1
|
Tian L, Wong EL, Dong D, Cheung AW, Chan SKW, Cao Y, Mok PK, Zhou L, Xu RH. Improving mental health literacy using web- or app-based interventions: A scoping review. Digit Health 2024; 10:20552076241243133. [PMID: 38585191 PMCID: PMC10998496 DOI: 10.1177/20552076241243133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/14/2024] [Indexed: 04/09/2024] Open
Abstract
Background Given the rapid advancement in technology, the Internet has grown to play a significant role in the field of healthcare. Individuals can now access a profusion of easily available materials for self-management of their health. The purpose of this review is to describe Web/App-based interventions that are primarily or secondarily designed to improve mental health literacy (MHL) and to investigate the effectiveness of online interventions for improving mental health. Materials and Method A scoping review was conducted by searching five databases: PsycINFO, EMBASE, PubMed, CINAHL, and Web of Science. The search was limited to peer-reviewed journals published in English between 2000 and 2022. Studies focusing on enhancements of MHL or its constituent components were included. Results Twenty-four studies met the inclusion criteria. The interventions primarily targeted patients or individuals exhibiting symptoms of mental disorders, with a higher representation of female participants. All the interventions yielded positive outcomes. The included studies were categorized according to three themes: knowledge, attitude, and self-care skills. Although numerous studies have focused on knowledge improvement, research on interventions targeting self-care skills is scarce. Furthermore, existing literature on knowledge enhancement is limited in terms of the coverage of risk factors. Conclusion This review indicates gaps in web/app interventions including limited evidence on risk factors, inconsistent help-seeking awareness, and inadequate self-care skills training. Further research is critically needed to address these deficiencies and promote comprehensive MHL.
Collapse
Affiliation(s)
- Lidan Tian
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Eliza Laiyi Wong
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wailing Cheung
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sherry Kit-wa Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Yuan Cao
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Phoenix K.H. Mok
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lingming Zhou
- Department of Research and Education, Hospital of Guangzhou Medical University, Guangzhou, China
| | - Richard Huan Xu
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| |
Collapse
|
2
|
Nagar R, Quirk HD, Anderson PL. User experiences of college students using mental health applications to improve self-care: Implications for improving engagement. Internet Interv 2023; 34:100676. [PMID: 37867616 PMCID: PMC10587513 DOI: 10.1016/j.invent.2023.100676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/29/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023] Open
Abstract
The purpose of this study is to evaluate themes on 'user experiences' among college students (N = 265) enrolled in an upper-division Psychopathology course who were assigned a project in which they were instructed to identify a self-care goal, choose from a list of six mental health-focused mobile applications (apps) provided by the instructor, and use the app over the course of three weeks to support progress towards their goal. Prior literature on user experiences typically evaluates user reviews, or asks participants to reflect on past app use or anticipate future use. Students reported their experiences using the app during key decision points: app selection, while using the app, and at the conclusion of the assignment. Using thematic analysis, results identified seven central themes and eight subthemes pertaining to the content of the app (e.g., app features) and the context of using the app (e.g., classroom assignment). Content-wise students liked: 1) features with a strong evidence base, namely, thought diaries and guided meditations; 2) progress tracking, because it increased awareness of mood/stressors, motivated students to see improvement, and helped them stay on track. Students appreciated having 3) crisis support resources; 4) app interfaces that allowed for customization (poor app interfaces were sometimes cited as the reason for disengagement); and 5) apps that included varied, comprehensive resources such that it felt like a one-stop shop. In addition to the content of features and design interface, the context in which mental health apps are introduced and used is important. The remaining themes related to the context in which the app was used, including 6) preparation for app usage, such as reviewing scholarly/credible sources, and 7) social support from fellow students completing the same assignment. Future research should evaluate the 'who, what, when, why, where, and how' of app utilization during key decision points, such as initial app selection or subscription renewal, to better understand the impact of user experience on engagement.
