Corona Health—A Study- and Sensor-Based Mobile App Platform Exploring Aspects of the COVID-19 Pandemic

Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing such an app is not trivial, necessitates strict regulatory and legal requirements, and requires short development cycles to appropriately react to abrupt changes in the pandemic. Based on an existing app framework, we developed Corona Health, an app that serves as a platform for deploying questionnaire-based studies in combination with recordings of mobile sensors. In this paper, we present the technical details of Corona Health and provide first insights into the collected data. Through collaborative efforts from experts from public health, medicine, psychology, and computer science, we released Corona Health publicly on Google Play and the Apple App Store (in July 2020) in eight languages and attracted 7290 installations so far. Currently, five studies related to physical and mental well-being are deployed and 17,241 questionnaires have been filled out. Corona Health proves to be a viable tool for conducting research related to the COVID-19 pandemic and can serve as a blueprint for future EMA-based studies. The data we collected will substantially improve our knowledge on mental and physical health states, traits and trajectories as well as its risk and protective factors over the course of the COVID-19 pandemic and its diverse prevention measures.

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Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders

Journal of Clinical Medicine ◽

10.3390/jcm9020322 ◽

2020 ◽

Vol 9 (2) ◽

pp. 322 ◽

Cited By ~ 6

Author(s):

Claire R. van Genugten ◽

Josien Schuurmans ◽

Femke Lamers ◽

Harriëtte Riese ◽

Brenda W. J. H. Penninx ◽

...

Keyword(s):

Ecological Momentary Assessment ◽

Affective Disorders ◽

Negative Impact ◽

Well Being ◽

High Rate ◽

Healthy Controls ◽

Perceived Burden ◽

Ecological Momentary ◽

Mental Well Being ◽

Momentary Assessment

(1) Background: The use of smartphone-based ecological momentary assessment (EMA) questionnaires in affective disorder research has rapidly increased. Though, a thorough understanding of experienced burden of and adherence to EMA is crucial in determining the usefulness of EMA. (2) Methods: Persons with current affective disorders (n = 100), remitted persons (n = 190), and healthy controls (n = 94) participated in a smartphone-based EMA two-week monitoring period. Our primary outcomes were (momentary) perceived burden of and adherence to EMA. (3) Results: In the whole sample, lower positive and higher negative affect were associated with slightly higher levels of perceived momentary burden (B = −0.23 [95%CI = −0.27–0.19], B = 0.30 [95%CI = 0.24–0.37], respectively). The persons with current affective disorders reported slightly higher levels of experienced momentary burden (Mdn = 1.98 [IQR = 1.28–2.57]), than the remitted persons (Mdn = 1.64 [IQR = 1.11–2.24]) and healthy controls (Mdn = 1.28 [IQR = 1.04–1.92]). Nevertheless, the persons with current affective disorders still showed very high adherence rates (Mdn = 94.3% [IQR = 87.9–97.1]), at rates on a par with the remitted persons (Mdn = 94.3% [IQR = 90.0–97.1]) and healthy controls (Mdn = 94.3% [IQR = 90.0–98.6]). (4) Discussion: Frequent momentary questionnaires of mental well-being are slightly more burdensome to the persons with current affective disorders, but this does not seem to have a negative impact on adherence. Their high rate of adherence to EMA—which was similar to that in remitted persons and healthy controls —suggests that it is feasible to apply (short-duration) EMA.

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Mental Health of Young Australians during the COVID-19 Pandemic: Exploring the Roles of Employment Precarity, Screen Time, and Contact with Nature

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115630 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5630

Author(s):

Tassia K. Oswald ◽

Alice R. Rumbold ◽

Sophie G. E. Kedzior ◽

Mark Kohler ◽

Vivienne M. Moore

Keyword(s):

