How do adolescents experience a newly developed Online Single Session Sleep Intervention? A Think-Aloud Study: A Think-Aloud Study

Ananya Maity, Angela Wang, Melissa Drier, Faith Orchard, Jessica Schleider, Jessica Hamilton, Maria Loades

Research output: Contribution to journalArticlepeer-review


Background: Sleep problems are common in adolescents and have detrimental impacts on physical and mental health and daily functioning. Evidence-based treatment like cognitive behaviour therapy for insomnia (CBT-I) is often hard to access, and adolescents may not engage in and adhere to longer, clinician-delivered interventions. Brief, self-guided, and accessible sleep interventions are needed. Objective: To explore the user experience of a prototype online self-help single session sleep intervention developed for adolescents. Methods: Eleven participants aged 17–19 years (8 females, 3 males) took part in online retrospective think-aloud interviews. Participants first completed the prototype intervention independently and were then shown the intervention page by page and asked to verbalise their thoughts and experiences. Transcripts were analyzed thematically. Results: Participants found the intervention helpful. Four themes were generated - ‘Educative: Learning, but more fun’, ‘Effortless: Quicker and Easier’, ‘Personalization: Power of Choice’, and ‘Positivity: Just Good Vibes’. The theme ‘Educative: Learning, but more fun’ encompassed two sub-themes ‘Opportunity to Learn’ and ‘Aesthetics and Learning’. These themes reflected participants’ views that the intervention was educative, personalised, solution-oriented and easy to use, but could incorporate more graphics and visuals to aid in learning and could be made more effortless and positive through modifications to its design. Conclusions: Findings convey the importance of ensuring educative well-designed content, personalization, a positive tone, and ease of use while designing interventions targeting adolescents’s sleep and mental health. They also indicate areas for further developing the intervention.

Original languageEnglish
JournalClinical Child Psychology and Psychiatry
Early online date18 Nov 2023
Publication statusPublished - 18 Nov 2023

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute for Mental Health (K01MH121584) and National Institute for Health Research (Development and Skills Enhancement Award, 302367; Advanced Fellowship, 302929).

Funding Information:
Dr Jessica L. Hamilton is funded by National Institute for Mental Health (K01MH121584). Dr. Maria Loades (Development and Skills Enhancement Award, 302367; Advanced Fellowship, 302929) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. Thanks to all the young people who took the time out to participate in this study and provide their valuable input and suggestions. We also appreciate the support and advice we received from the Lab for Scalable Mental Health at Stony Brook University, and the assistance from Amelia Peck at the University of Bath in the early stages of developing the intervention.

Publisher Copyright:
© The Author(s) 2023.


  • Qualitative
  • single session intervention
  • sleep
  • think-aloud
  • user experience
  • user experience design

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Pediatrics, Perinatology, and Child Health


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