Usability Testing of a Technology-Based Bystander Bullying Intervention for Middle School Students in Rural, Low-Income Communities: A Mixed-Methods Study.

Abstract

BACKGROUND\nStudents who are targets of bullying and who witnessing bullying as bystanders are at high risk for negative mental health outcomes including depression, anxiety, and suicidal ideation. Bystander training is essential to reduce both bullying and the negative associated consequences for targets and bystanders. Resources necessary for program delivery, however, pose significant implementation barriers to schools, particularly those in rural, low-income communities. Technology-based programs can reduce health disparities for student in these communities through a cost-effective, easy to disseminate programming.\n\n\nOBJECTIVE\nThe aim of this study was to conduct usability testing of a prototype of a bystander bullying web app (STAC-T) as an initial step in the development of a the full-scale STAC-T intervention. Objectives included assessing the usability and acceptability of the STAC-T prototype; understanding school needs and barriers to program implementation, and assessing differences in usability between school personnel and students.\n\n\nMETHODS\nA sample of 16 participants including school personnel and students recruited from three middle schools in rural, low-income communities completed usability testing followed by a qualitative interview. Descriptive statistics, independent sample t-tests, and consensual qualitative research (CQR) were used to assess usability and program satisfaction and to extract themes related to acceptability, feasibility, needs, barriers, and feedback for intervention development.\n\n\nRESULTS\nUsability testing indicated the app was easy to use, acceptable, and feasible. Both school personnel (M = 89.6, SD = 5.1) and students (M = 91.8, SD = 7.0) rated the app well above the standard cutoff score for above average usability (i.e., 68.0) and both school personnel (M = 5.83, SD = 0.41) and students (M = 6.10, SD = 0.57) gave the app high user-friendliness ratings (0-7 scale, with 7 high user-friendliness). Overall ratings also suggested school personnel and students were satisfied with the program. Among school personnel, 100% (n = 6) said they would recommend the program to others and 17% (n = 1), 66% (n = 4), and 17% (n = 1) rated the program as 3, 4, and 5 stars, respectively. Among students, 80% (n = 8) said they would recommend the program to others and 60% (n = 6) and 40% (n = 4) rated the program as 4 stars and 5 stars, respectively. Qualitative data revealed that both school personnel and students found the STAC-T app was useful, user-friendly, and relevant, while providing feedback related to the importance of virtual interaction. Data from school personnel also indicated positive perceptions regarding program feasibility and probability of program adoption, with the most significant barrier being cost, suggesting the importance of considering the financial resources available to schools in rural, low-income communities when setting the price point for the full-scale STAC-T intervention.\n\n\nCONCLUSIONS\nThis study provides support for the development of the full-scale development of the STAC-T app and provides key information for revision to enhance used engagement.\n\n\nCLINICALTRIAL\nClinicaltrials.gov NCT04681495.