Health App Use Among Individuals With Symptoms of Depression and Anxiety: A Survey Study With Thematic Coding

Background Researchers have largely turned to commercial app stores, randomized trials, and systematic reviews to make sense of the mHealth landscape. Few studies have approached understanding by collecting information from target end users. The end user perspective is critical as end user interest in and use of mHealth technologies will ultimately drive the efficacy of these tools. Objective The purpose of this study was to obtain information from end users of mHealth technologies to better understand the physical and mental health apps people use and for what purposes. Methods People with depressive or anxious symptoms (N=176) seeking entry into a trial of mental health and well-being apps for Android devices completed online questionnaires assessing depression and anxiety (Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7), past and current mental health treatment-seeking behavior, overall mobile device use, and use of mobile health apps. Participants reported the physical health and mental health apps on their devices and their reasons for using them. Data were extracted from the participant self-reports and apps and app purposes were coded in order to categorize them. Results Participants were largely white, middle-aged females from the Midwest region of the United States recruited via a health care organization and Web-based advertising (135 female, 41 male, mean age 38.64 years, age range 19-75 years.) Over three-quarters (137/176, 77.8%) of participants indicated having a health app on their device. The top 3 kinds of apps were exercise, fitness, and pedometers or heart rate monitoring apps (93/176, 52.8%); diet, food, or calorie counting apps (65/177, 36.9%); and mental health/wellness apps (46/177, 26.1%). The mean number of mobile physical and mental health apps on a participant’s phone was 2.15 (SD 3.195). Of 176 participants, 107 (60.8%) specifically reported the top 5 health apps that they used and their purposes. Across the 107 participants, a total of 285 apps were reported, with 139 being unique apps. The majority of these apps were free (129/139, 92.8%). Almost two-thirds of participants (67/107, 62.6%) reported using health apps at least on a daily basis. Conclusions Among those seeking support for their well-being via physical and mental health apps, people are using a variety of health apps. These people use health apps on a daily basis, especially free apps. The most common reason for using a health app is to track some health-related data; for mental health apps specifically, training or habit building was the most popular reason. Understanding the end user perspective is important because it allows us to build on the foundation of previously established mHealth research and may help guide future work in mHealth. Trial Registration Clinicaltrials.gov NCT02176226; https://clinicaltrials.gov/ct2/show/NCT02176226 (Archived by WebCite at http://www.webcitation.org/6rGc1MGyM)

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Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189694 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9694

Author(s):

Christina E. Miyawaki ◽

Erin D. Bouldin ◽

Christopher A. Taylor ◽

Lisa C. McGuire

Keyword(s):

Mental Health ◽

Baby Boomers ◽

Baby Boomer ◽

Well Being ◽

The United States ◽

Health Condition ◽

Behavioral Risk ◽

Physical And Mental Health ◽

Chi Square ◽

Weighted Estimates

One in four Baby Boomers fills the informal caregiver role in the United States. The objectives of this study were to estimate the prevalence of Baby Boomers who are informal caregivers for people living with dementia and compare their physical and mental health status to caregivers for persons with conditions other than dementia using 2015–2018 Behavioral Risk Factor Surveillance System data (N = 10,602). We identified caregiving status (assisting a family member/friend with a long-term illness or disability in the past month, managing personal care, and not caring for a child/grandchild) and whether the care recipient’s major health condition was dementia. We calculated weighted estimates and used chi-square tests and log-binomial regression for comparisons of selected characteristics. Among Baby Boomer caregivers, 15.4% were caring for someone with dementia. Dementia caregivers were more likely to be female, caring for a parent/parent-in-law, and providing care longer than caregivers for persons without dementia. After adjusting for sociodemographic and caregiving characteristics, the prevalence of fair/poor health, frequent mental distress, and chronic conditions were similar across types of caregivers. Although no differences in caregiver’s physical and mental health by care recipient’s dementia status were found, we should underscore the importance of maintaining Baby Boomer caregivers’ health and well-being.

