Resilience strengthening in youth with a chronic medical condition- a randomized controlled feasibility trial of a combined app and coaching program

Abstract

Abstract Objective: Youth with a chronic medical condition (CMC) are often affected by comorbid mental disorders. Resilience-strengthening interventions can protect youth’s mental health, yet evidence-based programs remain scarce. To address this lack, this study aimed to evaluate the feasibility of a dual approach combining app-based resilience training and cognitive-behavioral group coaching. Methods: 51 youths with CMC treated at a German university children’s hospital aged 12-16 years were recruited. They were randomly assigned to a combined app-game and coaching intervention or sole app gameplay. Pre-, postintervention and at a two-months follow-up resilience, automatic negative thoughts and an app and coaching evaluation were assessed. Feasibility was defined as a recruitment rate of ≥ 70%, an 85% adherence rate for the REThink app, and 70% participation in both coaching sessions. Results: Feasibility criteria were reached for coaching participation but not for recruitment or app adherence. While both the REThink app and coaching intervention had high acceptance rates among youth with CMC, participants receiving additional coaching sessions showed higher satisfaction and adherence rates. Participants preferred remote to in-person meetings. Conclusions: The findings support a combination of a gamification app-approach with online group coaching. Group coaching can improve adherence while online options increase accessibility. Future research should focus on testing in diverse participant samples, language and age-adapted updates of the REThink app. These findings provide guidance for increasing adherence in future intervention studies in youth with CMC cohorts. Trial registration number: DRKS00027870, registered 24.01.2022.