# Effects of an App-Based Intervention on Psychological Well-Being Among Young Individuals not in Employment, Education, or Training With and Those Without Disability: Subgroup Analysis of a Randomized Controlled Trial

## TL;DR

An app-based mental health intervention for young people not in education or work showed no overall mental health benefits but suggested possible employment gains for those who engaged with it.

## Contribution

This study is the first to investigate the effects of an app-based ACT intervention on NEETs with and without disabilities using a randomized controlled trial.

## Key findings

- No significant differences in mental health outcomes were found between the app-based intervention and control groups.
- Participants who completed the app modules had higher likelihoods of being active in employment or education.
- NEETs with disabilities had lower self-esteem, less education, and more prolonged NEET status compared to those without disabilities.

## Abstract

The population of young individuals not in employment, education, or training (NEET) is highly diverse, but a common problem appears to be their mental health. NEETs due to illness or disability are of particular concern for social exclusion, but little is known of how young individuals who are NEET with and without disability make use of, and gain from, employment interventions. There is also a scarcity of research on psychological interventions and mental health outcomes among young NEETs. Acceptance and commitment therapy (ACT) has shown promising results in psychological outcomes in young adults.

This study aimed to expand the knowledge on the effects of an app-based intervention built on ACT on NEETs with and without disabilities.

A 2-arm randomized controlled trial was conducted in 2021, including 151 young NEETs aged 16-24 years. Participants were recruited mainly via social media platforms and through organizations working with young NEETs. The intervention group (n=77) used an app for psychological well-being with the possibility for digital group meetings for 6 weeks, and the control group (n=74) received film clips once a week. Outcomes were self-assessed through questionnaires. Statistical analyses were made using chi-square, Mann-Whitney U test, general linear model, and logistic regression.

No differences in effects on mental health were seen between the intervention and control group, neither overall nor between young NEETs with or without disability. Usage data show that 68.8% (53/77) of the participants in the intervention group downloaded the app, and 24.7% (19/77) completed all 6 modules. Effects on employment and education levels were only seen within the intervention group, where those who had completed one or more modules had a higher likelihood of being active in terms of employment and education compared to those who did not complete modules. No significant effects were seen in employment and education levels in relation to disability status. A high proportion of the participants had a disability, few were in contact with a youth employment center, and there was an overrepresentation of young women in general. Participants with disabilities had lower self-esteem, had less frequently completed high school, had less work experience, and a larger proportion had been in the NEET situation for over a year. A higher dropout were seen among participants in the intervention group and among young men.

No effects of the app-based intervention were seen for psychological well-being between young NEETs with disabilities and those without, but the results showed potential effects on employment and education levels related to engagement in the intervention. NEETs with disabilities are of particular concern and might need additional efforts or other types of interventions than the one investigated in this study. Findings can be considered weak due to the low adherence and high attrition.

ISRCTN Registry ISRCTN46697028; https://www.isrctn.com/ISRCTN46697028