Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 24, 2025
Date Accepted: Dec 15, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Exploring the Role of App Features in Providing Continuity of Care to Users on a Digital Mental Health Platform (Wysa): A Retrospective Study of Real World Evidence
ABSTRACT
Background:
Despite digital mental health services growing at a rapid pace to address global mental health needs, there exist challenges of low engagement and attrition. Ensuring continuity of care in the digital context can positively impact mental health care delivery and adherence to treatment, thus establishing digital mental health interventions (DMHIs) as a viable option for mental health support.
Objective:
This study aimed to examine the impact of adjunct app features of the mental health app Wysa, and their ability to promote engagement and adherence with the text-based coaching sessions.
Methods:
This retrospective mixed-methods observational study was based on real-world app data from users (n=1210) who subscribed to text-based sessions with mental health coaches (MHCs) between 1st February and 31st July 2022. Their engagement with the adjunct app features, such as brief interventions with the conversational agent (CA), self-management tools, and journaling was analyzed quantitatively using descriptive and inferential statistics. Acceptability of the app features was also assessed using qualitative feedback data.
Results:
Findings demonstrated high usage of the adjunct app features which allowed communication with the MHCs in between sessions. The thematic analysis captures user experiences of helpfulness within the application and with the MHCs. Mann-Whitney test indicated that users who accessed one or more features completed significantly more sessions compared to users who did not use any feature (W=154085.0, P<.001, rB=0.73) with a large effect size. Odds ratio analysis indicated that users were almost thrice as likely to complete sessions after using the adjunct app features (OR=2.98, 95% CI [2.63, 3.37], P<.001).
Conclusions:
The inclusion of adjunct app features enhances continuity in care delivery between sessions, and boosts engagement and adherence to digital mental health interventions. Further efforts are needed to improve care continuity and expand the applicability of DMHIs to meet global mental health demands.
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