Collapse
Affiliation(s)
- Ria Nagar
- Department of Psychology, Georgia State University, United States of America
| | - Heather D. Quirk
- Department of Psychology, Georgia State University, United States of America
| | - Page L. Anderson
- Department of Psychology, Georgia State University, United States of America
| |
Collapse
|
3
|
Truscott A, Hayes D, Bardsley T, Choksi D, Edbrooke-Childs J. Defining young people's mental health self-care: a systematic review and co-development approach. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02320-7. [PMID: 37947894 DOI: 10.1007/s00787-023-02320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Self-care is among the emerging types of mental health support which operate outside traditional services, although the meaning and practice of self-care for young people with mental health difficulties are currently unclear. This systematic review was pre-registered with PROSPERO (CRD42021282510) and investigated conceptualizations of self-care in academic publications which investigated or discussed self-care for young people's mental health or wellbeing. A Patient and Public Involvement (PPI) workshop facilitated young people with experience of mental health difficulties to respond to the identified concepts and co-develop a definition of self-care. Searches in PsycINFO, MEDLINE, Embase, CINAHL Plus, Scopus, Cochrane Library of Systematic Reviews, and gray literature sources resulted in 90 included publications. Content analysis indicated little conceptual consistency, with health and wellness promotion most commonly used to define self-care. The PPI workshop co-developed a definition of mental health self-care, which attendees felt should emphasize an individual process of self-awareness, self-compassion, and specific strategies to work toward emotional balance. This study highlights the gap between current academic understandings of young people's mental health self-care and young people's experience. The presented definition will enable future research to begin from an understanding of self-care which is relevant to young people with experience of mental health difficulties.
Collapse
Affiliation(s)
- Alex Truscott
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK.
| | - Daniel Hayes
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Tom Bardsley
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Disha Choksi
- Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Julian Edbrooke-Childs
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| |
Collapse
|
4
|
D’Adamo L, Paraboschi L, Grammer AC, Fennig M, Graham AK, Yaeger LH, Newman MG, Wilfley DE, Taylor CB, Eisenberg D, Fitzsimmons-Craft EE. Reach and uptake of digital mental health interventions based on cognitive-behavioral therapy for college students: A systematic review. JOURNAL OF BEHAVIORAL AND COGNITIVE THERAPY 2023; 33:97-117. [PMID: 37724304 PMCID: PMC10506850 DOI: 10.1016/j.jbct.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Background Mental health problems are increasing in prevalence among college students, yet few students receive treatment due to barriers such as insufficient resources in college counseling centers. Digital mental health interventions (DMHIs) have potential to overcome barriers and offer accessible, evidence-based care to college students. However, to evaluate the true public health impact of evidence-based DMHIs, it is important to assess the reach and uptake rates of DMHIs on college campuses. Objectives We conducted a systematic review to examine the reach (i.e., % of invited students who express interest) and uptake (i.e., % of enrolled participants who initiate an intervention) of DMHIs based on cognitive-behavioral therapy (CBT) for college students. Methods Eight databases were searched. Inclusion criteria included: (1) college population; (2) experimental design; (3) CBT-based intervention; (4) intervention targeting specific mental health conditions; and (5) digital intervention. Reach and uptake rates were calculated from data reported. A systematic narrative review framework was used to synthesize results. Results Of 10,315 articles screened, 90 were included. Seventeen studies (19%) reported sufficient data to calculate reach; 35 studies (39%) reported uptake rates. Of studies that reported reach or uptake, most evaluated unguided (n = 20) or guided (n = 16) self-help programs. Measurement methods varied widely. Overall reach was low, whereas uptake was high among enrolled participants. Discussion Despite evidence that improving reach and uptake can increase the public health impact of DMHIs, most studies did not report on either outcome. Suggested practices to improve these outcomes, and their reporting, are discussed.
