Over two million people in the US download health apps onto their smartphones and tablets, with the intent of improving their quality of life. Despit widespread use of these apps, there is relatively little information regarding app user access (do users download health apps and use them more than once), app user engagement (do users follow the app protocols) and app impact on mood, cognition and daily functioning. Our long-term goal is to conduct a future randomized controlled trial investigating access, engagement and impact of two types of mental health apps, apps based on evidence-based therapeutic principles (i.e.: Problem Solving Therapy) and apps based on cognitive neuroscience principles of depression (i.e.: a cognitive training game called Evolution) and compare both to an information only app. Our intent is to conduct this study entirely on mobile devices, in order to investigate access, engagement, and impact in an ecologically valid manner. The purpose of this pilot study is to test the feasibility of conducting our future randomized controlled trial comparing three mobile mental health apps for the management of depressed mood, improvement of cognitive control, and improvement in activities of daily living in people aged 18 and older. Recruitment, consent, randomization, app use and outcome assessment will be conducted entirely on mobile devices. We will recruit 150 people through four different recruitment avenues to determine which avenue results in the most representative sample of our target population (people 18 and older who have symptoms of depression that are interfering with their quality of life). We will also determine the number we need to recruit to have a final sample of 150 people willing to be randomized between the 3 apps and complete an 12-week study of app impact on mood, cognition and function. This pilot will provide information on the completeness of data from a study conducted in this manner, and uncover any other challenges we may face by using mobile devices for data collection, and if we will find differential drop out between app type (e.g.: will more people stop using of the information only app prematurely?). Although we will not have sufficient statistical power to answer questions about comparative effectiveness between the apps, we plan to explore relationships between sample demographics, app use, and improvement in cognitive control on improvements in mood and function.

Public Health Relevance

Millions of people in the US download apps onto their smartphones and tablets to be used for health and mental health reasons. Although these apps are popular, and smartphone/tablet owners can download any number of apps to improve mood and improve their concentration, memory, and thinking, we have almost no information as to whether these apps work as they are meant to work. In particular, we have little information as to whether people really download and use these apps they way they are supposed to, and if the apps result in better mood, clearer thinking, and better management of daily chores and activities. In this proposed study, 150 people will be assigned, by chance, one of three different apps, one based on an evidence-based depression treatment, one based on brain theories of depression, and an information control. Because no one has yet done a study entirely over smartphone and tablet devices, will be developing the research methods needed to find out if these apps are used as intended and if they really help with mood and thinking. The information we learn from this project will use used to plan a study large enough to detect the true effects of health apps on mood, thinking and daily activities.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Special Emphasis Panel (ZMH1-ERB-I (01))
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Sherrill, Joel
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University of California San Francisco
Schools of Medicine
San Francisco
United States
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Pratap, Abhishek; Atkins, David C; Renn, Brenna N et al. (2018) The accuracy of passive phone sensors in predicting daily mood. Depress Anxiety :
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