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JMIR Res Protoc. 2016 Nov 4;5(4):e201. doi: 10.2196/resprot.6446.

Enhancing Self-Efficacy for Help-Seeking Among Transition-Aged Youth in Postsecondary Settings With Mental Health and/or Substance Use Concerns, Using Crowd-Sourced Online and Mobile Technologies: The Thought Spot Protocol.

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University Health Network, Toronto, ON, Canada.
Centre for Mental Health and Addiction, Toronto, ON, Canada.
University of Toronto, Toronto, ON, Canada.
Centre for Global eHealth Innovation, Toronto, ON, Canada.
Centre for Excellence in Economic Analysis Research (CLEAR), St. Michael's Hospital, Toronto, ON, Canada.
Department of Public Health Sciences, University of California, Davis, CA, United States.
Cancer Care Ontario, Toronto, ON, Canada.
Michael Garron Hospital, Toronto, ON, Canada.
QoC Health, Toronto, ON, Canada.



Seventy percent of lifetime cases of mental illness emerge prior to age 24. While early detection and intervention can address approximately 70% of child and youth cases of mental health concerns, the majority of youth with mental health concerns do not receive the services they need.


The objective of this paper is to describe the protocol for optimizing and evaluating Thought Spot, a Web- and mobile-based platform cocreated with end users that is designed to improve the ability of students to access mental health and substance use services.


This project will be conducted in 2 distinct phases, which will aim to (1) optimize the existing Thought Spot electronic health/mobile health intervention through youth engagement, and (2) evaluate the impact of Thought Spot on self-efficacy for mental health help-seeking and health literacy among university and college students. Phase 1 will utilize participatory action research and participatory design research to cocreate and coproduce solutions with members of our target audience. Phase 2 will consist of a randomized controlled trial to test the hypothesis that the Thought Spot intervention will show improvements in intentions for, and self-efficacy in, help-seeking for mental health concerns.


We anticipate that enhancements will include (1) user analytics and feedback mechanisms, (2) peer mentorship and/or coaching functionality, (3) crowd-sourcing and data hygiene, and (4) integration of evidence-based consumer health and research information.


This protocol outlines the important next steps in understanding the impact of the Thought Spot platform on the behavior of postsecondary, transition-aged youth students when they seek information and services related to mental health and substance use.


crowd-sourcing; eHealth; help-seeking; mental health; mobile applications; participatory action research; substance use; transition-aged youth 

Conflict of interest statement

Sarah Sharpe is a cofounder and shareholder in QoC Health. Gunther Eysenbach is the editor-in-chief and publisher of JMIR.

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