Adolescence is a critical window for building lifelong health habits, yet young people face an evidence gap when it comes to high quality, scientifically backed digital wellness tools. A staggering 98% of available stress management apps lack peer reviewed research supporting their design.
Key Takeaways |
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Increased Engagement through Hardware: The introduction of the wearable device dramatically increased user engagement, more than doubling overall app interactions in the final four weeks. |
| Preference for Self-Tracking: Students prioritized self-tracking and biological data (HRV Biofeedback and mood checks) over prescriptive advice, making these features the most popular. |
| The Power of Co-Design: Effective digital tools for adolescents must be co-designed to align with their desire for autonomy and self-directed wellness, which is key to engaging high-risk youth in their health journeys. |
To bridge this gap, doctoral researcher Justin Laiti and an engineering team at the Royal College of Surgeons in Ireland (RCSI) collaborated directly with local youth. Together, they built and evaluated Wellby, a mobile application and wearable system tailored and designed specifically to address adolescent stress, sleep, and psychological well-being.
Published in JMIR Human Factors, Laiti’s mixed methods study evaluated the system with 43 students across three distinct settings: two mainstream secondary schools and one Youthreach center supporting early school leavers.
The baseline assessments painted a clear picture of why student centered support is so vital. Using validated psychological instruments, researchers captured a notable difference between schools, as well as a stark gender-based divide in adolescent stress and sleep hygiene:
The intervention split the eight week study period into two distinct phases. For the first four weeks, students used the mobile application alone. For the final four weeks, they integrated a custom-built, wrist-worn hardware device.
The system targeted four primary operational touchpoints:
Home Dashboard: Features everyday self-tracking utilities, including an interactive daily checklist and a mood monitor where students could select emojis to chart their emotional states over time.
Educational Resources: A repository of infographics and videos focused on time management, digital hygiene, and stress science.
Health Coaching: An optional text-based portal connecting students directly to certified health coaches.
Wearable Biofeedback: A hardware tab linked via Bluetooth to a custom wristband, which measured continuous heart activity and guided students through heart rate variability (HRV) breathing exercises.
According to the user version of the Mobile App Rating Scale, the ease of use scored high across all key criteria, including information quality (4.2 out of 5.0), functionality (4.1 out of 5.0), and aesthetics (4.1 out of 5.0). Crucially, the app’s alignment with personal goals was highest among the students who actively participated in the original co-design sessions (21 out of 24, 88%).
App engagement metrics revealed that introducing physical hardware radically altered user behavior. Overall app interactions more than doubled during the final four weeks once the wearable device was distributed.
The user analytics logged 1,688 discrete interactions across the four tabs, showing that students prioritized biological tracking and personalization over text-based advice:
Wearable Tab (HRV Biofeedback): 38% (643 interactions)
Home Tab (Mood Checks & Personalization): 25% (430 interactions)
Resources Tab (Educational Content): 20% (338 interactions)
Coaching Tab (Text Messaging): 16% (277 interactions)
Qualitative focus groups confirmed that the interface personalization features and the interactive mood tracker were the most popular elements of the system. However, early school leavers at the Youthreach center noted that the physical casing needed to be rounder and offer sleeker, metallic material finishes to better align with local social fashion norms.
Student engagement patterns and feedback indicated a strong interest in self-directed wellness over prescriptive content. This connects deeply to adolescents' developmental needs for greater autonomy and identity formation. By building a tool that aligns with their stylistic preferences and desire for self-exploration, the research demonstrates how to effectively engage high risk youth in their own health journeys.
| In this video, Dr. Justin Laiti discusses his latest research team study from the Royal College of Surgeons in Ireland, published in JMIR Human Factors, evaluating "Wellby", a mobile app and wearable stress-management system co-designed directly with secondary school students. |
Why JMIR?
The authors chose JMIR Human Factors to share these findings due to the journal's focus on user centered design, human-computer interaction, and the practical implementation of digital health technologies. As education and public health systems look to build scalable support structures for youth, this study provides the methodological roadmap required to create tools that respect adolescent autonomy and identity formation.
Curious to see how participatory design is shaping the future of youth mental health? Watch the video featuring Justin Laiti and read the full research paper to explore the co-design framework and the technical roadmap for next generation adolescent health tools.