Collapse
Affiliation(s)
- Laura D’Adamo
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
- Department of Psychological and Brain Sciences and Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, 3201 Chestnut St. Philadelphia, PA 19104, USA
| | - Layna Paraboschi
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Molly Fennig
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Andrea K. Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N St Clair St, Chicago, IL 60611, USA
| | - Lauren H. Yaeger
- Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA
| | - Michelle G. Newman
- Department of Psychology, The Pennsylvania State University, 371 Moore Building, University Park, PA 16801, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA
- Center for m Health, Palo Alto University, 5150 El Camino Real, Los Altos, CA 94022, USA
| | - Daniel Eisenberg
- Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Ellen E. Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Mailstop 8134-29-2100, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| |
Collapse
|
5
|
Yee LM, Leziak K, Jackson J, Niznik C, Saber R, Yeh C, Simon MA. SweetMama: Usability Assessment of a Novel Mobile Application Among Low-Income Pregnant People to Assist With Diabetes Management and Support. Diabetes Spectr 2023; 36:171-181. [PMID: 37193207 PMCID: PMC10182966 DOI: 10.2337/ds22-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Mobile health tools may be effective strategies to improve engagement, education, and diabetes-related health during pregnancy. We developed SweetMama, a patient-centered, interactive mobile application (app) designed to support and educate low-income pregnant people with diabetes. Our objective was to evaluate the SweetMama user experience and acceptability. Methods SweetMama is a mobile app with static and dynamic features. Static features include a customized homepage and resource library. Dynamic features include delivery of a theory-driven diabetes-specific curriculum via 1) motivational, tip, and goal-setting messages aligning with treatment and gestational age; 2) appointment reminders; and 3) ability to mark content as "favorite." In this usability assessment, low-income pregnant people with gestational or type 2 diabetes used SweetMama for 2 weeks. Participants provided qualitative feedback (via interviews) and quantitative feedback (via validated usability/satisfaction measures) on their experience. User analytic data detailed the duration and type of interactions users had with SweetMama. Results Of 24 individuals enrolled, 23 used SweetMama and 22 completed exit interviews. Participants were mostly non-Hispanic Black (46%) or Hispanic (38%) individuals. Over the 14-day period, users accessed SweetMama frequently (median number of log-ins 8 [interquartile range 6-10]), for a median of 20.5 total minutes, and engaged all features. A majority (66.7%) rated SweetMama as having moderate or high usability. Participants emphasized design and technical strengths and beneficial effects on diabetes self-management and also identified limitations of the user experience. Conclusion Pregnant people with diabetes found SweetMama to be user-friendly, informative, and engaging. Future work must study its feasibility for use throughout pregnancy and its efficacy to improve perinatal outcomes.
Collapse
Affiliation(s)
- Lynn M. Yee
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Karolina Leziak
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jenise Jackson
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Charlotte Niznik
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Rana Saber
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Chen Yeh
- Department of Preventive Medicine, Division of Biostatistics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Melissa A. Simon
- Departments of Obstetrics and Gynecology and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
6
|
Quirk HD, Nagar R, Anderson PL. A qualitative exploration of college students' experiences using mobile apps to improve self-care during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37053590 DOI: 10.1080/07448481.2023.2198033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/09/2023] [Accepted: 03/19/2023] [Indexed: 06/19/2023]
Abstract
Objective: This project examines students' experiences using a mental health mobile application (app) as part of a class assignment developed to support student well-being. Participants: Data was collected from 265 undergraduate students enrolled in a psychology course during the COVID-19 pandemic. Methods: Students developed a self-care goal and used an app to support progress toward it. Thematic analysis was applied to students' written reflections about their experiences using the app and practicing self-care. Results: Students reported using an app for self-care was 1) more helpful than expected for improving focus, productivity, motivation, sleep, and mental health symptoms; 2) challenging due to loss of interest, slow improvement, difficulty integrating into routine, or negative feelings triggered; and 3) influenced by the pandemic and transition to remote learning. Conclusions: A classroom assignment designed to promote self-care using a mental health app shows promise. Future research is needed to better understand engagement and impact.
