Apps for Mental Health: An Evaluation of Behavior Change Strategies and Recommendations for Future Development.

Oladapo Oyebode,Ghazayil Al Khalifah,Felwah Alqahtani,Rita Orji

doi:10.3389/frai.2019.00030

Oladapo Oyebode, Ghazayil Al Khalifah + Show 2 more

Open Access

https://doi.org/10.3389/frai.2019.00030

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Abstract

Mobile applications have shown promise in supporting people with mental health issues to adopt healthy lifestyles using various persuasive strategies. However, the extent to which mental health apps successfully employ various persuasive strategies remains unknown. Hence, it is important to understand the persuasive strategies integrated into mental health applications (apps) and how they are implemented to promote mental health. This paper aims to achieve three main objectives. First, we review 103 mental health apps and identify distinct persuasive strategies incorporated in them using the Persuasive Systems Design (PSD) model and Behavior Change Techniques (BCTs). We further classify the persuasive strategies based on the type of mental health issues the app is focused on. Second, we reveal the various ways that the persuasive strategies are implemented/operationalized in mental health apps to achieve their intended objectives. Third, we examine the relationship between apps effectiveness (measured by user ratings) and the persuasive strategies employed. To achieve this, two researchers independently downloaded and used all identified apps to identify the persuasive strategies using the PSD model and BCTs. Next, they also examine the various ways that these strategies are implemented in mental health apps. The results show that the apps employed 26 distinct persuasive strategies and a range of 1–10 strategies per app. Self-monitoring (n = 59), personalization (n = 55), and reminder (n = 49) were the most frequently employed strategies. We also found that anxiety, stress, depression, and general mental health issues were the common mental health issues targeted by the apps. Finally, we offer some design recommendations for designing mental health apps based on our findings.

Highlights

Nowadays, mental health issues have become a major public health challenge
We found that anxiety, stress, depression, and general mental health issues were the common mental health issues targeted by the apps
We deconstructed distinct persuasive strategies employed in 103 mental health applications using the Persuasive Systems Design (PSD) model and Behavior Change Techniques (BCTs)

Summary

Introduction

Mental health issues have become a major public health challenge. People with mental health issues find it difficult achieving their daily tasks such as work and study (Keyes, 2005). For mental health issues Roepke et al (2015) and Arean et al (2016) highlighted in their studies that mobile-based mental health intervention made a strong impact on reducing depressed mood. They reported a high rate of drop-out. According to Fogg’s Behavior Model (FBM) (Fogg, 2009), there are three factors that help users to perform their target behavior and/or attitudes These factors are motivation, ability, and triggers. The aim of FBM is to assist researchers and designers to think more about the target behavior that needs to be changed and understand how to design persuasive systems to achieve the desired outcome (Fogg, 2009)

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