Objectives: The current study sought to qualitatively characterize the experiences of American users in a recent open trial of the Horyzons digital platform. Methods: In total, 20 users on Horyzons USA completed semistructured interviews 12 weeks after their orientation to the platform and addressed questions related to (1) the platform, (2) their online therapist, and (3) the peer workers and community space. A hybrid inductive-deductive coding strategy was used to conduct a thematic analysis of the data (NCT04673851). Results: The authors identified seven prominent themes that mapped onto the three components of self-determination theory. Features of the platform itself as well as inter- and intra-personal factors supported the autonomous use of Horyzons. Users also reflected that their perceived competence in social settings and in managing mental health was increased by the familiarity, privacy, and perceived safety of the platform and an emphasis on personalized therapeutic content. The behaviors or traits of online therapists as perceived by users and regular contact with peers and peer support specialists satisfied users’ need for relatedness and promoted confidence in social settings. Users also described aspects of Horyzons USA that challenged their satisfaction of autonomy, competence, and relatedness, highlighting potential areas for future iterations of the platform's content and interface. Conclusions: Horyzons USA is a promising digital tool that provides young adults with psychosis with the means to access tailored therapy material on demand and a supportive digital community to aid in the recovery process.

Objectives: Parents of medically complex children juggle unique demands associated with caring for chronically ill children, many of which negatively impact their mental wellbeing. Despite this, parents of medically complex children often forgo mental health support due to concerns with costs, time, stigma, and accessibility. There is limited research on evidence-based interventions addressing such barriers for these caregivers. We piloted an adapted version of Mood Lifters, a peer-led wellness program, to equip parents of medically complex children with evidence-based strategies to manage their mental health while also reducing barriers to support. We hypothesized parents would find Mood Lifters to be feasible and acceptable. Further, parents would experience improvements in mental wellbeing upon program completion.Methods: We conducted a single-arm prospective pilot study to assess Mood Lifters for parents of medically complex children. Participants included 51 parents in the U.S. recruited from a local pediatric hospital providing care for their children. Caregiver mental wellbeing was assessed through validated questionnaires pre-intervention (T1) and post-intervention (T2). Repeated-measures analysis of variance was conducted to evaluate change between T1 and T2.Results: Analyses from T1 and T2 (n = 18) revealed improvements in parents’ depression (F(1,17) = 7.691, p = 0.013) and anxiety (F(1,17) = 6.431, p = 0.021) after program completion. Improvements in perceived stress and positive and negative emotion were significant at p < 0.0083.Significance of results: Parents of medically complex children experienced improved mental health upon participating in Mood Lifters. Results offer preliminary support for the feasibility and acceptability of Mood Lifters as an evidence-based care option that may also alleviate common barriers to care.

Mood Lifters (ML) is a dimensional, group-based, peer-led mental health program that has shown efficacy in mitigating psychopathology and promoting wellness within a variety of populations. There is not yet evidence for mechanism(s) driving these changes. Qualitative data exploring the lived experiences of participants may be a unique way to develop hypotheses about the potential mechanisms driving change. The current study used qualitative and quantitative data from the ML for Graduate Students (ML-GS) and Young Adults (ML-YA) studies to generate hypotheses regarding potential mechanisms of changes experienced in ML. Seventy-nine graduate students and fifty-nine non-student young adults provided quantitative and qualitative feedback after participating in a 12-week virtual ML program. Inductive qualitative analysis was conducted within a reflexive thematic framework. Descriptive statistics of quantitative measures were also calculated. Three themes suggest potential directions for future mechanism research on virtual ML programs. Most participants emphasized the social connections built in groups as the most potent and powerful aspects of ML, while others focused on the design or content of the program. Quantitative data presented contextualize the lived experiences of participants. Future ML research should explore the three themes identified within this study through continued qualitative and quantitative data collection and analysis. NCT05078450.

Background/Objectives: Several randomized controlled trials have found that dietary interventions promoting self-guided shifts away from ultra-processed foods (UPFs) and toward minimally processed, nutrient-dense foods may alleviate depressive symptoms. However, translating these interventions into scalable and sustainable real-world approaches remains a key challenge. Adopting a minimally processed dietary pattern requires sustained effort (e.g., meal planning, shopping, and preparation) within environments where UPFs are pervasive and convenient. These demands may be especially burdensome for individuals experiencing depressive symptoms. Consequently, interventions that rely heavily on individual effort may be difficult to maintain. Commercial meal delivery services may offer a structural solution by reducing logistical and cognitive barriers to dietary change, yet little is known about how individuals with depressive symptoms experience this approach. Methods: In a parent study, we conducted a randomized pilot study of a meal delivery service designed to provide minimally processed meals to adults with moderate to moderately severe depressive symptoms; here we report qualitative findings from post-intervention interviews with participants assigned to the meal delivery condition (n = 20). Results: Participants appreciated reductions in preparatory effort and mental load, which supported adherence. Dietary changes were also linked to improved mood through increased energy, mood stability, and more positive self-evaluation. However, social settings were a near-universal barrier, and acceptability depended on palatability, compatibility with personal preferences, and perceived autonomy. Several participants also described a temporal adjustment process (early cravings/withdrawal followed by adaptation). Conclusions: Overall, these findings suggest participant-informed priorities for future testing and refinement of scalable meal delivery interventions for depression, including personalization and choice, quality control, and support for social and withdrawal-related challenges.