JMIR Publications

ABSTRACT

Background:

Higher perceived stress is associated with negative mental health outcomes such as depression and anxiety. Digital mental health (DMH) interventions are efficacious tools to address negative mental health outcomes and have helped reduce psychological symptom severity such as anxiety and depression compared to waitlist controls. Although DMH tools have been studied in controlled settings, less is known about the real world evidence of such interventions.

Objective:

Evaluate changes in perceived stress among Headspace members and the relationship between real world engagement and perceived stress.

Methods:

We evaluated two timepoints of real world perceived stress and engagement data from Headspace app members with baseline moderate and severe perceived stress. Perceived stress was measured using the Perceived Stress Scale (PSS-10) and engagement using active days and active minutes engaged with Headspace as well as number of user sessions. Descriptive statistics were computed for all variables. Correlations examined relationships between PSS-10 baseline and follow-up scores, PSS-10 percent change, days between PSS-10, active days, active days/week, active minutes, active minutes/day, sessions, and sessions/week. T-tests investigated the differences in baseline PSS-10, follow-up PSS-10, PSS-10 percent change, active days, active days/week, active minutes, active minutes/day, sessions, and sessions/week between: 1) those who did and did not improve PSS-10 scores (yes vs. no improvement); and 2) those who improved ≥30% vs. those with <30% improvement.

Results:

Overall 21,088 Headspace members were included as participants in these analyses. On average, participants saw a 23.52% decrease in PSS-10 scores from baseline to follow-up. On average participants had 2.42±1.76 active days/week, 25.89±33.40 active minutes/day, and completed 7.11±8.34 sessions/week. T-tests suggest that participants who improved PSS-10 scores from baseline to follow-up had significantly higher baseline PSS-10 scores, more active days, more active days/week, more sessions, and more sessions/week than those who did not improve PSS-10 scores. Additional t-tests suggest that participants with ≥30% PSS-10 improvement had significantly higher baseline PSS-10 scores, more active days, more active days/week, more active minutes, more sessions, and more sessions/week than those with >30% PSS-10 improvement.

Conclusions:

Findings suggest that real world use of Headspace is associated with decreased perceived stress. Furthermore, data suggest that more engagement, specifically weekly active days and sessions, is associated with greater likelihood of stress reduction.