JMIR Publications

ABSTRACT

Background:

Behavior and mood are closely intertwined. The relationship between behavior and mood might be particularly important in populations of underserved people, such as people with physical or mental health issues. We used ecological momentary assessment (EMA) to examine the relationship between mood state and other characteristics among people with a history of chronic homelessness who were participating in a health coaching program.

Objective:

This study explores predictors of preferences and intentions to access e-mental health services relative to face-to-face services. Five domains were investigated (demographics, technology factors, personality, psychopathology, and beliefs), identified from previous studies and informed by the Internet interventions model. We expected that more participants would report intentions to use e-mental health services relative to reported preferences for this type of support and that these 5 domains would be significantly associated with both intentions and preferences toward online services.

Methods:

Participants in m.chat, a technology-assisted health coaching program, were recruited from housing agencies in Fort Worth, Texas. All participants had a history of chronic homelessness and reported at least one mental health condition. A subset of participants was asked to complete daily EMAs of mood and other behaviors. From the circumplex model of affect, the EMA included nine questions related to the current emotional state of the participant (happy, frustrated, sad, worried, restless, excited, calm, bored and sluggish). The responses were used to calculate two composite scores for valence and arousal.

Results:

Non-whites reported higher scores for both valence and arousal, but not at a statistically significant level after correcting for multiple testing. Among momentary predictors, greater time spent in one-on-one interactions, greater time spent in physical activities, greater number of servings of fruits and vegetables, greater time spent interacting in a one-on-one setting, as well as adherence to prescribed medication the previous day generally were associated higher scores for both valence and arousal, and statistical significance was achieved in most cases. Number of cigarettes smoked the previous day was generally associated with lower scores on both valence and arousal, though statistical significance was achieved for valence only when correcting for multiple testing.

Conclusions:

This study provides an important glimpse into factors that predict morning mood among people with mental health issues and a history of chronic homelessness. Behaviors considered to be positive (e.g., physical activity, consumption of fruits and vegetables) generally enhanced positive affect and restrained negative affect. The opposite was true for behaviors such as smoking that are considered to be negative.