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Tornero-Aguilera JF, Stergiou M, Rubio-Zarapuz A, Martín-Rodríguez A, Massuça LM, Clemente-Suárez VJ. Optimising Combat Readiness: Practical Strategies for Integrating Physiological and Psychological Resilience in Soldier Training. Healthcare (Basel) 2024; 12:1160. [PMID: 38921275 PMCID: PMC11202720 DOI: 10.3390/healthcare12121160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/16/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
This narrative review examines the intricate psychophysiological interplay between cognitive functions and physical responses within military personnel engaged in combat. It elucidates the spectrum of responses elicited by symmetric and asymmetric warfare alongside specialised combat scenarios, including close-quarters and subterranean warfare. Central to this discourse is the emphasis on integrating training programs beyond physical conditioning to encompass psychological resilience and decision-making efficacy under duress. The exploration further ventures into applying advanced technologies such as virtual reality and wearable devices, highlighting their pivotal role in augmenting training outcomes and supporting soldier health. Through a detailed analysis of psychophysiological variations across different military branches of service, the narrative review advocates for bespoke training regimens and support frameworks tailored to address the unique exigencies of each service branch. Concluding observations stress the importance of evolving military training paradigms, advocating for adopting realistic, immersive training simulations that mirror the complexities of the contemporary battlefield. This synthesis aims to contribute to the ongoing discourse on optimising military training protocols and enhancing the operational readiness and well-being of armed forces personnel. This narrative review is essential for military psychologists, trainers, and policymakers, aiming to bridge the gap between theoretical knowledge and practical implementation in military training programs.
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Affiliation(s)
- José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Maria Stergiou
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Luís Miguel Massuça
- ICPOL—Police Research Center, Higher Institute of Police Sciences and Internal Security, 1300-663 Lisbon, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Lusófona University, 1749-024 Lisbon, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Oporto, Portugal
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Germain A, Wolfson M, Pulantara IW, Wallace ML, Nugent K, Mesias G, Clarke-Walper K, Quartana PJ, Wilk J. Prototyping Apps for the Management of Sleep, Fatigue, and Behavioral Health in Austere Far-Forward Environments: Development Study. J Med Internet Res 2023; 25:e40640. [PMID: 37639304 PMCID: PMC10495854 DOI: 10.2196/40640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Military service inherently includes frequent periods of high-stress training, operational tempo, and sustained deployments to austere far-forward environments. These occupational requirements can contribute to acute and chronic sleep disruption, fatigue, and behavioral health challenges related to acute and chronic stress and disruption of team dynamics. To date, there is no centralized mobile health platform that supports self- and supervised detection, monitoring, and management of sleep and behavioral health issues in garrison and during and after deployments. OBJECTIVE The objective of this study was to adapt a clinical decision support platform for use outside clinical settings, in garrison, and during field exercises by medics and soldiers to monitor and manage sleep and behavioral health in operational settings. METHODS To adapt an existing clinical decision support digital health platform, we first gathered system, content, and context-related requirements for a sleep and behavioral health management system from experts. Sleep and behavioral health assessments were then adapted for prospective digital data capture. Evidence-based and operationally relevant educational and interventional modules were formatted for digital delivery. These modules addressed the management and mitigation of sleep, circadian challenges, fatigue, stress responses, and team communication. Connectivity protocols were adapted to accommodate the absence of cellular or Wi-Fi access in deployed settings. The resulting apps were then tested in garrison and during 2 separate field exercises. RESULTS Based on identified requirements, 2 Android smartphone apps were adapted for self-monitoring and management for soldiers (Soldier app) and team supervision and intervention by medics (Medic app). A total of 246 soldiers, including 28 medics, received training on how to use the apps. Both apps function as expected under conditions of limited connectivity during field exercises. Areas for future technology enhancement were also identified. CONCLUSIONS We demonstrated the feasibility of adapting a clinical decision support platform into Android smartphone-based apps to collect, save, and synthesize sleep and behavioral health data, as well as share data using adaptive data transfer protocols when Wi-Fi or cellular data are unavailable. The AIRE (Autonomous Connectivity Independent System for Remote Environments) prototype offers a novel self-management and supervised tool to augment capabilities for prospective monitoring, detection, and intervention for emerging sleep, fatigue, and behavioral health issues that are common in military and nonmilitary high-tempo occupations (eg, submarines, long-haul flights, space stations, and oil rigs) where medical expertise is limited.