Collapse
Affiliation(s)
| | - Ria Nagar
- Psychology, Georgia State University, Atlanta, Georgia, USA
| | | |
Collapse
|
7
|
Analysis of Mobile App-Based Mental Health Solutions for College Students: A Rapid Review. Healthcare (Basel) 2023; 11:healthcare11020272. [PMID: 36673640 PMCID: PMC9859497 DOI: 10.3390/healthcare11020272] [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: 12/28/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND College students are one of the most susceptible age groups to mental health problems. With the growing popularity of mobile health (mHealth), there is an increasing need to investigate its implications for mental health solutions. This review evaluates mHealth interventions for addressing mental health problems among college students. METHODS An online database search was conducted. Articles were required to focus on the impact of mHealth intervention on student mental health. Fifteen of the 487 articles, initially pulled from the search query, were included in the review. RESULTS The review identified three primary aspects of mental health: depression, anxiety, and stress. Research that found statistically significant improvements following mHealth intervention involved study durations between four and eight weeks, daily app use, guided lessons using cognitive behavioral therapy, acceptance and commitment therapy, and meditation. The review's findings show that future work must address the concern of digital divide, gender and sex differences, and have larger sample sizes. CONCLUSIONS There is potential to improve depressive symptoms and other similar mental health problems among college students via mobile app interventions. However, actions must be taken to improve barriers to communication and better reach the younger generations.
Collapse
|
8
|
Goozee R, Barrable A, Lubenko J, Papadatou-Pastou M, Haddad M, McKeown E, Hirani SP, Martin M, Tzotzoli P. Investigating the feasibility of MePlusMe, an online intervention to support mental health, well-being, and study skills in higher education students. J Ment Health 2022:1-11. [PMID: 35549804 DOI: 10.1080/09638237.2022.2069699] [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: 05/14/2021] [Revised: 12/17/2021] [Accepted: 01/14/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION While there are several web-based mental health interventions, few target higher education (HE) students. Importantly, more research is needed to establish their effectiveness. Here, we provide a pragmatic evaluation of an online intervention (MePlusMe) specifically designed to improve the mental health, well-being, and study skills of HE students. METHODS In accordance with the published protocol for a feasibility study, we recruited a convenience sample of 137 HE students to participate in an eight-week intervention, with 26 participants retained at week 8. Validated measures of mood (depression and anxiety), well-being, and self-efficacy were collected at baseline, 2, 4, and 8 weeks, alongside two feedback forms assessing design and functionality (baseline) and engagement (week 4 and 8). RESULTS We observed significant reductions in levels of anxiety and depression as well as increases in well-being, but no changes in self-efficacy. Participants rated the system design and functionality positively and qualitative findings indicated high levels of satisfaction with MePlusMe. DISCUSSION Findings support both the acceptability and the effectiveness of MePlusMe. Nonetheless, modest retention rates limit the precision and generalisability of these findings. Further investigation should ascertain optimal duration of engagement, most acceptable means of outcome assessment, and further detail about obstacles to utilisation.
