Table 4.

Qualitative themes uncovered and example quotes regarding HealthySMS’s acceptability

Theme	Example quote supporting acceptability	Example quote about limited acceptability
Group reminders	“I liked it, because sometimes when things got a little hectic, I would forget about group so it’s a useful reminder.”	“They weren't the most helpful, especially because I'm pretty sure I only ever got one text and it was just ‘there is group tomorrow. Don’t forget your binder,’ which I realize is probably works a lot better when you actually have to go somewhere to do it. But like I already said, I have nothing else going on [in quarantine], so I remember yep, that’s tomorrow. I felt like there definitely could be some variation in things like maybe it could bring up, like, remember the skills you learned or don’t be scared to share or something like that, that could be a little more emotional based.”
Personalized response texts	“I did like how if your mood was like a bad mood, it would give you like, it wouldn’t it just be like that sucks feel better, but it would give you like advice and strategies of how you can get better. I think that was nice. And I liked when if you were in a good mood, it would kind of still give you like a different kind of advice to keep you in that space and like be like, like you could use that experience to feel better later when you remember.”	“...having a little bit of background about like who it is I’m responding to, like, is it a computer or is it a person like this data is being used for what, kind of thing might be helpful.”
Mood ratings	“The rating of the mood...it kind of helped me figure out how I was feeling, like in a number form.”	“I would say it was kind of easy when I was like doing super well or super bad..., but little bit harder, I guess, like to be: ‘OK, well, I don’t really know. I’m average.’”
Skill reminder texts overall	“I thought they really were helpful...a really nice boost, and it was and it would remind me of the other things I had learned that I could also use to feel better.”	“Um if I was able to do something like kind of just the reminder was helpful. But with COVID a lot of the times, it wasn’t applicable.”
Activity skill reminders	“I always think it’s good to like set goals for yourself so you have something to work towards. So it’s almost like a little bit of motivation.”	“...like: ‘do a new activity’...a lot of activities have like kind of gotten harder to do with everything [in the context of the COVID-19 pandemic].”
Social skill reminders	“I liked the people [texts], because I struggle with my relationships with people.”	“Sometimes I couldn’t hang out with friends. So then sometimes that even made me, like, a little frustrated.”
Cognition skill reminders	“I think sometimes like I get so stuck in like the past or just like in the moment that it’s good to just like think about your future and like the good things that are to come.”	“...it was just odd getting text telling me to, like, change the way I’m thinking because I know like the way my brain works, it’s not going to just happen...So it was just annoying because I would like to make [the thoughts] go away, but they’re not going to.”
Statements vs questions	“I felt that they were good, I like them more when they were more statement based...I felt that just a clear like statement or like advice boost helped more for me personally.”	“I got confused a bit with the questions they’d ask because I wasn’t sure if I was supposed to, like, respond to them and it would respond back or it was just kind of a moment to reflect.”