Table 4.

Facilitators and barriers to young people’s engagement with eOrygen as a blended model of care integrated into specialized services.

		Description
Facilitators
	Clinician endorsement	Clinician endorsement of eOrygen seemed to increase young people’s trust in the platform. Several participants mentioned that their clinician’s recommendation to use eOrygen was central to their signing up to use the platform.
	Professional peer support workers	The presence of professional peer support workers on the platform was engaging and increased young people’s sense of safety in the community space.
	Community, connection, and belonging	Participants appreciated interacting with other young people or sharing space on the platform, even if they did not post much themselves. The sense of community and connection was a facilitator for engagement.
	Personalized therapy content	Young people found it helpful when clinicians recommended specific content aligned with their therapeutic work in face-to-face sessions. Therapeutic modules and resources within the platform were seen as valuable, trustworthy, and informative.
	Blended care	Young people commonly reported that eOrygen was used for between-sessions work. Follow-up discussions in sessions regarding the homework were described as helpful and valuable for consolidating learning and providing accountability to support homework completion.
	Ease of use	When participants found the platform easy to navigate and understand, it positively impacted their engagement.
Barriers
	Low motivation	Several participants mentioned a general lack of motivation as a barrier to engagement.
	Social anxiety	Some participants experienced anxiety or insecurity related to social interactions on the platform. This social anxiety acted as a barrier, and participants reported feeling too anxious to post or reply to other young people’s posts. Several young people felt anxiety about the perceived lack of clarity regarding the rules of the online community.
	Privacy concerns	Privacy and confidentiality concerns were mentioned by some participants, impacting their willingness to engage fully with the platform. Some young people reported that uncertainty about who could see their posts or information raised anxiety. Several young people expressed discomfort at the thought of their face-to-face clinician viewing personal content that they may post on the platform’s social network.
	Inflexible module progression	One interviewee identified the inability to skip sections or activities within a therapy module as a barrier and requested more autonomy when engaging with therapy modules. Some participants described desiring more flexibility with how they engaged with content, such as wanting to change therapy journeys (eg, from depression to anxiety) but not being able to.
	Limited content and interactions	Periods of low activity or limited content being posted by other young people on the platform could lead to reduced engagement. Participants mentioned that the lack of new posts or interactions could be discouraging. More young people and greater interaction was requested by several young people.