Abstract
BackgroundEmerging research suggests that mobile apps can be used to effectively treat common mental illnesses like depression and anxiety. Despite promising efficacy results and ease of access to these interventions, adoption of mobile health (mHealth; mobile device–delivered) interventions for mental illness has been limited. More insight into patients’ perspectives on mHealth interventions is required to create effective implementation strategies and to adapt existing interventions to facilitate higher rates of adoption.ObjectiveThe aim of this study was to examine, from the patient perspective, current use and factors that may impact the use of mHealth interventions for mental illness.MethodsThis was a cross-sectional survey study of veterans who had attended an appointment at a single Veterans Health Administration facility in early 2016 that was associated with one of the following mental health concerns: unipolar depression, any anxiety disorder, or posttraumatic stress disorder. We used the Veteran Affairs Corporate Data Warehouse to create subsets of eligible participants demographically stratified by gender (male or female) and minority status (white or nonwhite). From each subset, 100 participants were selected at random and mailed a paper survey with items addressing the demographics, overall health, mental health, technology ownership or use, interest in mobile app interventions for mental illness, reasons for use or nonuse, and interest in specific features of mobile apps for mental illness.ResultsOf the 400 potential participants, 149 (37.3%, 149/400) completed and returned a survey. Most participants (79.9%, 119/149) reported that they owned a smart device and that they use apps in general (71.1%, 106/149). Most participants (73.1%, 87/149) reported interest in using an app for mental illness, but only 10.7% (16/149) had done so. Paired samples t tests indicated that ratings of interest in using an app recommended by a clinician were significantly greater than general interest ratings and even greater when the recommending clinician was a specialty mental health provider. The most frequent concerns related to using an app for mental illness were lacking proof of efficacy (71.8%, 107/149), concerns about data privacy (59.1%, 88/149), and not knowing where to find such an app (51.0%, 76/149). Participants expressed interest in a number of app features with particularly high-interest ratings for context-sensitive apps (85.2%, 127/149), and apps focused on the following areas: increasing exercise (75.8%, 113/149), improving sleep (73.2%, 109/149), changing negative thinking (70.5%, 105/149), and increasing involvement in activities (67.1%, 100/149).ConclusionsMost respondents had access to devices to use mobile apps for mental illness, already used apps for other purposes, and were interested in mobile apps for mental illness. Key factors that may improve adoption include provider endorsement, greater publicity of efficacious apps, and clear messaging about efficacy and privacy of information. Finally, multifaceted apps that address a range of concerns, from sleep to negative thought patterns, may be best received.
Highlights
The majority of the US population owns smartphones (77% in 2016) [1], and the number of mobile apps for health has grown exponentially over the past decade
Research suggests that mobile health interventions can have a positive influence on a wide range of health conditions [3,4] and, while not a substitute for in-person treatment, these tools offer a treatment option that does not have as many access barriers as in-office treatment and may allow for reduced cost of care
Studies indicate that mobile health (mHealth) interventions can improve functioning and symptoms in those with depression and/or anxiety [8,9,10,11] and that technology offers some advantages over in-person treatments
Summary
The majority of the US population owns smartphones (77% in 2016) [1], and the number of mobile apps for health has grown exponentially over the past decade. Research suggests that mobile health (mHealth) interventions can have a positive influence on a wide range of health conditions [3,4] and, while not a substitute for in-person treatment, these tools offer a treatment option that does not have as many access barriers as in-office treatment (eg, no transportation is required) and may allow for reduced cost of care (since marginal cost is negligible). Studies indicate that mHealth interventions can improve functioning and symptoms in those with depression and/or anxiety [8,9,10,11] and that technology offers some advantages over in-person treatments. Emerging research suggests that mobile apps can be used to effectively treat common mental illnesses like depression and anxiety. More insight into patients’ perspectives on mHealth interventions is required to create effective implementation strategies and to adapt existing interventions to facilitate higher rates of adoption
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