JMIR Publications

ABSTRACT

Background:

Frontline healthcare workers are experiencing a myriad of physical and psychosocial challenges amid the COVID-19 pandemic. There is growing recognition that digital technologies have the potential for improving wellbeing of frontline workers. However, there is limited development of wellness interventions using mHealth technology. More importantly, little research has been conducted on how frontline workers perceive mHealth-based support to promote their wellbeing.

Objective:

This study aimed to explore frontline workers’ experience of conventional psychological wellness programs and their perceptions of the usefulness of mHealth apps and features for promoting wellbeing. It also sought to identify factors that influence uptake and retention of a mHealth-based wellness program.

Methods:

We conducted semi-structured interviews using purposive sampling with frontline workers involved in the COVID-19 response. Various visual materials, collated from existing mHealth app features, were presented to facilitate discussion. Interviews were audio-recorded and transcribed verbatim. Thematic analysis based on grounded theory was undertaken. Themes were subsequently mapped to key nudge strategies, commonly used for mHealth development, to assess participants’ preferences for particular features and their reasoning.

Results:

A total of 42 frontline workers participated in twelve one-to-one interviews or focus group discussions. Frontline workers generally had limited mental health literacy to identify their own psychological problems and liked the reminders functionality to track their mood over time. A personalised goal-setting feature (tailoring) and in-app resources were generally valued while frequent coaching and messages (framing) were seen as a distraction. The majority desired a built-in chat with a counsellor (guidance) for reasons of accessibility and protection of privacy. Very few participants appreciated a gamification function. Frontline workers commonly reported the need for ongoing social support and desired access to in-app peer support community (social influence). There were concerns regarding potential risks from virtual peer interactions. Intrinsic motivational factors, mHealth app technicality and tangible rewards were identified as critical for uptake and retention.

Conclusions:

Our study highlights the potential of mHealth with relevant features to safeguard the wellbeing of frontline workers. Future work should focus on developing a non-intrusive and personalised mHealth app with in-app counselling, peer support to improve wellbeing, and tangible and extrinsic rewards to foster continued use.