Supporting Mental Health During the COVID-19 Pandemic Using a Digital Behavior Change Intervention: An Open-Label, Single-Arm, Pre-Post Intervention Study.

Charlotte Summers,Philip Wu,Alisdair J G Taylor

doi:10.2196/31273

Abstract

BackgroundThe COVID-19 pandemic is taking a toll on people’s mental health, particularly as people are advised to adhere to social distancing, self-isolation measures, and government-imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and in supporting their mental health and well-being. Even before the COVID-19 pandemic, mental health and social services were already strained.ObjectiveOur objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health intervention, a holistic digital behavior change app designed for self-management of mental well-being, sleep, activity, and nutrition.MethodsThe study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. Adults who had joined the Gro Health app (intervention) and had a complete baseline dataset (ie, 7-item Generalized Anxiety Disorder scale, Perceived Stress Scale, and 9-item Patient Health Questionnaire) were followed up at 12 weeks (n=273), including 33 (12.1%) app users who reported a positive COVID-19 diagnosis during the study period. User engagement with the Gro Health platform was tracked by measuring total minutes of app engagement. Paired t tests were used to compare pre-post intervention scores. Linear regression analysis was performed to assess the relationship between minutes of active engagement with the Gro Health app and changes in scores across the different mental health measures.ResultsOf the 347 study participants, 273 (78.67%) completed both the baseline and follow-up surveys. Changes in scores for anxiety, perceived stress, and depression were predicted by app engagement, with the strongest effect observed for changes in perceived stress score (F1,271=251.397; R2=0.479; P<.001).ConclusionsA digital behavior change platform that provides remote mental well-being support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. The outcomes of this study may also support the implementation of remote digital health apps supporting behavior change and providing support for low levels of mental health within the community.

Highlights

The COVID-19 pandemic has created an unprecedented global health challenge and has strained health care systems worldwide [1]
Our study aims to add to the research and evidence base on the effectiveness and engagement levels of a digital behavior change app (Gro Health) in the context of the COVID-19 pandemic
App engagement was measured through total minutes of use, an analytic indicator used in prior studies to evaluate the effective engagement of digital health apps [44,45]

Summary

Introduction

The COVID-19 pandemic has created an unprecedented global health challenge and has strained health care systems worldwide [1]. Efforts to contain the spread of COVID-19, including prolonged social distancing and self-isolation, may trigger or exacerbate social, mental, and physical health problems, such as anxiety, relationship breakdowns, domestic violence, substance abuse or withdrawal, and obesity [5,6,7]. This could be especially serious for those with preexisting medical and psychological conditions [8]. Conclusions: A digital behavior change platform that provides remote mental well-being support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. The outcomes of this study may support the implementation of remote digital health apps supporting behavior change and providing support for low levels of mental health within the community

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