JMIR Publications

ABSTRACT

Background:

Mobile health apps are proving to be an important tool for increasing access to psychological therapies early on, reducing the risk of long-term illness into adulthood, particularly with rising rates of anxiety and depression in young people.

Objective:

We aimed to assess the usability, acceptability, safety and effectiveness of a new app, Clear Fear (CF) developed to help children and young people manage symptoms of anxiety using the principles of Cognitive Behavioural Therapy (CBT).

Methods:

The CF app was developed to provide cognitive behavioural strategies to suit anxiety disorders. The app was evaluated using an uncontrolled pre- and post-follow-up design over a 9-week period to assess the app and its effects. The study comprised three phases: i) Baseline (Stage 1); ii) Post-app familiarisation (Stage 2); and iii) Follow-up (Stage 3). Eligible participants were aged between 16-25 years, with mild to moderate anxiety, but not currently receiving treatment and/or in contact with specialist mental health services or using other inventions or apps to help monitor or manage their mental health. A community sample was recruited via adverts, relevant websites and social media networks. Eligible participants completed standardised, self-reported tools and questionnaires at each study stage. These measured probable symptoms of anxiety (GAD-7), depression (MFQ) and emotional/behavioural difficulties (SDQ), and feedback on the usability, accessibility and safety of the app. Mean scores at baseline and follow-up were compared using paired 2-tailed t tests or Wilcoxon Signed-Rank test. Qualitative data derived from open-ended questions were coded and entered into NVIVO (version 10) for analysis.

Results:

48 young people entered the study at baseline, with 37 (or 77.1%) completing all outcome measures at follow-up. The sample was mostly female 77.1% (or 37). The mean age was 20.1 years (SD=2.1). 47.9% (or 23) of participants reached the threshold for probable anxiety disorder, 56.3% (or 27) participants scored positive for probable depression, 75.0% (or 36) scored ‘very high’ on the SDQ total score for emotional/behavioural difficulties. The app was well received offering reassurance, practical and immediate help to manage symptoms, encouragement to seek help and generally found easy to use. A small minority found the app difficult to navigate. The app revealed statistically significant reductions in probable symptoms of anxiety (t1=2.6, 95% CIs 0.41-3.53, P=.014), depression (z=2.3, P=.019) and behavioural/emotional difficulties (t2=4.5, 95% CIs 3.67-9.65, P=<0.001)

Conclusions:

The CF app was found to be usable, acceptable, safe and effective in helping to manage symptoms of anxiety, depression and emotional/behavioural difficulties. Clinical Trial: n/a