Mental Health ◽

Mental Illness ◽

Young People ◽

Protective Factors ◽

Screen Time ◽

Well Being ◽

Core Beliefs ◽

Health States ◽

Precarious Employment ◽

Mental Well Being

The coronavirus disease 2019 (COVID-19) pandemic is widely understood to have contributed to mental health problems. In Australia, young people (18–24 years) have been disproportionately affected. To date, research has predominantly focused on the presence or absence of mental illness symptoms, while aspects of mental well-being have been overlooked. We aimed to explore associations between potential risk and protective factors and mental health more comprehensively, using the Complete State Model of Mental Health. An online survey of 1004 young Australians (55% female; M age = 21.23) was undertaken. Assessment of both mental illness and mental well-being enabled participants to be cross-classified into four mental health states. Those with ‘Floundering’ (13%) or ‘Struggling’ (47.5%) mental health reported symptoms of mental illness; a ‘Languishing’ group (25.5%) did not report symptoms of mental illness but mental well-being was compromised relative to those who were ‘Flourishing’ (14%) with high mental well-being. Multinomial logistic regressions were used to examine associations, adjusting for socio-demographic confounders. Protective factors associated with Flourishing mental health included being in secure employment, using screen time to connect with others, and reporting high levels of hope. Both incidental and purposive contact with nature were also associated with Flourishing, while a lack of green/bluespace within walking distance was associated with Languishing, absence of outdoor residential space was associated with Floundering, and lower neighbourhood greenness was associated with all three suboptimal mental health states. Precarious employment, financial stress, living alone, reporting decreased screen time during lockdowns, lower levels of hope, and high disruption of core beliefs were also associated with Struggling and Floundering mental health. Those who were Languishing reported somewhat less hardship and little disruption to core beliefs, but lower levels of hope compared to young people who were Flourishing. This study highlights that young adults require dedicated mental health services to deal with current burden, but should also be supported through a range of preventive strategies which target mental health risk factors, like precarious employment, and enhance protective factors, such as urban green infrastructure.

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Efficacy and Moderation of Mobile App–Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial

JMIR Mental Health ◽

10.2196/mental.8597 ◽

2018 ◽

Vol 5 (4) ◽

pp. e60 ◽

Cited By ~ 25

Author(s):

Winnie WS Mak ◽

Alan CY Tong ◽

Sindy YC Yip ◽

Wacy WS Lui ◽

Floria HN Chio ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Mobile Apps ◽

Well Being ◽

Mobile App ◽

Cognitive Behavioral ◽

Mindful Awareness ◽

Self Compassion ◽

Mental Well Being

Background Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health. Objective The aim of this study was to examine the efficacy of 3 mobile app–based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation. Methods This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators. Results Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users’ satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant. Conclusions Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs. Trial Registration Chinese Clinical Trial Registry (ChiCTR) ChiCTR-TRC-13003468; http://www.chictr.org.cn/hvshowproject.aspx?id=6220 (Archived by WebCite at http://www.webcitation.org/734PlOz50)

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Efficacy of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve Mental Well-Being Among University Students: Randomized Controlled Trial (Preprint)

10.2196/preprints.17767 ◽

2020 ◽

Author(s):

Sonia Ponzo ◽

Davide Morelli ◽

Jamie M Kawadler ◽

Nicola Rose Hemmings ◽

Geoffrey Bird ◽

...

Keyword(s):

University Students ◽

Controlled Trial ◽

Well Being ◽

Mobile App ◽

Control Group ◽

Full Time ◽

Digital Version ◽

Sustained Effects ◽

Mental Well Being

BACKGROUND University students in the United Kingdom are experiencing increasing levels of anxiety. A program designed to increase awareness of one’s present levels of well-being and suggest personalized health behaviors may reduce anxiety and improve mental well-being in students. The efficacy of a digital version of such a program, providing biofeedback and therapeutic content based on personalized well-being metrics, is reported here. OBJECTIVE The aim of this study was to test the efficacy and sustained effects of using a mobile app (BioBase) and paired wearable device (BioBeam), compared with a waitlist control group, on anxiety and well-being in university students with elevated levels of anxiety and stress. METHODS The study employed a randomized, waitlist-controlled trial with assessments at baseline, 2 weeks, postintervention (4 weeks), and follow-up (6 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored >14 points on the Depression, Anxiety, and Stress Scale-21 items (DASS-21) stress subscale or >7 points on the DASS-21 anxiety subscale, (3) owned an iOS mobile phone, (4) did not have any previous psychiatric or neurological conditions, (6) were not pregnant at the time of testing, and (7) were able to read and understand English. Participants were encouraged to use BioBase daily and complete at least one course of therapeutic content. A <i>P</i> value ≤.05 was considered statistically significant. RESULTS We found that a 4-week intervention with the BioBase program significantly reduced anxiety and increased perceived well-being, with sustained effects at a 2-week follow-up. Furthermore, a significant reduction in depression levels was found following the 4-week usage of BioBase. CONCLUSIONS This study shows the efficacy of a biofeedback digital intervention in reducing self-reported anxiety and increasing perceived well-being in UK university students. Results suggest that digital mental health interventions could constitute a novel approach to treat stress and anxiety in students, which could be combined or integrated with existing therapeutic pathways. CLINICALTRIAL Open Science Framework (OSF.io) 2zd45; https://osf.io/2zd45/

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A Web- and Mobile App–Based Mental Health Promotion Intervention Comparing Email, Short Message Service, and Videoconferencing Support for a Healthy Cohort: Randomized Comparative Study

Journal of Medical Internet Research ◽

10.2196/15592 ◽

2020 ◽

Vol 22 (1) ◽

pp. e15592 ◽

Cited By ~ 3

Author(s):

Melanie Elise Renfrew ◽

Darren Peter Morton ◽

Jason Kyle Morton ◽

Jason Scott Hinze ◽

Peter James Beamish ◽

...

