Abstract
BACKGROUND: Youth are increasingly experiencing psychological distress. Schools are ideal settings for disseminating mental health support, but they are often insufficiently resourced to do so. Digital mental health tools represent a unique avenue to address this gap. The Alongside digital program is one such tool, intended as a universal prevention and early intervention. The platform includes social-emotional learning and self-help wellness features as well as an artificial intelligence-powered chatbot designed to build coping skills. OBJECTIVE: This evaluation aimed to examine the near-term impact of Alongside app use on students' self-reported mental health outcomes. METHODS: We conducted a nonrandomized pilot pragmatic evaluation leveraging anonymized user data. All data came from current Alongside users attending public middle and high schools in Texas and New Mexico, between 10 and 18 years old. Schools were actively engaged in partnership with Alongside and approved all procedures. Users were asked to complete mental health questionnaires upon app registration and at 1 and 3 months post registration. We conducted preregistered analyses as well as exploratory analyses to determine how symptoms changed over time and what factors (eg, demographic and app use) predicted changes in distress. RESULTS: Analyses revealed statistically significant within-person decreases in overall distress (Young Person's CORE; primary outcome) from baseline to 1 month with a small effect size (t(42)=2.21, P=.03, r=0.34); however, there was no evidence that scores significantly decreased from baseline to 3 months (W=1821, n=85, P=.16). We found that at 3 months, identifying as part of the lesbian, gay, bisexual, transgender, queer, and questioning community predicted greater decreases in distress; otherwise, no demographic factors were significant predictors. In a nonregistered exploratory analysis of a subsample of users who reported elevated distress at baseline, decreases in distress were seen at both 1 month (W=128, n=20, P=.02, r=0.52) and 3 months (W=682, n=42, P=.004, r=0.45). CONCLUSIONS: There may be short-term benefits associated with using the Alongside digital program. Further studies are required to determine potential preventative effects.