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Quantitative Study of Individual Creative Caregiving Sessions on Well-Being of Caregivers and Care Recipients

Innovation in Aging ◽

10.1093/geroni/igaa057.244 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 74-75

Author(s):

Felicia Wheaton ◽

Safiyyah Cole ◽

Sai Raj Kappari ◽

Matilda Johnson

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Cost Effective ◽

Well Being ◽

The United States ◽

Physical And Mental Health ◽

Paired Samples ◽

The Arts ◽

Care Partners ◽

Arts Programs

Abstract There were approximately 34.2 million unpaid caregivers of adults age 50+ in the United States in the last 12 months (NAC & AARP, 2015). These individuals provide important care for older adults with physical, psychological and cognitive problems. There is a growing awareness that caregivers are also at risk for physical and mental health problems and therefore also require support to reduce stress and maintain optimal health. Research suggests that engaging in creative and artistic activities may reduce stress and improve physical and mental health among caregivers. Researchers from Bethune-Cookman University partnered with the Atlantic Center for the Arts in New Smyrna Beach, FL to evaluate their Creative Caregiving program. Approximately 10 informal caregivers and their care partners met for 2 hours each week over the course of 6 weeks from February 3-March 9, 2020. Participants learned how to connect mind, body and spirit by using the arts as a tool of self-care, social interaction, and learning. At each session, participants were asked to rate their overall wellbeing on a scale from 1-10. Pre- and post-session data was analyzed using paired samples t-tests. Results indicate that there was significant improvement in wellbeing and participants reported improvements in their stress, mood and relationship with their caregiver or care partner. These findings were observed for both caregivers and care partners, suggesting that arts programs can benefit both. Such programs are a fun and cost-effective way to improve wellbeing, at least in the short-term.

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Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study (Preprint)

10.2196/preprints.16476 ◽

2019 ◽

Author(s):

Philip I Chow ◽

Shayna L Showalter ◽

Matthew Gerber ◽

Erin M Kennedy ◽

David Brenin ◽

...

Keyword(s):

Breast Cancer ◽

Mental Health ◽

Mobile Phone ◽

The United States ◽

Cancer Center ◽

Measurement Information ◽

Depression And Anxiety ◽

Health Apps ◽

Distress Symptoms ◽

Patient Reported

BACKGROUND Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. OBJECTIVE The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. METHODS This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. RESULTS The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. CONCLUSIONS There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. INTERNATIONAL REGISTERED REPORT RR2-10.2196/11452

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Co-Designing a Mobile Application to Improve Mental Health and Well-being: Focus Group Study (Preprint)

10.2196/preprints.18172 ◽

2020 ◽

Author(s):

Felwah Alqahtani ◽

Andrea Winn ◽

Rita Orji

Keyword(s):

