Evidence map›Paper›PMID 40215430›Full record

ArticleJMIR pediatrics and parenting2025

Adapting Cognitive Behavioral Therapy for Adolescents in Iraq via Mobile Apps: Qualitative Study of Usability and Outcomes.

Radhwan Hussein Ibrahim, Marghoob Hussein Yaas, Mariwan Qadir Hamarash, Salwa Hazim Al-Mukhtar, Mohammed Faris Abdulghani, Osama Al Mushhadany

Abstract read
In one paragraph

Article in JMIR pediatrics and parenting, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Radhwan Hussein IbrahimDepartment of Clinical Nursing Sciences, College of Nursing, Ninevah University, Kirkuk St, Mosul, 41001, Iraq, 964 7722112891.ORCID http://orcid.org/0000-0002-6874-890X
Marghoob Hussein YaasCollege of Nursing, Al Kitab University, Kirkuk, Iraq.ORCID http://orcid.org/0009-0002-2816-6734
Mariwan Qadir HamarashCollege of Nursing, Al Kitab University, Kirkuk, Iraq.ORCID http://orcid.org/0009-0004-3472-6472
Salwa Hazim Al-MukhtarDepartment of Clinical Nursing Sciences, College of Nursing, University of Mosul, Mosul, Iraq.ORCID http://orcid.org/0009-0007-0223-4950
Mohammed Faris AbdulghaniDepartment of Clinical Nursing Sciences, College of Nursing, Ninevah University, Kirkuk St, Mosul, 41001, Iraq, 964 7722112891.ORCID http://orcid.org/0000-0002-5158-5235
Osama Al MushhadanyCollege of Medicine, Ninevah University, Mosul, Iraq.ORCID http://orcid.org/0000-0001-5956-0801

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Mental health challenges, including anxiety and depression, are increasingly common among adolescents. Mobile health (mHealth) apps offer a promising way to deliver accessible cognitive behavioral therapy (CBT) interventions. However, research on the usability and effectiveness of apps explicitly tailored for adolescents is limited. Objective: This study aimed to explore the usability, engagement, and perceived effectiveness of a mobile CBT app designed for adolescents, focusing on user experiences and mental health outcomes. Methods: A qualitative study was conducted with 40 adolescents aged 13-19 years (mean age 15.8, SD 1.9 years; 18/40, 45% male; 22/40, 55% female) who engaged with a CBT app for 4 weeks. Mental health diagnoses included anxiety (20/40, 50%), depression (15/40, 38%), and both (5/40, 13%). Of these, 10 (25%) of the 40 participants had previous CBT experience. Feedback was gathered through focus groups and individual interviews, and thematic analysis identified key themes related to usability, engagement, and perceived effectiveness. Quantitative data on mood and anxiety scores were analyzed with paired t tests. Results: The mean usability score was 3.8 (SD 0.6), and the mean effectiveness score was 3.9 (SD 0.7). Older participants (aged 16-19 years) reported significantly higher usability (mean 4.1, SD 0.4) and effectiveness scores (mean 4.3, SD 0.5) compared to younger participants (aged 13-15 years) (P=.03). Females had higher usability (mean 4, SD 0.6) and effectiveness scores (mean 4.2, SD 0.7) than males (mean 3.6, SD 0.7, and mean 3.5, SD 0.8, respectively; P=.03). Participants with prior CBT experience had 2.8 times higher odds of reporting high usability scores (95% CI 1.6-5; P=.002) and 3.1 times higher odds of reporting high effectiveness scores (95% CI 1.7-5.6; P=.001). Usability challenges included complex navigation (20/40, 50%), interface design issues (12/40, 30%), and content overload (8/40, 20%). Factors positively influencing engagement were motivation driven by personal relevance (20/40, 50%) and gamification features (10/40, 25%), while lack of personalization (14/40, 35%) and external distractions (18/40, 45%) were significant barriers. Mood improvement (15/40, 38%) and learning new coping skills (12/40, 30%) were the most reported outcomes. Conclusions: The mobile CBT app shows potential for improving adolescent mental health, with initial improvements in mood and anxiety. Future app iterations should prioritize simplifying navigation, adding personalization features, and enhancing technical stability to support long-term engagement.

Indexed as

adolescentsanxietyappCBTcognitive behavioral therapydepressiondigital healthengagementfocus groupinterviewmental healthmHealthpsychotherapyteenagerusabilityuser experienceUX

Identifiers

PMID40215430
PMCPMC12039940

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.