Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 12, 2026
Date Accepted: Oct 8, 2026
Examining the Feasibility, Acceptability and Preliminary Efficacy of a Health App for Post-acute Pandemic Years (HAPPY) in Managing Physical and Psychological Distress Symptoms: A Pilot Quasi-experimental Study
ABSTRACT
Background:
Physical and psychological distress symptoms can adversely affect daily functioning and quality of life, highlighting the need for accessible self-management support. Although m-Health interventions show promise in supporting physical symptom management, evidence regarding their feasibility and potential effects on psychological distress remains limited.
Objective:
This multi-method pilot study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of the HAPPY App for managing physical and psychological distress symptoms.
Methods:
A two-arm, single-blinded, quasi-experimental trial was conducted from July 2023 to January 2024. Thirty-eight participants experiencing distress symptoms related to COVID-19 were assigned to either an experimental group or a waitlist control group. The experimental group received a 24-week mHealth intervention through the HAPPY App, which included an 8-week supervised phase with weekly face-to-face sessions and a 16-week self-management phase. The control group received no active treatment. Feasibility was assessed through recruitment, adherence, and adverse event monitoring, while preliminary efficacy was evaluated at 8 weeks (T1) and 16 weeks (T2) comparing to the baseline (T0) using quantitative measures of distress, fatigue, sleep quality, pain, emotional regulation and post-traumatic stress disorder (PTSD).
Results:
The study demonstrated the feasibility of the HAPPY App, with a recruitment rate of 88.37%, a dropout rate of 10.5%, an adherence rate of 93.33% for the supervised sessions. No adverse events were reported. Significant within-group improvements were observed for distress (Kessler Psychological Distress Scale K10, P<.001), fatigue (Brief Fatigue Inventory- Chinese BFI-C, P <.001), sleep quality (Chinese Pittsburgh Sleep Quality Index CPSQI, P=.009), and PTSD symptoms (Chinese Impact of Event Scale – Revised CIES-R, P=.02). However, between-group differences were limited, likely due to the small sample size.
Conclusions:
The study demonstrated the HAPPY App's feasibility, acceptability, and potential efficacy for managing physical and psychological distress symptoms. High recruitment, retention, and adherence rates, along with measurable improvements in distress, fatigue, sleep quality, and pain, suggest the App’s promise as a scalable intervention. Clinical Trial: ClinicalTrials.gov NCT05459896; https://clinicaltrials.gov/study/NCT05459896
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