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Affiliation(s)
| | | | | | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Katie Nugent
- Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, Silver Spring, MD, United States
- TechWerks, LLC, Silver Spring, MD, United States
| | - George Mesias
- Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Kristina Clarke-Walper
- Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Phillip J Quartana
- Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Joshua Wilk
- Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, Silver Spring, MD, United States
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Asadi F, Rahimi F, Ghaderkhany S, Almasi S. Self-care for coronavirus disease through electronic health technologies: A scoping review. Health Sci Rep 2023; 6:e1122. [PMID: 36824616 PMCID: PMC9941480 DOI: 10.1002/hsr2.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/06/2023] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Background and Aims Considering the rapid spread and transmission of COVID-19 and its high mortality rate, self-care practices are of special importance during this pandemic to prevent and control the spread of the virus. In this regard, electronic health systems can play a major role in improving self-care practices related to coronavirus disease. This study aimed to review the electronic health technologies used in each of the constituent elements of the self-care (self-care maintenance, self-care monitoring, and self-care management) during the COVID-19 pandemic. Methods This scoping review was conducted based on Arksey and O'Malley's framework. In this study, the specific keywords related to "electronic health," "self-care," and "COVID-19" were searched on PubMed, Web of Science, Scopus, and Google. Results Of the 47 articles reviewed, most articles (27 articles) were about self-care monitoring and aimed to monitor the vital signs of patients. The results showed that the use of electronic health tools mainly focuses on training in the control and prevention of coronavirus disease during this pandemic, in the field of self-care maintenance, and medication management, communication, and consultation with healthcare providers, in the field of self-care management. Moreover, the most commonly used electronic health technologies were mobile web applications, smart vital signs monitoring devices, and social networks, respectively. Conclusion The study findings suggested that the use of electronic health technologies, such as mobile web applications and social networks, can effectively improve self-care practices for coronavirus disease. In addition, such technologies can be applied by health policymakers and disease control and prevention centers to better manage the COVID-19 pandemic.
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Affiliation(s)
- Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Fatemeh Rahimi
- Department of Health Information Technology and Management, School of Allied Medical SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Shady Ghaderkhany
- Clinical Research Development Unit, Kowsar Medical, Educational and Therapeutic CenterKurdistan University of Medical SciencesSanandajIran
| | - Sohrab Almasi
- Department of Health Information Technology and Management, Health Information Management, School of Allied Medical SciencesShahid Beheshti University of Medical SciencesTehranIran
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Voth M, Chisholm S, Sollid H, Jones C, Smith-MacDonald L, Brémault-Phillips S. Efficacy, Effectiveness, and Quality of Resilience-Building Mobile Health Apps for Military, Veteran, and Public Safety Personnel Populations: Scoping Literature Review and App Evaluation. JMIR Mhealth Uhealth 2022; 10:e26453. [PMID: 35044307 PMCID: PMC8811698 DOI: 10.2196/26453] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/09/2021] [Accepted: 11/19/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Military members (MMs) and public safety personnel (PSP) are vulnerable to occupational stress injuries because of their job demands. When MMs and PSP transition out of these professions, they may continue to experience mental health challenges. The development and implementation of resilience-building mobile health (mHealth) apps as an emergent mental health intervention platform has allowed for targeted, cost-effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of health care professionals. OBJECTIVE This study aims to evaluate the evidence-based quality, efficacy, and effectiveness of resilience-building mobile apps targeted toward the MMs, PSP, and veteran populations via a scoping literature review of the current evidence base regarding resilience apps for these populations and an evaluation of free resilience apps designed for use among these populations. METHODS The studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and were guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A narrative synthesis of the resulting papers was performed. The Alberta Rating Index for Apps was used to conduct a review of each of the identified apps. The inclusion criteria consisted of apps that were free to download in either the Google Play Store or the Apple App Store; updated within the last 3 years; available in English and in Canada; and intended for use by MMs, veterans, and PSP. RESULTS In total, 22 apps met the inclusion criteria for evaluation. The resilience strategies offered by most apps included psychoeducation, mindfulness, cognitive behavioral therapy, and acceptance and commitment therapy. Overall, 50% (11/22) of apps had been tested in randomized controlled trials, 7 (32%) apps had been evaluated using other research methods, and 5 (23%) apps had not been studied. Using the Alberta Rating Index for Apps, the app scores ranged from 37 to 56 out of 72, with higher rated apps demonstrating increased usability and security features. CONCLUSIONS The mHealth apps reviewed are well-suited to providing resilience strategies for MMs, PSP, and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. Although not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for posttraumatic stress disorder, depression, anxiety, and other mental health conditions. In clinical practice, apps can be used to supplement treatment and provide clients with population-specific confidential tools to increase engagement in the treatment process.