Collapse
Affiliation(s)
| | - Alexia Barrable
- School of Education and Social Work, University of Dundee, Dundee, UK
| | - Jelena Lubenko
- Department of Health Psychology and Paedagogy, Rīga Stradiņš University, Rīga, Latvia
| | | | - Mark Haddad
- School of Health Sciences, City, University of London, London, UK
| | - Eamonn McKeown
- School of Health Sciences, City, University of London, London, UK
| | | | - Maryanne Martin
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | | |
Collapse
|
9
|
McCallum M, Ho AS, Mitchell ES, May CN, Behr H, Ritschel L, Mochrie K, Michaelides A. Feasibility, Acceptability, and Preliminary Outcomes of a Cognitive Behavioral Therapy–Based Mobile Mental Well-being Program (Noom Mood): Single-Arm Prospective Cohort Study. JMIR Form Res 2022; 6:e36794. [PMID: 35436218 PMCID: PMC9055471 DOI: 10.2196/36794] [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: 01/26/2022] [Revised: 03/08/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background The prevalence of anxiety, depression, and general distress has risen in recent years. Mobile mental health programs have been found to provide support to nonclinical populations and may overcome some of the barriers associated with traditional in-person treatment; however, researchers have voiced concerns that many publicly available mobile mental health programs lack evidence-based theoretical foundations, peer-reviewed research, and sufficient engagement from the public. Objective This study aimed to evaluate the feasibility, acceptability, and preliminary outcomes of Noom Mood, a commercial mobile cognitive behavioral therapy– and mindfulness-based program. Methods In this single-arm prospective cohort study, individuals who joined Noom Mood between August and October 2021 completed surveys at baseline and 4-week follow-up. Per-protocol analyses included those who completed both surveys (n=113), and intention-to-treat analyses included all participants (N=185). Results A majority of the sample reported that the program is easy to use, they felt confident recommending the program to a friend, and they perceived the program to be effective at improving stress and anxiety. There were significant improvements in anxiety symptoms, perceived stress, depressive feelings, emotion regulation, and optimism in both the per-protocol and intention-to-treat analyses (all P<.001). Participants reported benefiting most from learning skills (eg, breathing and cognitive reframing techniques), interacting with the program features, and gaining awareness of their emotions and thought patterns. Participants also made a number of suggestions to improve product functionality and usability. Conclusions Results suggest that Noom Mood is feasible and acceptable to participants, with promising preliminary outcomes. Future studies should build on these results to evaluate the effects of Noom Mood using more rigorous designs.
Collapse
Affiliation(s)
| | | | | | | | - Heather Behr
- Academic Research, Noom Inc, New York, NY, United States
- Department of Integrative Health, Saybrook University, Pasadena, CA, United States
| | - Lorie Ritschel
- Triangle Area Psychology Clinic, Durham, NC, United States
- School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Kirk Mochrie
- Triangle Area Psychology Clinic, Durham, NC, United States
| | | |
Collapse
|
10
|
Uptake and effectiveness of a self-guided mobile app platform for college student mental health. Internet Interv 2021; 27:100493. [PMID: 35036331 PMCID: PMC8749061 DOI: 10.1016/j.invent.2021.100493] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/29/2021] [Accepted: 12/20/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND College students endorse high rates of mental health problems. While many colleges offer on-campus services, many students who could benefit from mental health services do not receive care. Indeed, nearly half of students who screen positive for depression, for example, do not receive treatment. Digital mental health programs, such as those delivered via mobile apps, may help expand access to mental health care and resources. This mixed-methods study aims to examine the uptake and effectiveness of an implementation of IntelliCare for College Students, a self-guided app-based mental health platform, on two university campuses. METHODS Data on counseling center utilization was collected prior to the implementation of the app (pre-implementation phase) and while the app was available on campus (implementation phase). Data on app usage was collected throughout the implementation phase. A subset of participants (n = 20), along with counseling center staff members (n = 10), completed feedback interviews. RESULTS Overall, uptake of the app platform was low. A total of 117 participants downloaded the app and registered their study ID during the implementation phase. Approximately 24% (28/117) of participants used the app only once. The number of days between the first and last day of app use ranged from 0 to 299, with a mean of 35.01 days and a median of 14 days. A relatively small portion of the sample (26.5%; 31/117) downloaded one or more of the IntelliCare interactive apps. In examining counseling center utilization, there were no significant changes in intake appointments, individual therapy sessions, or crisis appointments observed from the pre-implementation phase to the implementation phase of the study. Feedback interviews highlighted the significant level of disruption caused by the COVID-19 pandemic and shift to remote learning, including challenges disseminating information to students and a preference to spend less time with digital devices outside of class time. CONCLUSIONS Findings from this study indicate that there is an ongoing need to identify ways to reach college students and support student mental health and wellness for the remainder of the COVID-19 pandemic and beyond.
