Design for Mental Health: How Socio-Technological Processes Mediate Outcome Measures in a Field Study of a Wearable Anxiety App

Millions of children have challenges with anxiety that negatively impact their development, education and well-being. To address this challenge, we developed version 2.0 of Mind-Full, a wearable, mobile neurofeedback system, designed to teach young children to learn to self-regulate anxiety. We present a mixed methods evaluation of a seven week long intervention in schools. We report on a subset of outcome measures related to 10 children's anxiety and stress in the classroom and describe mediating socio-technological processes that may have impacted outcomes. Findings showed improvement in children's ability to self-regulate anxiety and reduced cortisol levels for some children. Qualitative findings suggested that children who made multimodal connections during system mediated learning and had teacher support for learning transfer responded well to the intervention. We suggest that framing mental health app design as a distributed, adaptive, socio-technological system enables designers to better meet individual's unique and changing mental health needs.