Acceptability and Preliminary Evaluation of a Campus-Integrated Digital Platform (Fruto) for University Students' Mental Health Help-Seeking: Sequential Mixed Methods Study.

Abstract

College 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. This 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. We 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. Scenario-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. Fruto 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. Clinical Research Information Service KCT0010622; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=30274&search_page=L.