Collapse
|
11
|
Xu W, Liang HN, Baghaei N, Ma X, Yu K, Meng X, Wen S. Effects of an Immersive Virtual Reality Exergame on University Students' Anxiety, Depression, and Perceived Stress: Pilot Feasibility and Usability Study. JMIR Serious Games 2021; 9:e29330. [PMID: 34813487 PMCID: PMC8663481 DOI: 10.2196/29330] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/07/2021] [Accepted: 08/25/2021] [Indexed: 01/20/2023] Open
Abstract
Background In recent years, there has been an increase in the number of students with depression, anxiety, and perceived stress. A solution that has been increasingly used for improving health and well-being is exergaming. The effects and acceptability of exergames have been studied widely but mostly with older adults. The feasibility and usability of exergames among university students, especially those of immersive virtual reality (iVR) exergames, remain unexplored. Objective This study aimed to explore the feasibility of a 6-week iVR exergame–based intervention in reducing anxiety, depression, and perceived stress among university students and to examine the usability and acceptability of such games. Methods A total of 31 university students were recruited to participate in a 6-week study in which they needed to play a boxing-style iVR exergame called FitXR (FitXR Limited) twice per week (30 minutes per session). Their anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), and perceived stress (Perceived Stress Scale) levels were measured before and after intervention. Results A total of 15 participants completed the 6-week study. Our results suggested that participants’ mean depression scores decreased significantly from 8.33 (SD 5.98) to 5.40 (SD 5.14) after the intervention (P=.01). In addition, most participants (14/15, 93%) believed that the iVR exergame has good usability. Furthermore, most participants (14/15, 93%) were satisfied with the iVR gameplay experience and would play the iVR exergame again in the future. Of the 15 participants, 11 (73%) would recommend the iVR exergame to their friends. Conclusions The results gained from this study show that the iVR exergame has good usability, is highly acceptable, and has the potential to reduce depression levels among university students.
Collapse
Affiliation(s)
- Wenge Xu
- Digital Media Technology Lab, School of Computing and Digital Technology, Birmingham City University, Birmingham, United Kingdom
| | - Hai-Ning Liang
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Nilufar Baghaei
- School of Natural and Computational Sciences, Massey University, Auckland, New Zealand.,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia
| | - Xiaoyue Ma
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Kangyou Yu
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Xuanru Meng
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Shaoyue Wen
- Department of Computing, School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| |
Collapse
|
12
|
Cislo C, Clingan C, Gilley K, Rozwadowski M, Gainsburg I, Bradley C, Barabas J, Sandford E, Olesnavich M, Tyler J, Mayer C, DeMoss M, Flora C, Forger DB, Cunningham JL, Tewari M, Choi SW. Monitoring beliefs and physiological measures in students at risk for COVID-19 using wearable sensors and smartphone technology: Protocol for a mobile health study. JMIR Res Protoc 2021; 10:e29561. [PMID: 34115607 PMCID: PMC8386373 DOI: 10.2196/29561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted lives significantly and greatly affected an already vulnerable population, college students, in relation to mental health and public safety. Social distancing and isolation have brought about challenges to student's mental health. Mobile health apps and wearable sensors may help to monitor students at risk for COVID-19 and support their mental well-being. OBJECTIVE Through the use of a wearable sensor and smartphone-based survey completion, this study aimed to monitor students at risk for COVID-19. METHODS We conducted a prospective study of students, undergraduate and graduate, at a public university in the Midwest. Students were instructed to download the Fitbit, Social Rhythms, and Roadmap 2.0 apps onto their personal mobile devices (Android or iOS). Subjects consented to provide up to 10 saliva samples during the study period. Surveys were administered through the Roadmap 2.0 app at five timepoints - at baseline, 1-month later, 2-months later, 3-months later, and at study completion. The surveys gathered information regarding demographics, COVID-19 diagnoses and symptoms, and mental health resilience, with the aim of documenting the impact of COVID-19 on the college student population. RESULTS This study enrolled 2,158 college students between September 2020 and January 2021. Subjects are currently being followed on-study for one academic year. Data collection and analysis are ongoing. CONCLUSIONS This study examined student health and well-being during the COVID-19 pandemic. It also assessed the feasibility of wearable sensor use and survey completion in a college student population, which may inform the role of our mobile health tools on student health and well-being. Finally, using wearable sensor data, biospecimen collection, and self-reported COVID-19 diagnosis, our results may provide key data towards the development of a model for the early prediction and detection of COVID-19. CLINICALTRIAL ClinicalTrials.gov NCT04766788.
