Abstract: Objective Youth mental health is a global challenge often compounded by fragmented services limiting access. In Canada, Integrated Youth Services (IYS) provide centralized access to youth health services, with youth engagement playing a key role during development and implementation. This study aims to identify key factors influencing youth engagement in mobile health (mHealth) development within an IYS setting. Methods We conducted 23 semi-structured interviews with youth, clinical service providers, and non-clinical staff involved in mHealth services at Foundry. The Consolidated Framework for Implementation Research guided deductive thematic analysis. Results We identified key facilitators and barriers across five domains: Recognizing core value of engagement, improving external coordination, addressing internal organizational challenges, mitigating power imbalances, and tailoring implementation strategies. Conclusion The findings highlight the need for inclusive approaches, regulatory frameworks, and strategies to engage underrepresented youth. Future efforts should prioritize iterative learning systems and safe, supportive spaces for meaningful youth engagement.
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