Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Monday, March 11, 2019 at 4:00 PM to 4:30 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?

Advertisement

Currently accepted at: JMIR Mental Health

Date Submitted: Jul 12, 2018
Open Peer Review Period: Jul 16, 2018 - Sep 10, 2018
Date Accepted: Dec 23, 2018
(closed for review but you can still tweet)

This paper has been accepted and is currently in production.

It will appear shortly on 10.2196/11572

The final accepted version (not copyedited yet) is in this tab.

The final, peer-reviewed published version of this preprint can be found here:

Towards managing a platform of mental health apps: A Secondary Analysis of the IntelliCare Field Trial

Kwasny M, Schueller SM, Lattie E, Gray EL, Mohr DC

Towards managing a platform of mental health apps: A Secondary Analysis of the IntelliCare Field Trial

JMIR Ment Health 2019;6(3):e11572

DOI: 10.2196/11572

PMID: 30896433

PMCID: 6447993

Towards managing a platform of mental health apps: A Secondary Analysis of the IntelliCare Field Trial

  • Mary Kwasny; 
  • Stephen M Schueller; 
  • Emily Lattie; 
  • Elizabeth L. Gray; 
  • David C. Mohr

ABSTRACT

Background:

People using apps for mental health and wellbeing are likely to try multiple apps over time. In general, people use apps to meet immediate needs, and often use a variety of apps to meet larger goals (for example people may have multiple apps to manage various transportation needs). IntelliCare is a mental health app platform that was designed with these principles in mind: the apps are elemental in that each app targets a different change strategy; they are simple and brief to use; and they are eclectic, allowing the user to select which strategies are useful to them. While this may improve engagement, it creates the same challenges faced by users of app stores. Thus, mental health app platforms will require navigation aids, such as recommender systems that can quickly get a person to an app that is useful.

Objective:

As a first step towards developing navigation and recommender tools, this study explored app use patterns across the IntelliCare platform, and their relationship to depression and anxiety outcomes.

Methods:

This secondary analysis of the IntelliCare Field Trial recruited people with depression and/or anxiety. Participants received 8 weeks of coaching, primarily by text, and weekly recommendations for apps. App use metrics included frequency of use and lifetime use were defined. Depression and anxiety, measured using the PHQ-9 and GAD-7, were assessed at baseline and end of treatment. Ordinal logistic regression models, log-rank tests and cluster analysis were utilized to determine patterns of use, and if these use metrics alone, or in combination, predicted improvement or remission(I/R) in depression or anxiety.

Results:

The analysis included 96 people with depression and/or anxiety. Peole generally followed recommendations to download and try new apps each week. Apps clustered into 5 groups: Thinking (apps that targeted or relied on thinking), Calming (relaxation and insomnia), Checklists (apps that used checklists), Activity (behavioral activation and activity), and Other. Both overall frequency of use and lifetime use were predictive in response for depression and anxiety. The Thinking, Calming, and Checklist clusters were associated with improvement in depression and anxiety, and the Activity cluster was associated with improvement in Anxiety only. However, the use of clusters was not more strongly associated with improvement than individual app use.

Conclusions:

Participants in a field trial remained engaged with a suite of apps for the full eight weeks of the trial. App use patterns did fall into clusters, suggesting knowing something about use of one app may be useful in helping select another app that the person is more likely to use. Clinical Trial: Clinicaltrials.gov NCT02176226


 Citation

Please cite as:

Kwasny M, Schueller SM, Lattie E, Gray EL, Mohr DC

Towards managing a platform of mental health apps: A Secondary Analysis of the IntelliCare Field Trial

JMIR Mental Health. (forthcoming/in press)

DOI: 10.2196/11572

URL: https://preprints.jmir.org/preprint/11572

PMID: 30896433

PMCID: 6447993

Download Accepted Manuscript PDF

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.