Abstract
BackgroundAlthough the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy.ObjectiveThis 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.MethodsFemale 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.ResultsAmong 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).ConclusionsThe well-being mobile app was effective in reducing employee stress and improving well-being.Trial RegistrationClinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.
Highlights
Women's Mental HealthOver the last few decades, studies have been investigating the impact of occupational stress complaints on workers’ mental health [1,2]
We developed 2 apps and hypothesized that a well-being mobile app, composed of an 8-week program with 4 lessons per week—based on relaxation training, breathing techniques, guided meditation, and positive psychology principles—could be effective in reducing stress and increasing well-being among working women when compared with an active control app designed to encourage self-observation and evaluation of subjective levels of stress and well-being, for the same period and weekly frequency
Participants who did not complete t4 and t8 assessments were distributed between groups (t4: control group=34.6% [83/240] and intervention group=40.8% [102/250]; X21=2.0; P=.16; effect size for chi-square test φ=0.064; t8: control group=29.9% [47/157] and intervention group=21.6% [32/148]; X21=2.7; P=.10; φ=0.095)
Summary
Women's Mental HealthOver the last few decades, studies have been investigating the impact of occupational stress complaints on workers’ mental health [1,2]. Research from the World Economic Forum’s Gender Gap study showed that women work nearly an hour longer than men every day, when both paid and unpaid tasks are considered [7] These findings indicate that working women may experience more stress than men and that the sources of stress are related to the expected and actual roles of women in society. We 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).
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