Mental Health ◽

Focus Group ◽

Well Being ◽

End Users ◽

Mobile App ◽

Health Issues ◽

Health Apps ◽

Mental Health Issues ◽

Relaxation Exercises ◽

Health And Well Being

BACKGROUND Recent advances in mobile technology have created opportunities to develop mobile applications (apps) to aid and assist people in achieving various health and wellness goals. Mental health apps hold significant potential to assist people suffering from various mental health issues at any time they may need it, considering the ubiquitous nature of mobile phones. However, there is a need for research exploring and understanding end-users’ perceptions, needs, and concerns with respect to such technologies. OBJECTIVE The goal of this paper is to explore the opinions, perceptions, preferences, and experiences of people who have experienced some forms of mental health issues based on self-diagnosis to inform the design of a next-generation mental health app that would be significantly more engaging and effective than currently available apps at improving mental health and well-being. METHODS We conducted six focus-group sessions with people who have experienced mental health issues based on self-diagnosis (Average age= 26.7, N = 32, 50% male, 50% female). We asked participants about their experiences with mental health issues and their viewpoints regarding two existing mental health apps (Happify app and the Self-Help Anxiety Management app). Finally, participants engaged in a design session where they each sketched a design for their ideal mental health and well-being mobile app. RESULTS Our findings revealed that participants used some strategies to deal with their mental health issues: 1) doing something to distract themselves from their current negative mood, 2) using relaxation exercises and methods to relieve symptoms, 3) interacting with others to share their issues, 4) looking for an external source to solve their problem, and 5) motivating themselves by repeating motivational sentences to support themselves or by following inspirational people. Moreover, regarding the design of mental health apps, participants identified that 1) general design characteristics, 2) personalization of the app, including 3) tracking and feedback, 4) live support, and 5) social community, and providing 6) motivational content and 7) relaxation exercises are the most important features users want in a mental health app. In contrast, including 8) games, 9) relaxation audio, 10) the Google map function, 11) personal assistance to provide suggestions, 12) goal setting, and 13) privacy preserving were surprisingly the least requested features. CONCLUSIONS Understanding end-users’ needs and concerns about mental health apps will inform the future design of mental health apps that are useful and used by many people. CLINICALTRIAL

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Social exclusion, mental health, and social well-being among African immigrants in the United States

International Social Work ◽

10.1177/0020872820963425 ◽

2021 ◽

pp. 002087282096342

Author(s):

Sherinah Saasa ◽

David Okech ◽

Yoon Joon Choi ◽

Larry Nackerud ◽

Tenesha Littleton

Keyword(s):

Mental Health ◽

United States ◽

Social Exclusion ◽

African Immigrants ◽

Well Being ◽

The United States ◽

Depression And Anxiety ◽

Negative Effects ◽

Economic Exclusion ◽

Social Work Interventions

This study examined the effects of social exclusion (socio-cultural and structural-economic exclusion) on the mental health and social well-being of African immigrants in the United States ( N = 409). We found that social exclusion increased depression and anxiety symptoms, decreased societal trust, increased subjective isolation, and increased worries about one’s safety among African immigrants. The results further indicated strong negative effects of discrimination on mental health and social well-being. The findings highlight the need for social work interventions that target discrimination and structural exclusionary mechanisms in efforts to improve the mental health and social well-being of African immigrants in the United States.

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Moderation of Physical Health on Emotional Health Among Grandparents Raising Grandchildren

Innovation in Aging ◽

10.1093/geroni/igaa057.1483 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 458-458

Author(s):

Yuqin Jiao ◽

Nathaniel Riggs ◽

Loriena Yancura ◽

Aimee Fox ◽

Christine Fruhauf

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Physical Health ◽

Emotional Health ◽

Depression Scale ◽

Indirect Evidence ◽

Well Being ◽

The United States ◽

Grandparents Raising Grandchildren ◽

Physical And Mental Health

Abstract An estimated 69.5 million older adults in the United States report being grandparents. It is also evident that the number of grandparents raising grandchildren among them is increasing. Although caring for their grandchildren often provides grandparents a sense of purpose and increased life satisfaction, unexpected responsibilities of parenting worsen the already challenging experience of aging (e.g., potential for poor physical and mental health). Thus, it is essential to study the well-being of grandparents raising grandchildren. Links between depressive symptoms and emotional health have been widely studied in previous research. However, limited research has focused on physical health as a potential moderator, despite indirect evidence shown that more depressive symptoms may be observed among those with worse physical health conditions. To address this, we used Optum® SF-36v2® Health Survey to collect physical- and mental-health data and Center for Epidemiological Studies Depression Scale (CES-D-10) to collect information on depressive symptoms in 137 grandparents raising grandchildren (age 40-83) before, immediately after, and six months after a six-week intervention focused on self-care practices. The presence of more depressive symptoms indicated worse emotional health. Physical health moderated these associations at all three time points, such that depressive symptoms were less strongly related to emotional health if grandparents self-reported better physical-health scores. These findings have important implications for future intervention studies. The importance of good physical health practices for grandparents raising grandchildren is evident, including increased physical engagement and better pain management.

