{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:09:13Z","timestamp":1791490153413,"version":"4.3.4"},"reference-count":55,"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 Adolescents who experience the loss of a family member are at increased risk of adverse mental health outcomes, yet many face barriers or may be reluctant to access in-person or group-based support. mHealth (mobile health) interventions can help address these barriers by offering flexible, accessible, and low-threshold support.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study evaluated the short- and long-term mental health effects of Alba \u2013 Youth in Grief, a preventive self-management mobile app for bereaved adolescents. The primary outcome was symptoms of prolonged grief, while secondary outcomes included grief reactions, personal growth, and symptoms of posttraumatic stress and depression. User-reported helpfulness and negative experiences were also examined.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In an unblinded randomized controlled trial (ClinicalTrials.gov NCT06093113), 126 adolescents aged 12\u201019 years who had lost a parent or sibling were allocated to either the unguided Alba app (n=61) or an active control condition receiving unguided web-based psychoeducation (n=65). Online self-assessments were conducted at baseline and at 2, 6, and 12 months. Participants generally demonstrated high levels of distress at baseline, with 40% (50\/126) reporting symptoms indicative of probable prolonged grief disorder according to\n ICD-11<\/jats:italic>\n (\n International Classification of Diseases, 11th Revision<\/jats:italic>\n ) diagnostic scoring rules. Mental health outcomes were analyzed using linear mixed models to examine changes over time between groups, while user experiences were examined using descriptive statistics and summative content analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Intention-to-treat analyses showed moderate reductions in prolonged grief symptoms at 12 months among adolescents randomized to Alba compared with the control group, with no significant effects at the 2- and 6-month follow-ups. The app group also demonstrated greater reductions in grief reactions, posttraumatic stress symptoms, and depressive symptoms compared with controls, with the strongest effects observed at long-term follow-up. No effect on personal growth was demonstrated. Most participants reported the app as helpful, while a minority disclosed negative experiences such as sadness.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Overall, the findings indicate that Alba may be beneficial in reducing mental health symptoms among bereaved adolescents and highlight its potential as a safe, acceptable, and scalable mHealth intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/94777","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:52:14Z","timestamp":1784188334000},"page":"e94777-e94777","source":"Crossref","is-referenced-by-count":2,"title":["Effects and User-Reported Experiences of a Self-Management Mobile Health App for Grieving Adolescents: Randomized Controlled Trial"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9440-8244","authenticated-orcid":false,"given":"Rebecca","family":"Rhodin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9396-9800","authenticated-orcid":false,"given":"Rakel","family":"Eklund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0540-3576","authenticated-orcid":false,"given":"Anneli","family":"Silv\u00e9n Hagstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4578-6927","authenticated-orcid":false,"given":"Rolf","family":"Gjestad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3281-030X","authenticated-orcid":false,"given":"Atle","family":"Dyregrov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5523-8126","authenticated-orcid":false,"given":"Josefin","family":"Sveen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1007\/s40653-021-00435-0","article-title":"Developmental manifestations of grief in children and adolescents: caregivers as key grief facilitators","volume":"16","author":"Alvis","journal-title":"J Child Adolesc Trauma"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1017\/S0954579424001834","article-title":"Trajectories of children\u2019s intrusive grief and association with baseline family and child factors and long-term outcomes in young adulthood","volume":"37","author":"Sandler","journal-title":"Dev Psychopathol"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1002\/wps.20293","article-title":"Bereavement after sibling death: a population-based longitudinal case-control study","volume":"15","author":"Bolton","journal-title":"World Psychiatry"},{"issue":"5","key":"R4","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1001\/archpedi.162.5.403","article-title":"Antecedents and sequelae of sudden parental death in offspring and surviving caregivers","volume":"162","author":"Melhem","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1177\/00302228211033661","article-title":"Parental death during adolescence: a review of the literature","volume":"87","author":"Farella Guzzo","journal-title":"Omega (Westport)"},{"issue":"10","key":"R6","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1007\/s00787-016-0833-6","article-title":"Parental death in childhood and self-inflicted injuries in young adults-a national cohort study from Sweden","volume":"25","author":"Rostila","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"12","key":"R7","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1093\/aje\/kww126","article-title":"Experience of sibling death in childhood and risk of death in adulthood: a national cohort study from Sweden","volume":"185","author":"Rostila","journal-title":"Am J Epidemiol"},{"issue":"5","key":"R8","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.encep.2023.11.016","article-title":"Prevalence of prolonged grief disorder in bereaved children and adolescents: a systematic review","volume":"50","author":"Falala","journal-title":"Encephale"},{"key":"R9","unstructured":"ICD-11. 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