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Affiliation(s)
- Melissa Voth
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Shannon Chisholm
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Hannah Sollid
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Leiden University Medical Centre, Leiden University, Leiden, Netherlands
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
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Jones C, Miguel Cruz A, Smith-MacDonald L, Brown MRG, Vermetten E, Brémault-Phillips S. Technology Acceptance and Usability of a Virtual Reality Intervention for Military Members and Veterans with Posttraumatic Stress Disorder: A Mixed Methods UTAUT Study (Preprint). JMIR Form Res 2021; 6:e33681. [PMID: 35451971 PMCID: PMC9073607 DOI: 10.2196/33681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/24/2021] [Accepted: 02/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background Military members and veterans exhibit higher rates of injuries and illnesses such as posttraumatic stress disorder (PTSD) because of their increased exposure to combat and other traumatic scenarios. Novel treatments for PTSD are beginning to emerge and increasingly leverage advances in gaming and other technologies, such as virtual reality. Without assessing the degree of technology acceptance and perception of usability to the end users, including the military members, veterans, and their attending therapists and staff, it is difficult to determine whether a technology-based treatment will be used successfully in wider clinical practice. The Unified Theory of Acceptance and Use of Technology model is commonly used to address the technology acceptance and usability of applications in 5 domains. Objective Using the Unified Theory of Acceptance and Use of Technology model, the purpose of this study was to determine the technology acceptance and usability of multimodal motion-assisted memory desensitization and reconsolidation (3MDR) on a virtual reality system in the primary user group (military members and veterans with treatment-resistant PTSD, 3MDR therapists, and virtual reality environment operators). Methods This mixed methods embedded pilot study included military members (n=3) and veterans (n=8) with a diagnosis of combat-related PTSD, as well as their therapists (n=13) and operators (n=5) who completed pre-post questionnaires before and on completion of 6 weekly sessions of 3MDR. A partial least squares structural equation model was used to analyze the questionnaire results. Qualitative data from the interviews were assessed using thematic analysis. Results Effort expectancy, which was the most notable predictor of behavioral intention, increased after a course of 3MDR with the virtual reality system, whereas all other constructs demonstrated no significant change. Participants’ expectations of the technology were met, as demonstrated by the nonsignificant differences in the pre-post scores. The key qualitative themes included feasibility and function, technical support, and tailored immersion. Conclusions 3MDR via a virtual reality environment appears to be a feasible, usable, and accepted technology for delivering 3MDR to military members and veterans who experience PTSD and 3MDR therapists and operators who facilitate their treatment.
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Affiliation(s)
- Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortum, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Leiden University Medical Centre, Leiden, Netherlands
- Edmonton Occupational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Antonio Miguel Cruz
- Glenrose Rehabilitation Hospital Research Innovation and Technology, Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortum, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Matthew R G Brown
- Heroes in Mind, Advocacy and Research Consortum, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortum, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Jones C, Miguel-Cruz A, Brémault-Phillips S. Technology Acceptance and Usability of the BrainFx SCREEN in Canadian Military Members and Veterans With Posttraumatic Stress Disorder and Mild Traumatic Brain Injury: Mixed Methods UTAUT Study. JMIR Rehabil Assist Technol 2021; 8:e26078. [PMID: 33983125 PMCID: PMC8160786 DOI: 10.2196/26078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/12/2021] [Accepted: 04/11/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Canadian Armed Forces service members (CAF-SMs) and veterans exhibit higher rates of injuries and illnesses, such as posttraumatic stress disorder (PTSD) and traumatic brain injury, which can cause and exacerbate cognitive dysfunction. Computerized neurocognitive assessment tools have demonstrated increased reliability and efficiency compared with traditional cognitive assessment tools. Without assessing the degree of technology acceptance and perceptions of usability to end users, it is difficult to determine whether a technology-based assessment will be used successfully in wider clinical practice. The Unified Theory of Acceptance and Use of Technology model is commonly used to address the technology acceptance and usability of applications in five domains. OBJECTIVE This study aims to determine the technology acceptance and usability of a neurocognitive assessment tool, which was titled BrainFx SCREEN, among CAF-SMs and veterans with PTSD by using the Unified Theory of Acceptance and Use of Technology model. METHODS This mixed methods embedded pilot study included CAF-SMs and veterans (N=21) aged 18-60 years with a diagnosis of PTSD who completed pre- and postquestionnaires on the same day the BrainFx SCREEN was used. A partial least squares structural equation model was used to analyze the questionnaire results. Qualitative data were assessed using thematic analysis. RESULTS Facilitating conditions, which were the most notable predictors of behavioral intention, increased after using the BrainFx SCREEN, whereas effort expectancy decreased. Performance expectancy, effort expectancy, and social interaction were not factors that could predict behavioral intention. Participants who reported a previous mild traumatic brain injury were significantly more likely to report current symptoms of cognitive impairment. The BrainFx SCREEN is a feasible, usable, and accepted assessment tool for CAF-SMs and veterans who experience PTSD. CONCLUSIONS As military health care systems integrate technological innovations to improve the services and care provided, research must continue to address the acceptability and use of these novel assessments and interventions.
