Digital mental health promotion in Finland: who engages, what works, and how to improve impact

Abstract Background Mental health issues burden Europe, with Finland among the most affected and North Savo showing the most problems nationwide. Digital interventions may be effective and scalable in promoting wellbeing, yet user adoption and adherence remain understudied. The PREWELL study aims to develop and evaluate digital screening tools and intervention to promote healthy lifestyle and mental wellbeing in North Savo. Our baseline analysis examines sociodemographic factors and wellbeing in relation to the use of wellbeing apps prior to baseline and initial intervention adherence. Methods Using the BitHabit web app we conduct a stepped wedge RCT with 1,600 participants. Data includes a digital wellbeing survey with demographic factors, health behaviour, and wellbeing measures as well as app user data over a two-year follow-up, starting in summer 2024. Register data will be used in later phases. Results Baseline findings indicate that past use of wellbeing apps was not associated with life satisfaction (p=.35) or mental wellbeing (SWEMWBS) (p=.41). Older adults (51% vs. 24% younger adults, p<.001), men (47% vs. 34% women, p<.001), and unemployed individuals (43% vs. 37% employed, p=.03) had more often never used wellbeing apps. Initial adherence to the BitHabit app was not associated with background characteristics or wellbeing measures. However, younger participants and men initially appeared to be reporting more mental wellbeing habits in the app, and older participants more physical activities. Conclusions Female gender, younger age, and employment appear associated with prior use of wellbeing promoting apps, but initial adherence to our intervention appeared to not follow this trend. Preliminary differences in app usage suggest that tailored strategies may improve support for individuals with unhealthy lifestyles or poor mental health. Our study will deepen scientific understanding of digital screening and mental health promotion feasibility and effectiveness. Key messages • Younger, female, and employed individuals seem more inclined to use wellbeing promoting apps. • User-driven tailored strategies could improve the effectiveness of digital mental health promotion.