Collapse
Affiliation(s)
- Christine Cislo
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
| | - Caroline Clingan
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
| | - Kristen Gilley
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
| | - Michelle Rozwadowski
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Izzy Gainsburg
- Management and Organizations Area, Ross School of Business, University of Michigan, Ann Arbor, US
| | - Christina Bradley
- Management and Organizations Area, Ross School of Business, University of Michigan, Ann Arbor, US
| | - Jenny Barabas
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Erin Sandford
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Mary Olesnavich
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Jonathan Tyler
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Department of Mathematics, University of Michigan, Ann Arbor, US
| | - Caleb Mayer
- Department of Mathematics, University of Michigan, Ann Arbor, US
| | - Matthew DeMoss
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Christopher Flora
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
| | - Daniel B Forger
- Department of Mathematics, University of Michigan, Ann Arbor, US
| | - Julia Lee Cunningham
- Management and Organizations Area, Ross School of Business, University of Michigan, Ann Arbor, US
| | - Muneesh Tewari
- Division of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, US
- Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor, US
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, US
| | - Sung Won Choi
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Michigan, 1500 E. Medical Center DrD4118 Medical Professional Building, Ann Arbor, US
- Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor, US
| |
Collapse
|
13
|
Oliveira C, Pereira A, Vagos P, Nóbrega C, Gonçalves J, Afonso B. Effectiveness of Mobile App-Based Psychological Interventions for College Students: A Systematic Review of the Literature. Front Psychol 2021; 12:647606. [PMID: 34045994 PMCID: PMC8144454 DOI: 10.3389/fpsyg.2021.647606] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/06/2021] [Indexed: 01/16/2023] Open
Abstract
Serious mental health disorders are increasing among college students and university counseling services are often overburdened. Mobile applications for mental health have been growing exponentially in the last decade and they are emerging in university settings as a promising tool to promote and intervene in college students' mental health. Additionally, considering the recent covid-19 pandemic, mHealth interventions, due to its nature and possibilities, may play an important role in these institutions. Our main objectives are to explore mhealth interventions in universities, regarding its conceptual framework, acceptability and efficacy outcomes and understand its impact and contributions to address treatment delivery and psychological difficulties resulting from covid-19 pandemic. The literature search was conducted in scientific databases, namely, Web of Science, Pubmed, and Scopus. A search in app stores was not conducted, thus regarding commercially available apps, only those found in our database search were included in our review. We selected studies with mobile applications addressing psychological interventions for college students. A total of 2,158 participants were included in the 8 selected studies and most interventions were delivered through mobile apps only and based in cognitive behavioral therapy. Results suggested that college students accept and adhere to these interventions and preliminary evidence of efficacy was demonstrated in different disorders, such as stress, anxiety, depression and risky behaviors such as alcohol and tobacco abuse and sexual knowledge. We conclude that universities, particularly college counseling services, may benefit from mhealth interventions, not only to address college students' mental health but to decrease some of its difficulties related to lack of human resources. Specifically in covid-19 pandemic context, these interventions may contribute significantly by promoting and delivering psychological interventions at a safe distance.
Collapse
Affiliation(s)
- Carla Oliveira
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Anabela Pereira
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Paula Vagos
- Department of Psychology and Education, Portucalense Institute for Human Development (INPP), Universidade Portucalense, Porto, Portugal
| | - Catarina Nóbrega
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - José Gonçalves
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Beatriz Afonso
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| |
Collapse
|