What Gets Adolescents to Click? Dissemination Message Features for Digital Single-Session Mental Health Interventions

Abstract Background Digital, self-guided single-session interventions (SSIs) are scalable, but little is known about how adolescents interpret dissemination messaging intended to promote their use. Methods Using a mixed methods design, we conducted two studies. First, we interviewed 19 adolescents with perceived mental health needs about their reactions to SSIs and promotional messaging. Findings from these interviews informed the development of three ad sets, each varying one COM-B aligned feature: (a) source of recommendation (peer vs. provider endorsement), (b) benefit framing (immediate vs. longer-term benefits), or (c) choice structure (single recommended SSI vs. multiple options). Second, 300 adolescents were recruited for a randomized experiment and assigned to view one prototype. Participants completed measures of hopefulness, readiness to initiate an SSI, prototype perceptions, and open-ended feedback. Data were summarized using descriptive statistics overall and by experimental condition. Qualitative and quantitative findings were integrated during interpretation. Results Most participants were unaware of SSIs (154/300, 51%), yet over half (53.0%) perceived them as helpful, compared with 19.7% who did not and 27.3% who were unsure. Across conditions, mean hopefulness ranged from 2.24 to 2.64 and readiness to initiate an SSI from 4.78 to 5.54, with overlapping 95% CIs. Mean perceived appropriateness was 2.78 (SD = 1.04, 95% CI [2.49, 3.07]) in the provider-endorsement condition. Condition-level differences were small, with overlapping confidence intervals. Conclusions Low awareness of SSIs and limited recall of promotional messaging suggest that dissemination should prioritize clear, concise explanations of SSIs and their immediate benefits. Trusted endorsements from peers and providers may enhance credibility and initial engagement, but additional research is needed to identify strategies that translate interest into SSI uptake. In a crowded digital landscape, where dissemination efforts have lagged behind intervention development, our study is among the first to examine how adolescents interpret and respond to promotional messaging for digital mental health interventions.