Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Oct 13, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
MHealth Support for Healthcare Providers: Mixed Methods Evaluation of Beyond Silence Adoption in Canadian Healthcare Organizations
ABSTRACT
Background:
There is an urgent and critical need to support the mental health of healthcare providers, given high rates of stress and burnout. Although the issues are complex, digital access to information and support can help to address the needs since technology can facilitate on-demand links to private, customized resources, including peer support. Beyond Silence is a new mobile app that has been designed by and for healthcare workers to reduce barriers to accessing local resources and peer support.
Objective:
This study aimed to; 1) explore how healthcare workers across diverse healthcare settings use the Beyond Silence app, and 2) identify opportunities and barriers to implementation
Methods:
A multiple-case study framework, informed by the Consolidated Framework for Implementation Research was applied to capture four months of implementation across a purposive sample of seven diverse Canadian healthcare organizations. Data included analytics regarding app downloads and use of key features, as well as interview data from baseline and follow-up interviews with organizational champions regarding the implementation process, organizational context, and perceived facilitators and barriers to app use.
Results:
Approximately 1062 employees downloaded the app over the four-month period, ranging from less than 2% to over 45% of employees across the seven organizations (average of 11.7%). It was opened an average of three times per user, and the most popular feature was viewing content (articles, videos, podcasts). Interviews with 28 organizational champions noted that there was good leadership support for the technology, aligning with their mission to address employee mental health. Barriers to use, however, included the workplace culture around mental health and help-seeking, lack of awareness of when and how to use the app, as well as infrastructure challenges such as limited time and few private spaces to download and use the technology.
Conclusions:
This study highlights key challenges in implementation of the Beyond Silence peer support app for healthcare workers, including slow adoption linked to mental health stigma, competing demands, and limited frontline engagement. Effective implementation is a precondition for positive outcomes, therefore strategies are needed to optimize technology implementation. Recommendations include: evaluating organizational readiness, building mental health literacy, creating a multi-modal communication and implementation plan, addressing technology requirements (digital literacy and mHealth access), and embedding the technology into organizational policies and practices. Innovative, trust-building strategies are needed to support meaningful uptake and sustained use. Clinical Trial: ClinicalTrials.gov NCT05514093
Citation
