PDF(Pubmed)
Abstract：
UNASSIGNED: Mobile mental health apps are a cost-effective option for managing mental health problems, such as posttraumatic stress disorder (PTSD). The efficacy of mobile health (mHealth) apps depends on engagement with the app, but few studies have examined how users engage with different features of mHealth apps for PTSD.
UNASSIGNED: This study aims to examine the relationship between app engagement indices and PTSD symptom reduction using data from an unblinded pilot randomized controlled trial of \"Renew\" (Vertical Design), an exposure-based app for PTSD with and without coaching support. Because exposure is an effective approach for treating PTSD, we expected that engagement with exposure activities would be positively related to symptom reduction, over and above overall app usage.
UNASSIGNED: Participants were veterans (N=69) with clinically significant PTSD symptoms who were recruited online using Facebook advertisements and invited to use the Renew app as often as they wanted over a 6-week period. Participants completed screening and assessments online but provided informed consent, toured the app, and completed feedback interviews via telephone. We assessed users\' self-reported PTSD symptoms before and after a 6-week intervention period and collected app usage data using a research-instrumented dashboard. To examine overall app engagement, we used data on the total time spent in the app, the number of log-in days, and the number of points that the user gained in the app. To examine engagement with exposure components, we used data on total time spent completing exposure activities (both in vivo and imaginal), the number of in vivo exposure activities completed, and the number of characters written in response to imaginal exposure prompts. We used hierarchical regression analyses to test the effect of engagement indices on change in PTSD symptoms.
UNASSIGNED: Usage varied widely. Participants spent an average of 166.09 (SD 156.52) minutes using Renew, over an average of 14.7 (SD 10.71) mean log-in days. Engagement with the exposure components of the app was positively associated with PTSD symptom reduction (F6,62=2.31; P=.04). Moreover, this relationship remained significant when controlling for overall engagement with the app (ΔF3,62=4.42; P=.007). The number of characters written during imaginal exposure (β=.37; P=.009) and the amount of time spent completing exposure activities (β=.36; P=.03) were significant contributors to the model.
UNASSIGNED: To our knowledge, this is the first study to show a relationship between symptom improvement and engagement with the active therapeutic components of an mHealth app (ie, exposure) for PTSD. This relationship held when controlling for overall app use, which suggests that it was engagement with exposure, specifically, that was associated with symptom change. Future work to identify ways of promoting greater engagement with self-guided exposure may help improve the effectiveness of mHealth apps for PTSD.
UNASSIGNED: This study aims to examine the relationship between app engagement indices and PTSD symptom reduction using data from an unblinded pilot randomized controlled trial of \"Renew\" (Vertical Design), an exposure-based app for PTSD with and without coaching support. Because exposure is an effective approach for treating PTSD, we expected that engagement with exposure activities would be positively related to symptom reduction, over and above overall app usage.
UNASSIGNED: Participants were veterans (N=69) with clinically significant PTSD symptoms who were recruited online using Facebook advertisements and invited to use the Renew app as often as they wanted over a 6-week period. Participants completed screening and assessments online but provided informed consent, toured the app, and completed feedback interviews via telephone. We assessed users\' self-reported PTSD symptoms before and after a 6-week intervention period and collected app usage data using a research-instrumented dashboard. To examine overall app engagement, we used data on the total time spent in the app, the number of log-in days, and the number of points that the user gained in the app. To examine engagement with exposure components, we used data on total time spent completing exposure activities (both in vivo and imaginal), the number of in vivo exposure activities completed, and the number of characters written in response to imaginal exposure prompts. We used hierarchical regression analyses to test the effect of engagement indices on change in PTSD symptoms.
UNASSIGNED: Usage varied widely. Participants spent an average of 166.09 (SD 156.52) minutes using Renew, over an average of 14.7 (SD 10.71) mean log-in days. Engagement with the exposure components of the app was positively associated with PTSD symptom reduction (F6,62=2.31; P=.04). Moreover, this relationship remained significant when controlling for overall engagement with the app (ΔF3,62=4.42; P=.007). The number of characters written during imaginal exposure (β=.37; P=.009) and the amount of time spent completing exposure activities (β=.36; P=.03) were significant contributors to the model.
UNASSIGNED: To our knowledge, this is the first study to show a relationship between symptom improvement and engagement with the active therapeutic components of an mHealth app (ie, exposure) for PTSD. This relationship held when controlling for overall app use, which suggests that it was engagement with exposure, specifically, that was associated with symptom change. Future work to identify ways of promoting greater engagement with self-guided exposure may help improve the effectiveness of mHealth apps for PTSD.
