Accepted for/Published in: JMIR Mental Health
Date Submitted: Jan 6, 2022
Open Peer Review Period: Jan 6, 2022 - Mar 3, 2022
Date Accepted: Mar 1, 2022
Date Submitted to PubMed: Mar 4, 2022
(closed for review but you can still tweet)
Predicting Uptake of the COVID Coach App Among U.S. Military Veterans: A Funnel Analysis Using a Probability-Based Panel
ABSTRACT
Background:
Although the pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of pre-existing mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated, but its uptake and usage among older veterans has not been explored.
Objective:
The purpose of the current study was to characterize smartphone ownership rates among U.S. veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app.
Methods:
Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3,078 U.S. military veterans before and one year into the pandemic. The NHRVS sample was drawn from KnowledgePanel®, a research panel of more than 50,000 households maintained by Ipsos, Inc. Median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peri-pandemic follow-up assessment on a mobile device (n = 814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n = 34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020 and November 7, 2021.
Results:
We found that most U.S. veterans own smartphones and veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related PTSD symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach was relatively low (3.3% of eligible participants, n = 34), 50% of the participants returned to the app for more than one day of use. The interactive tools for managing stress were used most frequently.
Conclusions:
Although the coronavirus pandemic has increased the need for and creation of digital mental health tools, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools, such as apps, to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.
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Copyright
© 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.