JMIR Publications

ABSTRACT

Background:

Encouraging physical activity improves mental health and is recommended in workplace mental health guidelines. Although mHealth interventions are promising for physical activity promotion, their impact on mental health outcomes is inconsistent. Furthermore, poor user retention rates of mHealth apps pose a major challenge.

Objective:

This study aimed to examine the effectiveness and implementation outcomes of the smartphone app ASHARE in Japanese workplace settings, leveraging a deep learning model to monitor depression and anxiety through physical activity.

Methods:

This hybrid effectiveness-implementation trial was a 3-month non-randomized controlled study conducted from October 2023 to September 2024. Work units and employees were recruited and allocated to the intervention or active control group based on preference. The intervention group installed the ASHARE app, whereas the control group participated in an existing multi-component workplace program promoting physical activity. Changes in physical activity and psychological distress levels were compared between the groups. User retention rates, participation rates, acceptability, appropriateness, feasibility, satisfaction, and potential harm were also assessed.

Results:

Eighty-four employees from seven work units participated (67 from five units in the intervention group and 17 from two units in the control group). Seventy-eight employees completed the 3-month follow-up survey (follow-up rate: 92.9%). Both groups showed increased physical activity, and the intervention group showed reduced psychological distress; however, the differences between groups were not statistically significant (p = 0.201; p = 0.358). In a sensitivity analysis of protocol-compliant employees (n = 21), psychological distress levels were significantly reduced in the intervention group compared to the control group (Coeff=-3.68, SE=1.65, p = 0.032). The app’s 3-month user retention rate was 19.7% (12/61), which was lower than the participation rate in each component of the control programs. Implementation outcomes evaluated by employees were less favorable in the intervention group than in the control group, whereas health promotion managers found them to be similar.

Conclusions:

The ASHARE app did not show superior effectiveness compared with an existing multi-component workplace program for promoting physical activity. An implementation gap may exist between health promotion managers and employees, possibly contributing to the app’s low user retention rate. Clinical Trial: UMIN-CTR (UMIN000052374, registered October 10, 2023).