Keyword(s):

Mental Health ◽

Health Promotion ◽

Life Satisfaction ◽

Well Being ◽

Mobile App ◽

Mental Health Promotion ◽

Health Promotion Intervention ◽

Healthy Cohort ◽

Mental Well Being ◽

Human Support

Background The rapid increase in mental health disorders has prompted a call for greater focus on mental health promotion and primary prevention. Web- and mobile app–based interventions present a scalable opportunity. Little is known about the influence of human support on the outcomes of these interventions. Objective This study aimed to compare the influence of 3 modes of human support on the outcomes (ie, mental health, vitality, depression, anxiety, stress, life satisfaction, and flourishing) of a 10-week, Web- and mobile app–based, lifestyle-focused mental health promotion intervention among a healthy adult cohort. Methods Participants were recruited voluntarily using a combination of online and offline advertising. They were randomized, unblinded into 3 groups differentiated by human support mode: Group 1 (n=201): standard—fully automated emails (S); Group 2 (n=202): standard plus personalized SMS (S+pSMS); and Group 3 (n=202): standard plus weekly videoconferencing support (S+VCS), hosted by 1 trained facilitator. Participants accessed the intervention, including the questionnaire, on a Web-based learning management system or through a mobile app. The questionnaire, administered at pre- and postintervention, contained self-reported measures of mental well-being, including the “mental health” and “vitality” subscales from the Short Form Health Survey-36, Depression Anxiety and Stress Scale-21, Diener Satisfaction With Life Scale (SWLS), and Diener Flourishing Scale. Results Of 605 potential participants, 458 (S: n=157, S+pSMS: n=163, and S+VCS: n=138) entered the study by completing registration and the preintervention questionnaire. At post intervention, 320 out of 458 participants (69.9%; S: n=103, S+pSMS: n=114, and S+VCS: n=103) completed the questionnaire. Significant within-group improvements were recorded from pre- to postintervention in all groups and in every outcome measure (P≤.001). No significant between-group differences were observed for outcomes in any measure: mental health (P=.77), vitality (P=.65), depression (P=.93), anxiety (P=.25), stress (P.57), SWLS (P=.65), and Flourishing Scale (P=.99). Adherence was not significantly different between groups for mean videos watched (P=.42) and practical activity engagement (P=.71). Participation in videoconference support sessions (VCSSs) was low; 37 out of 103 (35.9%) participants did not attend any VCSSs, and only 19 out of 103 (18.4%) attended 7 or more out of 10 sessions. Stratification within the S+VCS group revealed that those who attended 7 or more VCSSs experienced significantly greater improvements in the domains of mental health (P=.006; d=0.71), vitality (P=.005; d=0.73), depression (P=.04; d=0.54), and life satisfaction (P=.046; d=0.50) compared with participants who attended less than 7. Conclusions A Web- and mobile app–based mental health promotion intervention enhanced domains of mental well-being among a healthy cohort, irrespective of human support. Low attendance at VCSSs hindered the ability to make meaningful between-group comparisons. Supplementing the intervention with VCSSs might improve outcomes when attendance is optimized. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR): 12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx

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Affect Improvements and Measurement Concordance Between a Subjective and an Accelerometric Estimate of Physical Activity

European Journal of Health Psychology ◽

10.1027/2512-8442/a000050 ◽

2020 ◽

Vol 27 (2) ◽

pp. 66-75

Author(s):

Björn Pannicke ◽

Julia Reichenberger ◽

Dana Schultchen ◽

Olga Pollatos ◽

Jens Blechert

Keyword(s):

Physical Activity ◽

Well Being ◽

Physiological Mechanisms ◽

Activity Tracker ◽

Negative Affects ◽

Ecological Momentary ◽

Relationship Of ◽

Assessment Strategies ◽

Mental Well Being ◽

The Relationship

Abstract. Objectives: Physical activity (PA) positively influences several aspects of mental well-being including affect improvements. Yet, the fact that subjective and objective measures of PA often diverge challenges research on the relationship of PA and affect. Methods: Subjective (ecological momentary assessment, EMA) and objective (combined heart rate and accelerometric activity tracker) measures of PA alongside repeated ratings of positive and negative affects were obtained from 37 participants over 7 consecutive days. Results: Subjective and objective PA were significantly positively correlated. Affect improvements, that is, negative affect decrease as well as positive affect increase, were predicted by both subjective (EMA) and objective (activity tracker) data. Conclusions: Measurement concordance supports the validity of both assessment strategies. Affect improvements result from both subjective representations of one’s own activity as well as from physiological mechanisms of PA that one is not aware of, suggesting two independent routes to affect improvements.

