journal-title":"Res Soc Work Pract"},{"issue":"3","key":"R12","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1007\/s12671-019-01257-w","article-title":"Effects of a brief mindfulness curriculum on self-reported executive functioning and emotion regulation in Hong Kong adolescents","volume":"11","author":"Lam","journal-title":"Mindfulness (N Y)"},{"issue":"4","key":"R13","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1080\/1364436X.2011.639747","article-title":"Preliminary outcomes of a mindfulness-based programme for Hong Kong adolescents in schools: well-being, stress and depressive symptoms","volume":"16","author":"Lau","journal-title":"International Journal of Children\u2019s Spirituality"},{"issue":"11","key":"R14","doi-asserted-by":"publisher","first-page":"4147","DOI":"10.1007\/s10803-020-04729-4","article-title":"Brief report: mindfulness training for Chinese adolescents with autism spectrum disorder and their parents in Hong Kong","volume":"51","author":"Ho","journal-title":"J Autism Dev Disord"},{"issue":"5","key":"R15","doi-asserted-by":"publisher","DOI":"10.14221\/ajte.2015v40n5.2","article-title":"Teaching mindfulness to year sevens as part of health and personal development","volume":"40","author":"Arthurson","journal-title":"Australian Journal of Teacher Education"},{"issue":"2","key":"R16","first-page":"21","volume":"6","author":"Costello","journal-title":"Int J Emot Educ"},{"issue":"3","key":"R17","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1162\/105474698565686","article-title":"Measuring presence in virtual environments: a presence questionnaire","volume":"7","author":"Witmer","journal-title":"Presence (Camb)"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1057\/s41599-025-04380-3","article-title":"Being there but where? Sense of presence theory for virtual reality applications","volume":"12","author":"Triberti","journal-title":"Humanit Soc Sci Commun"},{"issue":"8","key":"R19","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/S0010-4485(96)00094-2","article-title":"Virtual assembly using virtual reality techniques","volume":"29","author":"Jayaram","journal-title":"Computer-Aided Design"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00055","article-title":"Evaluation of a mindfulness-based intervention with and without virtual reality dialectical behavior therapy mindfulness skills training for the treatment of generalized anxiety disorder in primary care: a pilot study","volume":"10","author":"Navarro-Haro","journal-title":"Front Psychol"},{"issue":"3","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/16106","article-title":"Understanding how virtual reality can support mindfulness practice: mixed methods study","volume":"22","author":"Seabrook","journal-title":"J Med Internet Res"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.explore.2022.08.001","article-title":"The effectiveness of immersive virtual reality (VR) based mindfulness training on improvement mental-health in adults: a narrative systematic review","volume":"19","author":"Ma","journal-title":"Explore (NY)"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.2196\/52186","article-title":"Effectiveness of virtual reality-based well-being interventions for stress reduction in young adults: systematic review","volume":"11","author":"Xu","journal-title":"JMIR Ment Health"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.2196\/49171","article-title":"Using Virtual Reality to Reduce Stress in Adolescents: Mixed Methods Usability Study","volume":"1","author":"Bj\u00f6rling","journal-title":"JMIR XR Spatial Comput"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1002\/nur.20247","article-title":"Considerations in determining sample size for pilot studies","volume":"31","author":"Hertzog","journal-title":"Res Nurs Health"},{"key":"R26","unstructured":"Segal ZV Williams JMG Teasdale JD . Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. The Guilford Press; 2002. ISBN: 1-57230-706-4"},{"issue":"4","key":"R27","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1037\/\/0022-006x.68.4.615","article-title":"Prevention of relapse\/recurrence in major depression by mindfulness-based cognitive therapy","volume":"68","author":"Teasdale","journal-title":"J Consult Clin Psychol"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1037\/a0038212","article-title":"Integrating mindfulness with parent training: effects of the Mindfulness-Enhanced Strengthening Families Program","volume":"51","author":"Coatsworth","journal-title":"Dev Psychol"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-23287-x","article-title":"Further validating of the Depression Anxiety Stress Scales-21 (Dass-21) in Chinese adolescents: factor structure and measurement invariance","volume":"25","author":"Luo","journal-title":"BMC Public Health"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1177\/1073191111415365","article-title":"Psychometric assessment of the Mindful Attention Awareness Scale (MAAS) among Chinese adolescents","volume":"19","author":"Black","journal-title":"Assessment"},{"issue":"16","key":"R31","doi-asserted-by":"publisher","first-page":"8305","DOI":"10.3390\/ijerph18168305","article-title":"Psychological morbidity among university students in Hong Kong (2014\u20132018): psychometric properties of the Depression Anxiety Stress Scales (DASS) and related correlates","volume":"18","author":"Li","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"R32","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1037\/pas0000207","article-title":"Cross-cultural validation of the Depression Anxiety Stress Scale-21 in China","volume":"28","author":"Wang","journal-title":"Psychol Assess"},{"issue":"3","key":"R33","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-u","article-title":"The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories","volume":"33","author":"Lovibond","journal-title":"Behav Res Ther"},{"issue":"4","key":"R34","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1037\/0022-3514.84.4.822","article-title":"The benefits of being present: mindfulness and its role in psychological well-being","volume":"84","author":"Brown","journal-title":"J Pers Soc Psychol"},{"issue":"9","key":"R35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138921","article-title":"Validity of (ultra-)short recordings for heart rate variability measurements","volume":"10","author":"Munoz","journal-title":"PLoS One"},{"key":"R36","unstructured":"Rodr\u00edguez-Li\u00f1ares L M\u00e9ndez AJ Lado MJ Olivieri DN Vila XA . Heart Rate Variability Analysis with the R Package RHRV. Springer International Publishing; 2017. ISBN: 9783319653144"},{"issue":"10","key":"R37","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6579\/aae021","article-title":"An