The effects of Apps on Mental and Physical wellbeing (AMP)

Smartphones are increasingly used to promote physical and mental wellbeing. Numerous downloadable applications (“apps”) have been developed to improve physical and mental wellbeing utilizing mobile devices (mHealth) and these apps can be accessed via most smart phone operating systems. The potential of these apps to produce positive changes in either physical or mental wellbeing remains insufficiently understood. The primary goal of this project is to evaluate: (a) whether apps targeting psychological factors produce improvements in mental wellbeing; and (b) whether individual characteristics prior to the use of these apps predict app effectiveness in improving mental wellbeing. A pre-post repeated measures design will be used in which four publicly available and “free” (no-payment) apps are compared and a fifth group will comprise of a no-app control condition. Participants will use the app for 2 weeks and will provide self-report data at baseline (prior to randomization), and at 1, 2 and 4 weeks follow-up.

Research Question 1: Do mental health apps improve mental wellbeing? This question will be investigated by testing the following hypothesis: There will be an interaction between condition (allocation to one of the 4 apps vs. no-app control; between-subjects factor) and time (pre- and post-app use assessments of the Mental Health Continuum questionnaire (MHC; within-subjects factor). Data will be analyzed using analysis of variance (general linear model) using a 5 x 2 mixed model design. Data will be analyzed using an intention-to-treat approach with carry-forward of missing values.

Ancillary Research Questons: Additional analyses will be conducted examining: (a) the nature of the mental health apps (i.e., whether or not users are encouraged to engage in specific behaviors or whether only self-monitoring is involved); (b) which psychological measures might function as explanatory variables for changes in MHC scores; (c) which app-related characteristics (e.g., user-friendlyness) play a role in the effectiveness of the app; and (d) other health outcomes (e.g., physical activity, sleep quality, and physical health status & symptoms).

Baseline (pre-randomization), 1, 2 and 4 weeks follow-up.

Four open access, no-cost (free), publicly available apps will be compared with a no-app control condition and also among themselves (see hypothesis for details). After the initial assessments, participants will be randomized to one of the 4 apps or the control condition, and they will use the app for 2 weeks. The four 'active' apps focus on: daily monitoring of emotions, meditation, mindfulness, and keeping a gratitude diary.

The project was reviewed and approved by the Ethics Review Board (ERB) of the Tilburg School of Social and Behavioral Sciences (project #: RP110) and does not require full METC review. The project was reviewed and approved for compliance with GDPR regulations.