A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial

Background Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. Objective This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. Methods Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t1), midintervention (t4=4 weeks after t1) and postintervention (t8=8 weeks after t1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. Results Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t4 and t8 assessments were equally distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F2,426=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F2,426=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F2,426=5.50; P=.004 and F2,426=8.59; P<.001, respectively). Conclusions The well-being mobile app was effective in reducing employee stress and improving well-being. Trial Registration Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

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A New Mental Health Mobile App for Well-Being and Stress Reduction in Working Women: Randomized Controlled Trial (Preprint)

10.2196/preprints.14269 ◽

2019 ◽

Author(s):

Cássia Canha Coelhoso ◽

Patricia Renovato Tobo ◽

Shirley Silva Lacerda ◽

Alex Heitor Lima ◽

Carla Regina Camara Barrichello ◽

...

Keyword(s):

Mental Health ◽

Repeated Measures ◽

Intervention Group ◽

Working Women ◽

Well Being ◽

Mobile App ◽

World Health ◽

Control Group ◽

Work Related

BACKGROUND Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. OBJECTIVE This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. METHODS Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (<italic>t</italic>1), midintervention (<italic>t</italic>4=4 weeks after <italic>t</italic>1) and postintervention (<italic>t</italic>8=8 weeks after <italic>t</italic>1). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. RESULTS Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete <italic>t</italic>4 and <italic>t</italic>8 assessments were equally distributed between groups (<italic>t</italic>4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; <italic>P</italic>=.16; <italic>t</italic>8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; <italic>P</italic>=.10). Both groups showed a significant increase in general well-being as a function of time (<italic>F</italic>2,426=5.27; <italic>P</italic>=.006), but only the intervention group presented a significant increase in work-related well-being (<italic>F</italic>2,426=8.92; <italic>P</italic><.001), as well as a significant reduction in work-related and overall stress (<italic>F</italic>2,426=5.50; <italic>P</italic>=.004 and <italic>F</italic>2,426=8.59; <italic>P</italic><.001, respectively). CONCLUSIONS The well-being mobile app was effective in reducing employee stress and improving well-being. CLINICALTRIAL Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.

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Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

10.2196/preprints.30976 ◽

2021 ◽

Author(s):

Silvina Catuara-Solarz ◽

Bartlomiej Skorulski ◽

Inaki Estella ◽

Claudia Avella-Garcia ◽

Sarah Shepherd ◽

...

Keyword(s):

Mental Health ◽

Perceived Stress ◽

Intervention Group ◽

Well Being ◽

Self Report ◽

World Health ◽

Randomised Control Trial ◽

Control Group ◽

Mental Well Being ◽

Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

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Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial (Preprint)

10.2196/preprints.17541 ◽

2019 ◽

Author(s):

Matthew Fuller-Tyszkiewicz ◽

Ben Richardson ◽

Keriann Little ◽

Samantha Teague ◽

Linda Hartley-Clark ◽

...

Keyword(s):

Active Control ◽

Psychological Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Self Esteem ◽

Mobile App ◽

Control Group ◽

Self Monitoring

BACKGROUND Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. OBJECTIVE This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. METHODS In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. RESULTS In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). CONCLUSIONS This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

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Destress 9-1-1—an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105598 ◽

2019 ◽

Vol 76 (10) ◽

pp. 705-711 ◽

Cited By ~ 1

Author(s):

Michelle Lilly ◽

Rebecca Calhoun ◽

Ian Painter ◽

Randal Beaton ◽

Scott Stangenes ◽

...