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Complete Health: Prevalence and Predictors among U.S. Adults in 1995

American Journal of Health Promotion ◽

10.4278/0890-1171-17.2.122 ◽

2002 ◽

Vol 17 (2) ◽

pp. 122-131 ◽

Cited By ~ 8

Author(s):

Corey L. M. Keyes ◽

Joseph G. Grzywacz

Keyword(s):

Mental Health ◽

Mental Illness ◽

Well Being ◽

The United States ◽

Physical Illness ◽

Healthy Adults ◽

Mental Illnesses ◽

Physical And Mental Health ◽

Complete Health ◽

Low Levels

Purpose. To operationalize, estimate the prevalence, and ascertain the epidemiology of complete health. Design. Cross-sectional analyses of self-reported survey data collected via a telephone interview and a self-administered questionnaire. Setting. Households in the 48 contiguous states in the United States in 1995. Subjects. Random-digit dialing sample of 3032 adults between the ages of 25 and 74, with a response rate of 61%. Measures. Physical illness and health were measured with a total of 37 items—a checklist of 29 chronic health conditions, a six-item scale of limitations of daily living, and a single item for perceived current health and for perceived 5-year change in energy. Mental illness and health were measured with the Composite International Diagnostic Interview Short Form diagnostic scale of major depression, panic, and generalized anxiety disorders and three established multi-item scales of subjective well-being (emotional, psychological, and social well-being). Completely healthy adults have high levels of physical and mental health and low levels of physical and mental illnesses; completely unhealthy adults have high levels of physical and mental illnesses and low levels of physical and mental health. Incompletely healthy adults consisted of two groups: one group is physically healthy (high physical health and low physical illness) and mentally unhealthy, and the second group is mentally healthy (high mental health and low mental illness) and physically unhealthy. Results. Nineteen percent of adults were completely healthy, 18.8% were completely unhealthy, and 62.2% had a version of incomplete health. Compared with completely unhealthy adults, completely healthy adults are likely to be young (25–34 years of age) or old (55–64 and 65–74 years), are married, are male, are college educated, and have higher household incomes. Conclusions. Operationalizing complete health highlights objectives for increasing the prevalence of complete health, and reducing the prevalence of complete ill-health and incomplete health.

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Promoting Gender Equality by Supporting Men’s Emotional Flexibility

Policy Insights from the Behavioral and Brain Sciences ◽

10.1177/2372732220984491 ◽

2021 ◽

Vol 8 (1) ◽

pp. 42-49

Author(s):

Alyssa Croft ◽

Ciara Atkinson ◽

Alexis M. May

Keyword(s):

Mental Health ◽

Gender Equality ◽

Gender Stereotypes ◽

Well Being ◽

The United States ◽

Policy Recommendations ◽

Physical And Mental Health ◽

Psychological Barriers ◽

Emotional Flexibility ◽

Health And Well Being

Progress toward gender equality has slowed or stalled in recent years, primarily because gender stereotypes and roles are changing more quickly for women than men. Women are increasingly free to behave more like men, whereas a similar freedom for men (to behave more like women) has been slower to emerge. Expectations governing men remain rigid: They are discouraged from showing weakness/vulnerability and encouraged to assert masculinity by demonstrating strength/toughness. These expectations undermine men’s emotional flexibility, which not only harms their physical health and well-being but also systematically impedes gender equality efforts. We summarize both the direct and indirect consequences of men’s relative emotional inflexibility, as well as cultural and psychological barriers to men’s emotional flexibility development. We then provide empirically based policy recommendations for cultivating emotional flexibility in men, which could in turn foster their physical and mental health, undermine traditional gender stereotypes, and promote broader gender equality in the United States.

