Barriers and facilitators to mobile application use during PTSD
                        treatment: Clinician adoption of PE coach.

Reger, Greg M.; Browne, Kendall C.; Campellone, Timothy R.; Simons, Carol; Kuhn, Eric; Fortney, John C.; Sayre, George; Reisinger, Heather Schacht

doi:10.1037/pro0000153

Cited by 34 publications

(34 citation statements)

References 17 publications

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“…Indeed, even when people do use existing mental health apps, they typically only use 1 or 2 features. For example, in an evaluation of PE Coach, which contains a number of features, it was found that clinicians and patients mostly used the app to audio-record sessions [16]. This gap between the design of mental health apps, which is typically based on complex psychotherapy models, and how people use their devices, which commonly occurs in short bursts for single purposes, likely is 1 reason for the low engagement with mental health apps seen in real-world settings [17].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial

et al. 2019

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Background IntelliCare is a modular platform that includes 12 simple apps targeting specific psychological strategies for common mental health problems. Objective This study aimed to examine the effect of 2 methods of maintaining engagement with the IntelliCare platform, coaching, and receipt of weekly recommendations to try different apps on depression, anxiety, and app use. Methods A total of 301 participants with depression or anxiety were randomized to 1 of 4 treatments lasting 8 weeks and were followed for 6 months posttreatment. The trial used a 2X2 factorial design (coached vs self-guided treatment and weekly app recommendations vs no recommendations) to compare engagement metrics. Results The median time to last use of any app during treatment was 56 days (interquartile range 54-57), with 253 participants (84.0%, 253/301) continuing to use the apps over a median of 92 days posttreatment. Receipt of weekly recommendations resulted in a significantly higher number of app use sessions during treatment (overall median=216; P=.04) but only marginal effects for time to last use (P=.06) and number of app downloads (P=.08). Coaching resulted in significantly more app downloads (P<.001), but there were no significant effects for time to last download or number of app sessions (P=.36) or time to last download (P=.08). Participants showed significant reductions in the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) across all treatment arms (P s<.001). Coached treatment led to larger GAD-7 reductions than those observed for self-guided treatment (P=.03), but the effects for the PHQ-9 did not reach significance (P=.06). Significant interaction was observed between receiving recommendations and time for the PHQ-9 (P=.04), but there were no significant effects for GAD-7 (P=.58). Conclusions IntelliCare produced strong engagement with apps across all treatment arms. Coaching was associated with stronger anxiety outcomes, and receipt of recommendations enhanced depression outcomes. Trial Registration ClinicalTrials.gov NCT02801877; https://clinicaltrials.gov/ct2/show/NCT02801877

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Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial

et al. 2019

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“…Establishing the standards for creating PTSD-related mHealth apps and following them seem to be essential in transferring mobile apps to the clinical field [ 4 ]. Moreover, practitioners need to explore the factors facilitating and limiting the effective use of mHealth for PTSD treatment [ 57 , 58 ]. Cooperation between mobile app creators, researchers, and practitioners is essential in creating new technology that will match the needs and expectations of both health care staff and patients [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Scientific Publication Patterns of Mobile Technologies and Apps for Posttraumatic Stress Disorder Treatment: Bibliometric Co-Word Analysis