open source benchmarked toolbox for cardiovascular waveform and interval analysis","volume":"39","author":"Vest","journal-title":"Physiol Meas"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043","article-title":"Heart rate variability: standards of measurement, physiological interpretation, and clinical use","volume":"93","author":"Malik","journal-title":"Circulation"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2017.00258","article-title":"An overview of heart rate variability metrics and norms","volume":"5","author":"Shaffer","journal-title":"Front Public Health"},{"issue":"4","key":"R40","doi-asserted-by":"publisher","first-page":"132","DOI":"10.18178\/ijpmbs.8.4.132-137","article-title":"The impacts of mindfulness on heart rate variability: a brief review","volume":"8","author":"Tung","journal-title":"International Journal of Pharma Medicine and Biological Sciences"},{"issue":"2","key":"R41","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","journal-title":"Qual Res Psychol"},{"issue":"4","key":"R42","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","journal-title":"Qual Res Sport Exerc Health"},{"key":"R43","unstructured":"Creswell J Clark VLP . Designing and Conducting Mixed Methods Research. 3rd ed. SAGE Publications; 2017."},{"issue":"6","key":"R44","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1370\/afm.1865","article-title":"Integrating quantitative and qualitative results in health science mixed methods research through joint displays","volume":"13","author":"Guetterman","journal-title":"Ann Fam Med"},{"key":"R45","unstructured":"Households. Census and statistics department. 2025. URL: https:\/\/www.censtatd.gov.hk\/en\/scode500.html [Accessed 17-12-2025]"},{"issue":"4","key":"R46","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1080\/15332985.2014.932885","article-title":"Developing mindfulness programs for adolescents: lessons learned from an attempt in Hong Kong","volume":"13","author":"Lam","journal-title":"Soc Work Ment Health"},{"issue":"4","key":"R47","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2022.01.231","article-title":"Implementation barriers to using virtual reality to administer mindfulness therapy: lessons from the field","volume":"30","author":"Cinalioglu","journal-title":"Am J Geriatr Psychiatry"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2024.1472780","article-title":"Virtual reality vs. imagery: comparing approaches in guided meditation","volume":"15","author":"Jo","journal-title":"Front Psychol"},{"issue":"2","key":"R49","doi-asserted-by":"publisher","DOI":"10.23937\/2572-4037.1510067","article-title":"Adolescent experience of mindfulness as taught in dialectical behaviour therapy: a qualitative analysis","volume":"9","author":"Jennifer","journal-title":"Int J Psychol Psychoanal"},{"issue":"6","key":"R50","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11060905","article-title":"Nature-based mindfulness: a qualitative study of the experience of support for self-regulation","volume":"11","author":"Djernis","journal-title":"Healthcare (Basel)"},{"issue":"1","key":"R51","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14775-5","article-title":"Students experiences of an 8-week mindfulness-based intervention at a college of opportunity: a qualitative investigation of the mindfulness-based college program","volume":"22","author":"Nardi","journal-title":"BMC Public Health"},{"issue":"10","key":"R52","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1007\/s00787-022-02005-7","article-title":"The effectiveness of a single session of mindfulness-based cognitive training on cardiac vagal control and core symptoms in children and adolescents with attention-deficit\/hyperactivity disorder (ADHD): a preliminary randomized controlled trial","volume":"32","author":"Robe","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"12","key":"R53","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0243488","article-title":"Heart rate variability is enhanced during mindfulness practice: a randomized controlled trial involving a 10-day online-based mindfulness intervention","volume":"15","author":"Kirk","journal-title":"PLoS One"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3758\/s13428-020-01407-2","article-title":"t-Test and ANOVA for data with ceiling and\/or floor effects","volume":"53","author":"Liu","journal-title":"Behav Res Methods"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-12430-8","article-title":"Brain activation and heart rate variability as markers of autonomic function under stress","volume":"15","author":"Huber","journal-title":"Sci Rep"},{"issue":"3","key":"R56","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1111\/eip.12849","article-title":"Effectiveness of mindfulness-based interventions on anxiety for children and adolescents: a systematic review and meta-analysis","volume":"14","author":"Ruiz-\u00cd\u00f1iguez","journal-title":"Early Interv Psychiatry"},{"issue":"1","key":"R57","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.cpr.2012.10.006","article-title":"Mindfulness: top-down or bottom-up emotion regulation strategy?","volume":"33","author":"Chiesa","journal-title":"Clin Psychol Rev"},{"issue":"1","key":"R58","doi-asserted-by":"publisher","DOI":"10.1186\/s12906-025-04972-1","article-title":"Can heart rate variability demonstrate the effects and the levels of mindfulness? a repeated-measures study on experienced and novice mindfulness practitioners","volume":"25","author":"Wei","journal-title":"BMC Complement Med Ther"},{"issue":"1","key":"R59","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1007\/s10826-015-0209-4","article-title":"School referral patterns among adolescents with serious emotional disturbance enrolled in systems of care","volume":"25","author":"Green","journal-title":"J Child Fam Stud"},{"key":"R60","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1241469","article-title":"Community-based programs for youth with mental health conditions: a scoping review and practical implications","volume":"11","author":"Tuaf","journal-title":"Front Public Health"},{"issue":"3","key":"R61","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e06473","article-title":"Comparison of DASS-21, PHQ-8, and GAD-7 in a virtual behavioral health care setting","volume":"7","author":"Peters","journal-title":"Heliyon"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e91819","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:24:04Z","timestamp":1785536644000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e91819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":61,"URL":"https:\/\/doi.org\/10.2196\/91819","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"article-number":"v10i3e91819"}}