Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 25, 2025
Date Accepted: Mar 12, 2026
Multimodal Personalized mHealth Just-in-Time Adaptive Intervention for Occupational Stress Management: A Pilot Study
ABSTRACT
Background:
As digital health solutions gain traction, there is an urgent need for effective person-centered stress management tools for employees. Technological advances in wearable stress measurement and machine learning are enabling more complex ways to measure real-time data and personalize interventions in terms of timing and content.
Objective:
This pilot study explores the effectiveness of a personalized mobile health (mHealth) intervention for reducing occupational stress, leveraging the just-in-time adaptive intervention (JITAI) concept.
Methods:
A two-arm randomized trial was conducted with 46 employees over two phases of three weeks each. Participants used the RELAX mHealth app, which adapts interventions based on real-time stress data and user’s preferences. Stress levels were measured through physiological parameters via wearable sensors and subjective questionnaires. The satisfaction and usability of the application were also measured.
Results:
The study revealed mixed findings. While selected subjective stress indicators showed a reduction at the end of the study compared to baseline, one physiological measure demonstrated an increase. The retrospective assessment of chronic stress and the stress of the most recent stress event prior to app entry showed a reduction; however, the LF/HF ratio of heart rate variability (HRV) showed an increase. The effects were not affected by the degree of personalization. Furthermore, a contradictory effect on satisfaction and usability was observed, with a decrease in satisfaction and an increase in usability over the course of the study.
Conclusions:
Although the results support some effectiveness of the app, the variability raises concerns about its current usability and the integration of mHealth into daily work routines. Technical issues and user discomfort were also noted, indicating areas for improvement. This study highlights the potential of a personalized mHealth approach to enhance occupational stress management. However, further refinement of the app and more comprehensive evaluations are necessary to fully understand the impact and functional usability of an app based on the JITAI concept in real-world settings. Clinical Trial: doi: 10.17605/OSF.IO/MYRD9
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