Research Appraisalqualitative

Evaluation of Wellby, a Cocreated Mobile App and Wearable to Support Stress Management and Overall Well-Being: Mixed Methods Acceptability and Usability Study

JMIR human factorsLaiti, Justin, Javadpour, Sina, Mullen, Jenna et al.9 Apr 2026DOI

Clinical Snapshot

65CEBM
Evidence: Moderatequalitative

PICO Framework

P — PopulationIrish secondary school students (n=43) aged adolescent, including mainstream secondary schools and Youthreach center for early school leavers
I — InterventionWellby mobile app and wearable device system including mood tracking, to-do lists, educational resources, text-based health coaching, and heart rate variability biofeedback with guided breathing exercises
C — ComparatorNo control group - single-arm acceptability and usability study
O — OutcomesPrimary: acceptability and usability measured by uMARS, focus groups, and app engagement analytics. Secondary: baseline well-being measures (Perceived Stress Scale, Pittsburgh Sleep Quality Index, EPOCH Measure of Adolescent Well-Being)

Bottom Line

This mixed methods study demonstrates that a co-created mobile app and wearable system (Wellby) achieved high acceptability and usability among Irish secondary school students. The technology acceptance model effectively captured student experience, with particularly high scores for information quality, functionality, and aesthetics (all >4.0/5.0). Students valued self-tracking and personalization features most, with app engagement doubling after wearable introduction. However, the study's single-arm design, small sample size (n=43), and lack of statistical testing limit the strength of evidence. While promising for digital adolescent well-being interventions, the findings require replication in larger controlled studies before clinical implementation. The co-creation approach appears valuable for developing acceptable digital health tools for young people, though technical improvements in battery life and connectivity were identified as priorities.

Evidence: Moderate

Key Findings

  • P Value: Not reported

  • Effect Size: Well-being awareness impact score 3.8/5.0, help-seeking intention 3.9/5.0

  • Primary Outcome: High acceptability and usability scores on uMARS: information quality (4.2/5.0), functionality (4.1/5.0), aesthetics (4.1/5.0)

  • Nnt Or Sensitivity: 88% (21/24) felt wearable aligned with co-design feedback, 83% (20/24) felt app aligned with feedback

  • Confidence Interval: Not reported

Clinical Application

Moderate feasibility - requires mobile app development, wearable device provision, and technical support infrastructure Relevant to Australian adolescent mental health initiatives and digital health strategies, though would require adaptation to local educational systems and TGA device regulations for wearables Australian secondary school students, particularly those in mainstream and alternative education settings requiring digital well-being support

Abstract

BACKGROUND: Digital well-being support tools can offer adolescents tailored interventions embedded in their digital environments. However, there is a lack of high-quality, evidence-based digital interventions specifically designed for young people's well-being needs. Wellby is a mobile app and wearable device cocreated with Irish secondary school students to support stress management and overall well-being. OBJECTIVE: This study aimed to evaluate the acceptability and usability of the Wellby system using the technology acceptance model, focusing on ease of use, perceived usefulness, and behavioral intention among Irish secondary school students. METHODS: A mixed methods acceptability and usability study was conducted with Irish secondary school students (n=43) across 3 schools: 2 mainstream secondary schools and 1 Youthreach center for early school leavers. Students accessed the Wellby mobile app for 8 weeks and received the custom wearable device for the final 4 weeks (April-May 2024). Wellby included mood tracking, to-do lists, educational resources, text-based health coaching, and heart rate variability biofeedback with guided breathing exercises. Acceptability and usability were evaluated using the user version of the Mobile App Rating Scale (uMARS), structured focus groups, and app engagement analytics. Secondary measures included baseline well-being questionnaires (Perceived Stress Scale, Pittsburgh Sleep Quality Index, and EPOCH Measure of Adolescent Well-Being). RESULTS: Among survey respondents (n=29), uMARS subscale scores were high: information quality (mean 4.2/5.0), functionality (4.1/5.0), and aesthetics (4.1/5.0). The perceived impact subscale showed the highest scores for well-being awareness (3.8/5.0) and help-seeking intention (3.9/5.0). Of survey respondents who participated in prior co-design sessions, 88% (21/24) and 83% (20/24) felt the wearable and app, respectively, aligned with their co-design feedback. App engagement more than doubled following the introduction of the wearable and revealed that the wearable tab was most accessed (643/1688, 38% of interactions), followed by the home (430/1688, 25%), resources (338/1688, 20%), and coaching (277/1688, 16%) tabs. Focus group feedback highlighted the mood tracker as the most valued feature and identified technical improvements, including better battery life, enhanced Bluetooth connectivity, and more personalization options. CONCLUSIONS: This study demonstrates that cocreated digital well-being tools can achieve high acceptability and usability with Irish secondary school students. Applying the technology acceptance model effectively captured student experience through mixed methods feedback. Students particularly valued self-tracking and personalization features over coaching or educational features. These findings highlight the importance of aligning digital technologies with adolescents' needs and preferences, such as features that encourage increased autonomy and identity formation. Future iterations of Wellby should address the technical limitations while continuing the involvement of students to adapt to their developmental needs and maintain high acceptability.

References

  1. 1.Laiti, J., Javadpour, S., Mullen, J., Conway, C., Byrne, E., & Dunne, P. (2026). Evaluation of Wellby, a cocreated mobile app and wearable to support stress management and overall well-being: Mixed methods acceptability and usability study. JMIR Human Factors. https://doi.org/10.2196/79381
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