Kulaklı¹,

Shubina²

2020

JMIR Mhealth Uhealth

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Background Mobile apps are viewed as a promising opportunity to provide support for patients who have posttraumatic stress disorder (PTSD). The development of mobile technologies and apps shows similar trends in PTSD treatment. Therefore, this emerging research field has received substantial attention. Consequently, various research settings are planned for current and further studies. Objective The aim of this study was to explore the scientific patterns of research domains related to mobile apps and other technologies for PTSD treatment in scholarly publications, and to suggest further studies for this emerging research field. Methods We conducted a bibliometric analysis to identify publication patterns, most important keywords, trends for topicality, and text analysis, along with construction of a word cloud for papers published in the last decade (2010 to 2019). Research questions were formulated based on the relevant literature. In particular, we concentrated on highly ranked sources. Based on the proven bibliometric approach, the data were ultimately retrieved from the Web of Science Core Collection (Clarivate Analytics). Results A total of 64 studies were found concerning the research domains. The vast majority of the papers were written in the English language (63/64, 98%) with the remaining article (1/64, 2%) written in French. The articles were written by 323 authors/coauthors from 11 different countries, with the United States predominating, followed by England, Canada, Italy, the Netherlands, Australia, France, Germany, Mexico, Sweden, and Vietnam. The most common publication type was peer-reviewed journal articles (48/64, 75%), followed by reviews (8/64, 13%), meeting abstracts (5/64, 8%), news items (2/64, 3%), and a proceeding (1/64, 2%). There was a mean of 6.4 papers published per year over the study period. There was a 100% increase in the number of publications published from 2016 to 2019 with a mean of 13.33 papers published per year during this latter period. Conclusions Although the number of papers on mobile technologies for PTSD was quite low in the early period, there has been an overall increase in this research domain in recent years (2016-2019). Overall, these findings indicate that mobile health tools in combination with traditional treatment for mental disorders among veterans increase the efficiency of health interventions, including reducing PTSD symptoms, improving quality of life, conducting intervention evaluation, and monitoring of improvements. Mobile apps and technologies can be used as supportive tools in managing pain, anger, stress, and sleep disturbance. These findings therefore provide a useful overview of the publication trends on research domains that can inform further studies and highlight potential gaps in this field.

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“…Similar research has been conducted among VA CBT-i providers yielding comparable findings for CBT-i Coach (48,49). Finally, a qualitative study of 25 VA PE providers (who reported using PE Coach with 450 of their patients) found that providers appreciated that the app enhanced treatment credibility, "side-by-side" collaboration, and having forms and resources consolidated in the app, but did not appreciate lack of parity between Android and iOS versions of the app and not being able to readily access data stored in the app (60).…”

Section: Cbt-i Coachmentioning

confidence: 92%

VA mobile apps for PTSD and related problems: public health resources for veterans and those who care for them

Owen

Kuhn

Jaworski

et al. 2018

mHealth

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Many public health agencies, including the U.S. Department of Veterans Affairs (VA), have identified the use of mobile technologies as an essential part of a larger strategy to address major public health challenges. The VA's National Center for PTSD (NCPTSD), in collaboration with VA's Office of Mental Health and Suicide Prevention and the Defense Health Agency inside the U.S. Department of Defense (DoD), has been involved in the development, evaluation, and testing of 15 mobile apps designed specifically to address the needs and concerns of veterans and others experiencing symptoms of posttraumatic stress disorder (PTSD). These applications include seven treatment-companion apps (designed to be used with a provider, in conjunction with an evidence-based therapy) and eight self-management apps (designed to be used independently or as an adjunct or extender of traditional care). There is growing evidence for the efficacy of several of these apps for reducing PTSD and other symptoms, and studies of providers demonstrate that the apps are engaging, easy-to-use, and provide a relative advantage to traditional care without apps. While publicly available apps do not collect or share personal data, VA has created research-enabled versions of many of its mental health apps to enable ongoing product enhancement and continuous measurement of the value of these tools to veterans and frontline providers. VA and DoD are also collaborating on provider-based implementation networks to enable clinicians to optimize implementation of mobile technologies in care. Although there are many challenges to developing and integrating mHealth into care, including cost, privacy, and the need for additional research, mobile mental health technologies are likely here to stay and have the potential to reach large numbers of those with unmet mental health needs, including PTSD-related concerns.

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Barriers and facilitators to mobile application use during PTSD treatment: Clinician adoption of PE coach.

Cited by 34 publications

References 17 publications

Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial

Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial

Scientific Publication Patterns of Mobile Technologies and Apps for Posttraumatic Stress Disorder Treatment: Bibliometric Co-Word Analysis

VA mobile apps for PTSD and related problems: public health resources for veterans and those who care for them

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