JMIR Publications

ABSTRACT

Background:

Mobile applications and wearable devices may help to facilitate early detection of mental health conditions by providing objective, real-time data to supplement other forms of feedback and diagnoses. Few studies have investigated the acceptability and feasibility of using wearable devices to track mental health indicators in Sub-Saharan Africa.

Objective:

This pilot study evaluated the feasibility and acceptability of using a mobile application and wearables to capture mental health indicators among Kenyan healthcare workers.

Methods:

A mixed-method study was conducted among healthcare workers employed at four hospitals in Nairobi, Kenya, over 30 days. A mobile application was used to collect and integrate active (baseline questionnaire, daily mood) and passive (wearable) data. The baseline questionnaire gathered information on socio-demographics, work environment, and mental health assessments on depression, anxiety, personality, early family environment, post-traumatic stress disorder, and substance use. A wrist-worn tracking device was used to gather data on steps, heart rate, and sleep. Qualitative interviews were conducted post-trial to gain in-depth insights into participants' experiences during the study.

Results:

Fifty-one participants enrolled in the pilot study. They were primarily nurses (47%) and female (70%), with a mean±SD age of 32.8±5.8 years. Attrition over 30 days was low with only one participant dropping out. Completeness of the baseline survey was high, with participants completing 96.1% of the questions. Further, 58% of the daily mood ratings were completed over the 30 days. For the wearable measures, participants submitted steps, heart rate, and sleep data on 93%, 73%, and 51% of study days, respectively. The proportion of days the wearable was worn for over 10 hours was 63%. Interviews revealed two primary themes. The first was intrinsic and extrinsic motivation; participants indicated that they liked having their health metrics tracked and receiving congratulatory messages from the app encouraging increased step counts. The second theme was technical and usability challenges; 47% of the participants reported discomfort wearing the watch while sleeping and challenges with synchronization of data due to the non-automated nature of the process. Participants suggested additional prompts to remind them to complete the daily mood question.

Conclusions:

This pilot study demonstrates that the use of mobile applications and wearables in mental health research in low- and middle-income countries (LMIC) is feasible. Healthcare workers in Kenya were willing to provide sensitive information through mental health assessments using a mobile application. To improve adherence to longitudinal data collection, future studies should consider contextual factors such as daily prompts, enhanced data synchronization methods and comfort concerns to improve adherence especially during sleep.