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Affiliation(s)
- Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- 1 Field Ambulance Physical Rehabilitation Department, Canadian Forces Health Services, Department of National Defense, Edmonton, AB, Canada
- Leiden University Medical Centre, Leiden, Netherlands
| | - Antonio Miguel-Cruz
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
- Glenrose Rehabilitation Hospital Research Innovation and Technology, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
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Schlage J, Perich T. Mental health mobile application usage in young adults with a family history of mental illness. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jasmin Schlage
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Psychology, Western Sydney University, Sydney, NSW, Australia,
| | - Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Psychology, Western Sydney University, Sydney, NSW, Australia,
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Jones C, O'Toole K, Jones K, Brémault-Phillips S. Quality of Psychoeducational Apps for Military Members With Mild Traumatic Brain Injury: An Evaluation Utilizing the Mobile Application Rating Scale. JMIR Mhealth Uhealth 2020; 8:e19807. [PMID: 32808937 PMCID: PMC7463411 DOI: 10.2196/19807] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Military personnel have an elevated risk of sustaining mild traumatic brain injuries (mTBI) and postconcussion symptoms (PCS). Smartphone apps that provide psychoeducation may assist those with mTBI or PCS to overcome unique barriers that military personnel experience with stigma and access to health care resources. OBJECTIVE This study aims to (1) use the Mobile Application Rating Scale (MARS) to evaluate smartphone apps purporting to provide psychoeducation for those who have sustained an mTBI or a PCS; (2) explore the relevance, utility, and effectiveness of these apps in facilitating symptom management and overall recovery from mTBI and PCS among military personnel; and (3) discuss considerations pertinent to health care professionals and patients with mTBI when considering the use of mobile health (mHealth), including apps for mTBI psychoeducation. METHODS A five-step systematic search for smartphone apps for military members with mTBI or PCS was conducted on January 31, 2020. Cost-free apps meeting the inclusion criteria were evaluated using the MARS and compared with evidence-based best practice management protocols for mTBI and PCS. RESULTS The search yielded a total of 347 smartphone apps. After applying the inclusion and exclusion criteria, 13 apps were subjected to evaluation. Two apps were endorsed by the US Department of Veterans Affairs and the US Department of Defense; all the others (n=11) were developed for civilians. When compared with evidence-based best practice resources, the apps provided various levels of psychoeducational content. There are multiple considerations that health care professionals and those who sustain an mTBI or a PCS have to consider when choosing to use mHealth and selecting a specific app for mTBI psychoeducation. These may include factors such as the app platform, developer, internet requirement, cost, frequency of updates, language, additional features, acknowledgment of mental health, accessibility, military specificity, and privacy and security of data. CONCLUSIONS Psychoeducational interventions have a good evidence base as a treatment for mTBI and PCS. The use of apps for this purpose may be clinically effective, cost-effective, confidential, user friendly, and accessible. However, more research is needed to explore the effectiveness, usability, safety, security, and accessibility of apps designed for mTBI management.
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Affiliation(s)
- Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Canadian Forces Health Services, Department of National Defence, Government of Canada, Ottawa, ON, Canada
| | - Kaitlin O'Toole
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kevin Jones
- Edmonton North Primary Care Network, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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