Feasibility, engagement, and outcomes of a mobile-based sleep intervention coproduced with adolescents. (Preprint)

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Abstract
BACKGROUND Most adolescent mental health issues remain undetected and untreated, with insomnia a potent risk factor for psychopathology and suicidality. Digital single-session interventions (SSIs), targeting sleep, offer scalable, accessible opportunities for preventive solutions that may overcome barriers such as stigma and low engagement, particularly among underserved groups. OBJECTIVE This study evaluated the feasibility of a mobile-based sleep intervention delivered through educational settings. METHODS This study employed a non-randomised, mixed-methods, longitudinal design to evaluate the feasibility of a multi-level intervention in young people aged 14-18 years. 1,046 participants were recruited from schools and colleges across England. Participants accessed a stepped-care mobile intervention and completed self-report measures at baseline and 6-week follow-up. Outcomes included feasibility (recruitment, retention), engagement (usage analytics, completion rates), and changes in insomnia (Insomnia Severity Index) and mental health symptoms (Revised Children’s Anxiety and Depression Scale). Logistic regression models examined predictors of attrition and engagement RESULTS 1048 participants completed baseline assessments and 656 (62.6%) completed 6-week follow-up. Among participants with linked usage data (n=603), 57.7% completed the core intervention content. Attrition was higher among males and lower among participants from more deprived areas. Significant improvements were observed in insomnia symptoms (Cohen d=0.29, p<.001), as well as anxiety and depression (d=0.11-0.19, all p<.01). Among participants with baseline insomnia symptoms, 26.9% achieved remission at follow-up. CONCLUSIONS The intervention was well-received across diverse groups, supporting the acceptability and scalability of brief, school-based digital interventions to reduce sleep-related mental health disparities CLINICALTRIAL Not applicable.

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