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Coping During the COVID-19 Pandemic: A Qualitative Study of Older Adults Across the United States

Frontiers in Public Health ◽

10.3389/fpubh.2021.643807 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jessica M. Finlay ◽

Jasdeep S. Kler ◽

Brendan Q. O'Shea ◽

Marisa R. Eastman ◽

Yamani R. Vinson ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Older Adults ◽

Coping Strategies ◽

Daily Life ◽

Qualitative Content Analysis ◽

Well Being ◽

The United States ◽

Physical And Mental Health ◽

Sample Mean

Objective: Older adults may struggle with stresses and daily life challenges associated with the Coronavirus Disease 2019 (COVID-19) pandemic. Yet they may also utilize emotional and behavioral coping strategies. This qualitative paper aims to identify ways of coping with worries and stress during the pandemic from the perspectives of older adults in the United States.Methods: The COVID-19 Coping Study recruited 6,938 adults aged ≥55 through online multi-frame sampling from April 2-May 31, 2020 across all 50 US states, the District of Columbia, and Puerto Rico. The online questionnaire focused on the effects of COVID-19 on daily life, mental health, and well-being. This included an open-ended question regarding participants' coping strategies. We used qualitative content analysis to identify and code diverse coping strategies. Our general inductive approach enabled findings to emerge from the most frequent and dominant themes in the raw data.Results: A total of 5,180 adults [74% of the total sample; mean age 67.3 (SD 7.9); 63.8% female] responded to the question about using strategies to cope with living through the COVID-19 pandemic. Frequently-reported strategies included exercising and going outdoors, modifying routines, following public health guidelines, adjusting attitudes, and staying socially connected. Some coping strategies were health-limiting (e.g., overeating), while most strategies encouraged self-improvement, positive adjustment, and wellness.Conclusions: This study provides novel qualitative evidence on coping strategies of older adults early in the COVID-19 pandemic. Findings can inform community and clinical interventions to support older adults that harness positive coping strategies such as exercise, modified routines, and social strategies to improve physical and mental health, foster social support, and encourage meaningful daily activities during times of stress and trauma.

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Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study

JMIR Cancer ◽

10.2196/16476 ◽

2020 ◽

Vol 6 (1) ◽

pp. e16476 ◽

Cited By ~ 1

Author(s):

Philip I Chow ◽

Shayna L Showalter ◽

Matthew Gerber ◽

Erin M Kennedy ◽

David Brenin ◽

...

Keyword(s):

Breast Cancer ◽

Mental Health ◽

Mobile Phone ◽

The United States ◽

Cancer Center ◽

Measurement Information ◽

Depression And Anxiety ◽

Health Apps ◽

Distress Symptoms ◽

Patient Reported

Background Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. Objective The aim of this study was to evaluate the feasibility of in-clinic recruitment for a mobile phone app study and to evaluate the usability and preliminary impact of a suite of mental health apps (IntelliCare) with phone coaching on psychosocial distress symptoms in patients recently diagnosed with breast cancer. Methods This pilot study adopted a within-subject, 7-week pre-post study design. A total of 40 patients with breast cancer were recruited at a US National Cancer Institute–designated clinical cancer center. Self-reported distress (Patient Health Questionnaire-4) and mood symptoms (Patient-Reported Outcomes Measurement Information System depression and anxiety scales) were assessed at baseline and postintervention. App usability was assessed at postintervention. Results The minimum recruitment threshold was met. There was a significant decrease in general distress symptoms, as well as symptoms of depression and anxiety, from baseline to postintervention. Overall, participants reported high levels of ease of app use and learning. Scores for app usefulness and satisfaction were reinforced by some qualitative feedback suggesting that tailoring the apps more for patients with breast cancer could enhance engagement. Conclusions There is a dire need for scalable, supportive interventions in cancer. The results from this study inform how scalable mobile phone–delivered programs with additional phone support can be used to support patients with breast cancer. International Registered Report Identifier (IRRID) RR2-10.2196/11452

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