BackgroundA large number of health apps are available directly to consumers through app marketplaces. Little information is known, however, about how consumers search for these apps and which factors influence their uptake, adoption, and long-term use.ObjectiveThe aim of this study was to understand what people look for when they search for health apps and the aspects and features of those apps that consumers find appealing.MethodsParticipants were recruited from Northwestern University’s Center for Behavioral Intervention Technologies’ research registry of individuals with mental health needs. Most participants (n=811) completed a survey asking about their use and interest in health and mental health apps. Local participants were also invited to participate in focus groups. A total of 7 focus groups were conducted with 30 participants that collected more detailed information about their use and interest in health and mental health apps.ResultsSurvey participants commonly found health apps through social media (45.1%, 366/811), personal searches (42.7%, 346/811), or word of mouth (36.9%, 299/811), as opposed to professional sources such as medical providers (24.6%, 200/811). From the focus groups, common themes related to uptake and use of health apps included the importance of personal use before adoption, specific features that users found desirable, and trusted sources either developing or promoting the apps.ConclusionsAs the number of mental health and health apps continue to increase, it is imperative to better understand the factors that impact people’s adoption and use of such technologies. Our findings indicated that a number of factors—ease of use, aesthetics, and individual experience—drove adoption and use and highlighted areas of focus for app developers and disseminators.

BackgroundMobile apps have become popular resources for mental health support. Availability of information about developers' data security procedures for health apps, specifically those targeting mental health, has not been thoroughly investigated. If people are to use and trust these tools for their mental health, it is crucial we evaluate the transparency and quality around the data practices of these apps. The present study reviewed data security and privacy policies of mobile apps for depression.MethodsWe reviewed mobile apps retrieved from iTunes and Google Play stores in October 2017, using the term “depression”, and evaluated the transparency of data handling procedures of those apps.ResultsWe identified 116 eligible mobile phone apps. Of those, 4% (5/116) received a transparency score of acceptable, 28% (32/116) questionable, and 68% (79/116) unacceptable. Only a minority of the apps (49%) had a privacy policy. The availability of policies differed significantly by platform, with apps from iTunes more likely to have a policy than from the Google Play store. Mobile apps collecting identifiable information were significantly more likely to have a privacy policy (79%) compared to those collecting only non-identifiable information (34%).ConclusionThe majority of apps reviewed were not sufficiently transparent with information regarding data security. Apps have great potential to scale mental health resources, providing resources to people unable or reluctant to access traditional face-to-face care, or as an adjunct to treatment. However, if they are to be a reasonable resource, they must be safe, secure, and responsible.

Despite the growth of behavioral health services in the United States, reports show persistent disparities in racial and ethnic minority populations' access to them. Primary care practices are often where patients go first for their medical and mental healthcare, placing the burden for treatment of behavioral health problems on primary care physicians. Integrated behavioral healthcare (IBHC), which embeds behavioral health clinicians in medical settings, is growing rapidly and should become an important component of the healthcare system. This paper proposes IBHC as a solution to reduce disparities in access to behavioral health services for underserved populations, specifically Latinx and African American populations, as well as racial and ethnic minority youth. The authors surveyed the literature to describe the history and current use of IBHC and present the case for addressing the behavioral health needs of underserved populations with IBHC. Research suggests that patients treated in IBHC settings experience an improvement in their symptoms and functioning across behavioral health problems. Furthermore, IBHC patients in primary care clinics report satisfaction with care and strong therapeutic alliance with behavioral health clinicians. Preliminary research suggests that IBHC may also reduce stigma and cultural barriers in underserved racial and ethnic minority populations. IBHC provides a unique opportunity to fulfill a critical need by meeting patients where they are. Therefore, we need to focus on improving and expanding IBHC for underserved racial and ethnic minority communities. What is the significance of this article for the general public?This paper outlines current barriers to accessing behavioral healthcare for Latinx, African American, and racial and ethnic minority youth and how IBHC combats those barriers. Additionally, it highlights outcomes of brief behavioral interventions and patient and physician satisfaction with IBHC. IBHC is a viable option for providing behavioral healthcare to underserved patient populations.

Background Many patients with poorly controlled multiple chronic conditions (MCC) also have unhealthy behaviors, mental health challenges, and unmet social needs. Medical management of MCC may have limited benefit if patients are struggling to address their basic life needs. Health systems and communities increasingly recognize the need to address these issues and are experimenting with and investing in new models for connecting patients with needed services. Yet primary care clinicians, whose regular contact with patients makes them more familiar with patients’ needs, are often not included in these systems. Methods We are starting a clinician-level cluster-randomized controlled trial to evaluate how primary care clinicians can participate in these community and hospital solutions and whether doing so is effective in controlling MCC. Sixty clinicians in the Virginia Ambulatory Care Outcomes Research Network will be matched by age and sex and randomized to usual care (control condition) or enhanced care planning with clinical-community linkage support (intervention). From the electronic health record we will identify all patients with MCC, including cardiovascular disease or risks, diabetes, obesity, or depression. A baseline assessment will be mailed to up to 50 randomly selected patients for each clinician (3000 total). Ten respondents per clinician (600 patients total) with uncontrolled MCC will be randomly selected for study inclusion, with oversampling of minorities. The intervention includes two components. First, we will use an enhanced care planning tool, My Own Health Report (MOHR), to screen patients for health behavior, mental health, and social needs. Patients will be supported by a patient navigator, who will help patients prioritize needs, create care plans, and write a personal narrative to guide the care team. Patients will update care plans every 1 to 2 weeks. Second, we will create community-clinical linkage to help address patients’ needs. The linkage will include community resource registries, personnel to span settings (patient navigators and a community health worker), and care team coordination across team members through MOHR. Discussion This study will help inform efforts by primary care clinicians to help address unhealthy behaviors, mental health needs, and social risks as a strategy to better control MCC. Trial registration ClinicalTrials.gov: NCT03885401. Registered on 19 September 2019.