Keyword(s):

Repeated Measures ◽

Controlled Trial ◽

Intervention Group ◽

Future Research ◽

Control Group ◽

Post Intervention ◽

Work Related ◽

Emergency Medical ◽

Emergency Medical Dispatchers

ObjectivesEmergency medical dispatchers (EMDs) experience significant stress in the workplace. Yet, interventions aimed at reducing work-related stress are difficult to implement due to the logistic challenges associated with the relatively unique EMD work environment. This investigation tested the efficacy of a 7-week online mindfulness-based intervention (MBI) tailored to the EMD workforce.MethodsActive-duty EMDs from the USA and Canada (n=323) were randomly assigned to an intervention or wait list control condition. Participants completed surveys of stress and mindfulness at baseline, post intervention, and 3 months follow-up. Repeated measures mixed effects models were used to assess changes in stress and mindfulness.ResultsDifferences between the intervention group and control group in pre–post changes in stress using the Calgary Symptoms of Stress Inventory were statistically significant, with a difference of −10.0 (95% CI: −14.9, −5.2, p<0.001) for change from baseline to post intervention, and a difference of −6.5 (95% CI: −11.9, −1.1, p=0.02) for change from baseline to 3 months follow-up. Change in mindfulness scores did not differ between groups. However, increases in mindfulness scores were correlated with greater reductions in stress for all participants, regardless of group (r=−0.53, p<0.001).ConclusionsDevelopment of tailored online MBIs for employees working in challenging work environments offer a promising direction for prevention and intervention. This study found that a short, weekly online MBI for EMDs resulted in reductions in reports of stress. Implications of online MBIs in other emergency responding populations and directions for future research are discussed.

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Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

JMIR Mental Health ◽

10.2196/17541 ◽

2020 ◽

Vol 7 (7) ◽

pp. e17541

Author(s):

Matthew Fuller-Tyszkiewicz ◽

Ben Richardson ◽

Keriann Little ◽

Samantha Teague ◽

Linda Hartley-Clark ◽

...

Keyword(s):

Active Control ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Self Esteem ◽

Mobile App ◽

Trial Registration ◽

Control Group ◽

Self Monitoring

Background Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. Objective This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. Methods In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. Results In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). Conclusions This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

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Improving Staff-Family End-of-Life Communication at Israeli Geriatric Facilities by Using a Mobile App

Innovation in Aging ◽

10.1093/geroni/igab046.1987 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 517-517

Author(s):

Rinat Cohen ◽

Gal Maydan ◽

Shai Brill ◽

Jiska Cohen-Mansfield

Keyword(s):

End Of Life ◽

Repeated Measures ◽

Group Intervention ◽

Medical Center ◽

Intervention Group ◽

Well Being ◽

Mobile App ◽

Control Group ◽

End Of Life Communication

Abstract Family caregivers (FCs) of persons institutionalized at geriatric facilities present significant unmet communication needs regarding receiving regular updates about their loved one’s condition and having available healthcare professionals (HPs) to approach when needed. We developed and tested a mobile-app for staff-family communication with both parties having active roles in app planning to tailor it to their needs and abilities. The app includes a daily-update module for FCs and a chat option for FCs and HPs. App use was piloted at one geriatric-medical-center for 15 months (unit-level randomization resulted in one complex-care and one assisted-ventilation unit in each group- intervention and control) and one single-unit nursing-home for three months. Personal interviews were conducted with 55 FCs (28 from intervention-group and 27 FCs from control-group) before-and-after app use (with mean duration of use 1.6[S.D.=.6] months. Most participants were women and the children of the patients; their mean age was 55.9 years (S.D.=12.4). Repeated-measures Analysis-of-Variance for the end-of-life communication sub-scale on the Quality-of-communication questionnaire yielded a main effect for time (F(1,53)=8.31, p=.006) with both groups’ ratings increasing over time and an interaction effect (F(1,53)=4.78, p=.033) with a greater increase for intervention-group compared to control-group. Intervention-group participants rated the app as convenient to use. Qualitative data revealed that FCs perceived app use as improving quality of communication with the HPs who used it and improving their own well-being. The app offers a feasible and an effective mode of communication that incorporates technology in daily communication between FCs and HPs while addressing FCs’ unmet needs.

