JMIR Publications

ABSTRACT

Background:

While mental ill-health is more prevalent among people from lower socio-economic groups, digital mental well-being innovations are often developed for people from higher socio-economic groups, who already have resources to maintain good mental and physical health. To decrease health inequalities and ensure that available solutions are appealing and accessible to people with fewer resources, new approaches should be explored. We developed the app Wakey!, which focused on creating engaging mental health content that is accessible, particularly among lower socio-economic groups in the United Kingdom.

Objective:

The aim of this study was to assess engagement with the app, investigate initial effectiveness data for six well-being outcomes, and explore participants’ subjective experiences of using Wakey!.

Methods:

The app Wakey! was publicly launched on 20th of January 2020 and was free to download from Apple and Android app stores. The app provided its users with entertaining and educational mental well-being related content. Concurrently, a single-arm mixed methods feasibility trial was carried out from January – April 2020 among people who had downloaded the app and created an account. The primary outcome was engagement, which was collected passively from usage data logs. Secondary outcome measures were six well-being outcomes, collected from self-report questionnaires. Individual interviews with 19 app users were carried out in April 2020.

Results:

In total, 5413 people fit the inclusion criteria and were included in the final sample – 66% women, 61% between ages 25–44, 62% in employment, 8% belonging to lower socio-economic group, and 8% were engaged users. There was no evidence of a difference in engagement regarding socio-demographic and socio-economic characteristics. There was evidence that users with a higher average daily sleep score, who joined the study more recently, who had higher baseline self-report of sleep quality and who found episodes more entertaining, were more likely to be engaged users. Among 230 users who provided follow-up data, there was evidence of improvements on four of the six well-being outcomes: life satisfaction (P<.001), feeling that life is worthwhile (P=.01), ease of getting up in the morning (P<.001) and self-efficacy (P=.04). The app and its content were well received by those who were interviewed, and several people perceived a positive change in their mental well-being.

Conclusions:

This study shows that the app Wakey! could potentially be engaging across different socio-economic groups and there is an indication that it could positively impact the mental well-being of those engaged with the app. However, this study was a pragmatic trial with a limited sample, and the selection bias was present in the qualitative and quantitative study. Further work is needed to make any generalisable conclusions.