摘要：
■移动心理健康应用程序是管理心理健康问题的具有成本效益的选择，如创伤后应激障碍（PTSD）。移动健康（mHealth）应用程序的功效取决于应用程序的参与度，但是很少有研究研究用户如何使用mHealth应用程序的不同功能进行PTSD。
■本研究旨在使用来自“Renew”（垂直设计）的非盲试点随机对照试验的数据，检查应用程序参与度指数与PTSD症状减轻之间的关系。一个基于暴露的创伤后应激障碍的应用程序，有和没有教练支持。因为暴露是治疗创伤后应激障碍的有效方法，我们预计参与接触活动将与症状减轻呈正相关，超过整体应用程序的使用。
■参与者是退伍军人（N=69），有临床上显著的PTSD症状，他们在网上使用Facebook广告招募，并邀请他们在6周内尽可能频繁地使用Renew应用程序。参与者在线完成筛查和评估，但提供知情同意。参观了应用程序，并通过电话完成反馈访谈。我们评估了用户在6周干预期之前和之后自我报告的PTSD症状，并使用研究仪器化的仪表板收集了应用程序使用数据。要检查整体应用参与度，我们使用了在应用程序中花费的总时间的数据，登录天数,以及用户在应用程序中获得的点数。为了检查与暴露部件的接合,我们使用了完成暴露活动所花费的总时间的数据(包括体内和想象)，完成的体内暴露活动的数量，以及响应想象曝光提示而写入的字符数。我们使用分层回归分析来测试参与指数对PTSD症状变化的影响。
■用法差异很大。参与者使用Renew平均花费166.09(SD156.52)分钟，平均登录天数超过14.7（SD10.71）。参与应用程序的暴露组件与PTSD症状减轻呈正相关（F6,62=2.31；P=.04）。此外，当控制应用的总体参与时，这种关系仍然显著(ΔF3,62=4.42；P=.007)。想象曝光期间书写的字符数（β=.37；P=.009）和完成曝光活动所花费的时间（β=.36；P=.03）是该模型的重要贡献者。
■据我们所知，这是第一项研究显示症状改善与mHealth应用程序的积极治疗成分之间的关系（即，暴露)用于创伤后应激障碍。在控制整体应用使用时保持这种关系，这表明它参与了暴露，具体来说,这与症状改变有关。未来的工作，以确定促进更多参与自我指导暴露的方式可能有助于提高mHealth应用程序对PTSD的有效性。
■本研究旨在使用来自“Renew”（垂直设计）的非盲试点随机对照试验的数据，检查应用程序参与度指数与PTSD症状减轻之间的关系。一个基于暴露的创伤后应激障碍的应用程序，有和没有教练支持。因为暴露是治疗创伤后应激障碍的有效方法，我们预计参与接触活动将与症状减轻呈正相关，超过整体应用程序的使用。
■参与者是退伍军人（N=69），有临床上显著的PTSD症状，他们在网上使用Facebook广告招募，并邀请他们在6周内尽可能频繁地使用Renew应用程序。参与者在线完成筛查和评估，但提供知情同意。参观了应用程序，并通过电话完成反馈访谈。我们评估了用户在6周干预期之前和之后自我报告的PTSD症状，并使用研究仪器化的仪表板收集了应用程序使用数据。要检查整体应用参与度，我们使用了在应用程序中花费的总时间的数据，登录天数,以及用户在应用程序中获得的点数。为了检查与暴露部件的接合,我们使用了完成暴露活动所花费的总时间的数据(包括体内和想象)，完成的体内暴露活动的数量，以及响应想象曝光提示而写入的字符数。我们使用分层回归分析来测试参与指数对PTSD症状变化的影响。
■用法差异很大。参与者使用Renew平均花费166.09(SD156.52)分钟，平均登录天数超过14.7（SD10.71）。参与应用程序的暴露组件与PTSD症状减轻呈正相关（F6,62=2.31；P=.04）。此外，当控制应用的总体参与时，这种关系仍然显著(ΔF3,62=4.42；P=.007)。想象曝光期间书写的字符数（β=.37；P=.009）和完成曝光活动所花费的时间（β=.36；P=.03）是该模型的重要贡献者。
■据我们所知，这是第一项研究显示症状改善与mHealth应用程序的积极治疗成分之间的关系（即，暴露)用于创伤后应激障碍。在控制整体应用使用时保持这种关系，这表明它参与了暴露，具体来说,这与症状改变有关。未来的工作，以确定促进更多参与自我指导暴露的方式可能有助于提高mHealth应用程序对PTSD的有效性。
