ArticleJournal of medical Internet research2026
Acceptability and Preliminary Evaluation of a Campus-Integrated Digital Platform (Fruto) for University Students' Mental Health Help-Seeking: Sequential Mixed Methods Study.
Article in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCollege students are at heightened risk for mental health problems; yet, professional help-seeking remains low. Although digital mental health tools can improve accessibility and reduce stigma, many focus on isolated functions, such as self-screening, psychoeducation, or symptom management, and are not fully integrated with campus counseling services. Multidomain platforms that combine screening, mental health information, counseling access, and campus service navigation may support help-seeking in university settings; however, their acceptability and implementation value remain underexplored.
objectiveThis mixed methods study examined the refinement and preliminary evaluation of Fruto, a campus-integrated, multidomain app developed to support university students' help-seeking attitudes and counseling-related beliefs in a real-world counseling-center setting. Phase 1 used scenario-based prototype sessions to analyze students' interactions with the platform and inform refinement. Phase 2 assessed whether 8 weeks of Fruto use was associated with pre-post changes in attitudinal and counseling-related outcomes.
methodsWe conducted a 2-phase, mixed methods study. Phase 1 involved vignette-based prototype sessions and semistructured interviews with 16 students to explore user experiences with an early version of Fruto. Scenario-based tasks facilitated feedback on the platform, and thematic analysis identified design implications that guided refinement. Phase 2 involved an 8-week single-group pre-post evaluation. A total of 109 students completed the baseline survey, and 70 provided follow-up responses. Surveys assessed help-seeking attitudes, counseling-related beliefs, and perceived app quality. Linear mixed effects models examined pre-post changes using all available data, and exploratory baseline-adjusted regressions examined the association between overall perceived app quality and postuse outcomes.
resultsScenario-based prototype sessions elicited actionable feedback on how students might use Fruto in realistic help-seeking contexts. Qualitative findings identified 3 refinement priorities that informed subsequent app updates: trusted and identifiable content providers, seamless integration across app features, and relatable self-discovery content to lower psychological barriers to app use. Following these refinements, Phase 2 assessed 8-week pre-post changes using linear mixed effects models. Fruto use was associated with significant increases in positive help-seeking attitudes (B=0.884, SE 0.284, 95% CI 0.327-1.441; P=.002) and positive counseling expectations (B=1.585, SE 0.541, 95% CI 0.526-2.645; P=.003). No significant changes were observed in negative attitudes, negative counseling beliefs, or socially supportive beliefs. In exploratory baseline-adjusted regressions, overall perceived app quality was associated with positive counseling expectations, but not with positive help-seeking attitudes.
conclusionsFruto shows promise as a campus-integrated, multidomain platform associated with more favorable help-seeking attitudes and counseling expectations among university students. These findings suggest that multidomain platforms may strengthen positive, approach-oriented beliefs toward professional support. Future studies with longer follow-up and objective usage or service-use data are needed to examine whether attitudinal changes translate into help-seeking behavior.
trial registrationClinical Research Information Service KCT0010622; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=30274&search_page=L.
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