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Efficacy of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve Mental Well-Being Among University Students: Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/17767 ◽

2020 ◽

Vol 8 (4) ◽

pp. e17767 ◽

Cited By ~ 1

Author(s):

Sonia Ponzo ◽

Davide Morelli ◽

Jamie M Kawadler ◽

Nicola Rose Hemmings ◽

Geoffrey Bird ◽

...

Keyword(s):

University Students ◽

Controlled Trial ◽

Well Being ◽

Mobile App ◽

Control Group ◽

Full Time ◽

Digital Version ◽

Sustained Effects ◽

Mental Well Being

Background University students in the United Kingdom are experiencing increasing levels of anxiety. A program designed to increase awareness of one’s present levels of well-being and suggest personalized health behaviors may reduce anxiety and improve mental well-being in students. The efficacy of a digital version of such a program, providing biofeedback and therapeutic content based on personalized well-being metrics, is reported here. Objective The aim of this study was to test the efficacy and sustained effects of using a mobile app (BioBase) and paired wearable device (BioBeam), compared with a waitlist control group, on anxiety and well-being in university students with elevated levels of anxiety and stress. Methods The study employed a randomized, waitlist-controlled trial with assessments at baseline, 2 weeks, postintervention (4 weeks), and follow-up (6 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored >14 points on the Depression, Anxiety, and Stress Scale-21 items (DASS-21) stress subscale or >7 points on the DASS-21 anxiety subscale, (3) owned an iOS mobile phone, (4) did not have any previous psychiatric or neurological conditions, (6) were not pregnant at the time of testing, and (7) were able to read and understand English. Participants were encouraged to use BioBase daily and complete at least one course of therapeutic content. A P value ≤.05 was considered statistically significant. Results We found that a 4-week intervention with the BioBase program significantly reduced anxiety and increased perceived well-being, with sustained effects at a 2-week follow-up. Furthermore, a significant reduction in depression levels was found following the 4-week usage of BioBase. Conclusions This study shows the efficacy of a biofeedback digital intervention in reducing self-reported anxiety and increasing perceived well-being in UK university students. Results suggest that digital mental health interventions could constitute a novel approach to treat stress and anxiety in students, which could be combined or integrated with existing therapeutic pathways. Trial Registration Open Science Framework (OSF.io) 2zd45; https://osf.io/2zd45/

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Perceived Overprotection and Its Association With Quality of Life in Dementia

GeroPsych ◽

10.1024/1662-9647/a000207 ◽

2019 ◽

Vol 32 (3) ◽

pp. 125-134

Author(s):

Mechthild Niemann-Mirmehdi ◽

Andreas Häusler ◽

Paul Gellert ◽

Johanna Nordheim

Keyword(s):

Quality Of Life ◽

Patient Autonomy ◽

Positive Association ◽

Well Being ◽

Negative Association ◽

Significant Positive Association ◽

Cross Sectional ◽

People With Dementia ◽

Mental Well Being

Abstract. To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.

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Family-, Media-, and School-Related Risk Factors of Video Game Addiction

Journal of Media Psychology Theories Methods and Applications ◽

10.1027/1864-1105/a000093 ◽

2013 ◽

Vol 25 (3) ◽

pp. 118-128 ◽

Cited By ~ 53

Author(s):

Florian Rehbein ◽

Dirk Baier

Keyword(s):

Risk Factors ◽

Video Game ◽

Age Groups ◽

Well Being ◽

Epidemiological Studies ◽

Prevention Measures ◽

School Life ◽

Video Game Addiction ◽

Effective Prevention ◽

Game Addiction

In recent years, a variety of epidemiological studies have provided empirical data on the prevalence of video game addiction (GA) in different age groups. However, few studies investigated the causes of GA and could explain why video game playing as a widespread phenomenon leads to a comparatively small percentage of addicted players. Additionally, the existing longitudinal studies mainly consider psychological trait variables and neglect the possible explanatory value of predictors in socialization regarding media availability, media use, and family and everyday school life. In this paper, the results of a two-wave longitudinal study comprising a sample of students from Grades 4 to 9 (N = 406) are presented. The data show that 15-year-old video game addicts had already exhibited a number of specific risk factors at the age of 10. Students from single-parent families seem to be particularly at risk, as are students with low experienced school well-being and with a weaker social integration in class. The data also indicate that problematic use of video games in childhood increases the risk of GA in adolescence. Male students are especially vulnerable for developing GA. The results of this study are an important contribution to understanding risk factors for GA in adolescents, thereby laying the groundwork for effective prevention measures.

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Implications of Physical and Mental Well-being of Migrant Head Start Parents

PsycEXTRA Dataset ◽

10.1037/e584762012-093 ◽

2008 ◽

Author(s):

Raquel Cumba ◽

Sandra Barrueco ◽

Kendra Sena ◽

Christine Alvarado

Keyword(s):

Head Start ◽

Well Being ◽

Mental Well Being

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