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Is there an app for that? A cluster randomised controlled trial of a mobile app–based mental health intervention

Health Informatics Journal ◽

10.1177/1460458219884195 ◽

2019 ◽

Vol 26 (3) ◽

pp. 1538-1559 ◽

Cited By ~ 3

Author(s):

Rachel Kenny ◽

Amanda Fitzgerald ◽

Ricardo Segurado ◽

Barbara Dooley

Keyword(s):

Mental Health ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Cluster Randomised Controlled Trial ◽

Well Being ◽

Mobile App ◽

Control Group ◽

Cluster Randomised ◽

Randomised Controlled

Demand for the use of mobile apps in mental health interventions has grown in recent years, particularly among adolescents who experience elevated levels of distress. However, there is a scarcity of evidence for the effectiveness of these tools within this population. The aim of this study was to test the effectiveness of CopeSmart, a mental health mobile app, using a multicentre cluster randomised controlled trial design. Participants were 15–18-years-olds (N = 560) recruited from 10 schools randomly assigned to an intervention or control condition. Intervention participants used the app over a 4-week period. Multi-level modelling analyses revealed no significant changes in the intervention group from pre-test to post-test, when compared to the control group, in terms of emotional distress, well-being, emotional self-awareness or coping strategies. Findings suggest that a 4-week app-based intervention may not be enough to elicit intra-personal changes in mental health outcomes in a general adolescent population.

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Randomized Trial Investigating of a Single-Session Character-Strength-Based Cognitive Intervention on Freshman’s Adaptability

Research on Social Work Practice ◽

10.1177/1049731517699525 ◽

2017 ◽

Vol 29 (1) ◽

pp. 82-92 ◽

Cited By ~ 12

Author(s):

Wenjie Duan ◽

He Bu

Keyword(s):

Randomized Trial ◽

Repeated Measures ◽

Intervention Group ◽

Well Being ◽

Cognitive Intervention ◽

Control Group ◽

Single Session ◽

Character Strength ◽

Strength Based

Purpose: To investigate the efficiency of a single-session character-strength-based cognitive intervention on enhancing freshmen’s adaptability. Method: A randomized trial, pretest, posttest, follow-up intervention was employed using repeated-measures analyses to evaluate the effect. This 90-min intervention contained four activities with 52 undergraduate freshmen (age 17–20) randomly assigned to the intervention and control group, 38 of whom completed all the programs (19 of each group). Results: Compared with the control group, the intervention group showed a remarkable increase in well-being and a significant reduction in depression and anxiety at post and follow-up assessment. The stress level of the intervention group significantly decreased only at the follow-up test. Time effect and the interaction between time and group were significant in anxiety and stress. Conclusions: This intervention can quickly reduce negative affect and elevate well-being for freshmen. It expands the role of social worker in the prevention of mental illness among college population.

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Assessing the impact of the European resilience curriculum in preschool, early and late primary school children

School Psychology International ◽

10.1177/01430343211025075 ◽

2021 ◽

pp. 014303432110250

Author(s):

Celeste Simões ◽

Anabela C. Santos ◽

Paula Lebre ◽

João R. Daniel ◽

Cátia Branquinho ◽

...

Keyword(s):

Mental Health ◽

Intervention Group ◽

Well Being ◽

Primary School Children ◽

Control Group ◽

Physical And Mental Health ◽

Quasi Experimental ◽

Mental Health Difficulties ◽

Prosocial Behaviours ◽

The Impact

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.

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The Effectiveness of Little Bird Programme on Improvement of Mental Health and Decrease Parental Stress in Mothers of Autistic Children

European Psychiatry ◽

10.1016/s0924-9338(09)71106-x ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

R. Khorramabadi ◽

H. Pouretemad ◽

M. Dehghani ◽

M. Mazaheri

Keyword(s):

Mental Health ◽

Parental Stress ◽

Intervention Group ◽

Control Group ◽

Autistic Children

This study was a trail of an intervention named Little Bird aimed to decrease parental stress and improve mental health in mothers of autistic children. The sample was 24 mothers of autistic children. The intervention compared across two groups, an intervention group and non-intervention control group. The result indicate that, compared with the control group, mothers in intervention group reported significant improvement in mental health and significant decrease in parental stress following the intervention, at the end of programme and 1 month follow-up.

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