Older Adults Engage With Personalized Digital Coaching Programs at Rates That Exceed Those of Younger Adults

Graham, Sarah; Stein, Natalie; Shemaj, Fjori; Branch, OraLee H.; Paruthi, Jason; Kanick, Stephen C.

doi:10.3389/fdgth.2021.642818

Cited by 28 publications

(32 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have found that desire for human contact and technology literacy barriers can be deterrents for mental health app use, particularly among older adults; thus, more coaching may be beneficial for these users [ 55 , 109 ]. Moreover, others have found older adults to be more engaged with digital coaches than younger ones [ 110 ]. In contrast, rather than necessarily wanting more contact, adolescents may prefer different approaches; to illustrate, integrating peer support and strength-based messaging may be preferable [ 111 ].…”

Section: Discussionmentioning

confidence: 99%

Human Support in App-Based Cognitive Behavioral Therapies for Emotional Disorders: Scoping Review

Bernstein¹,

Weingarden²,

Wolfe³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

Background Smartphone app–based therapies offer clear promise for reducing the gap in available mental health care for people at risk for or people with mental illness. To this end, as smartphone ownership has become widespread, app-based therapies have become increasingly common. However, the research on app-based therapies is lagging behind. In particular, although experts suggest that human support may be critical for increasing engagement and effectiveness, we have little systematic knowledge about the role that human support plays in app-based therapy. It is critical to address these open questions to optimally design and scale these interventions. Objective The purpose of this study is to provide a scoping review of the use of human support or coaching in app-based cognitive behavioral therapy for emotional disorders, identify critical knowledge gaps, and offer recommendations for future research. Cognitive behavioral therapy is the most well-researched treatment for a wide range of concerns and is understood to be particularly well suited to digital implementations, given its structured, skill-based approach. Methods We conducted systematic searches of 3 databases (PubMed, PsycINFO, and Embase). Broadly, eligible articles described a cognitive behavioral intervention delivered via smartphone app whose primary target was an emotional disorder or problem and included some level of human involvement or support (coaching). All records were reviewed by 2 authors. Information regarding the qualifications and training of coaches, stated purpose and content of the coaching, method and frequency of communication with users, and relationship between coaching and outcomes was recorded. Results Of the 2940 titles returned by the searches, 64 (2.18%) were eligible for inclusion. This review found significant heterogeneity across all of the dimensions of coaching considered as well as considerable missing information in the published articles. Moreover, few studies had qualitatively or quantitatively evaluated how the level of coaching impacts treatment engagement or outcomes. Although users tend to self-report that coaching improves their engagement and outcomes, there is limited and mixed supporting quantitative evidence at present. Conclusions Digital mental health is a young but rapidly expanding field with great potential to improve the reach of evidence-based care. Researchers across the reviewed articles offered numerous approaches to encouraging and guiding users. However, with the relative infancy of these treatment approaches, this review found that the field has yet to develop standards or consensus for implementing coaching protocols, let alone those for measuring and reporting on the impact. We conclude that coaching remains a significant hole in the growing digital mental health literature and lay out recommendations for future data collection, reporting, experimentation, and analysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Human Support in App-Based Cognitive Behavioral Therapies for Emotional Disorders: Scoping Review

Bernstein¹,

Weingarden²,

Wolfe³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…The COVID-19 pandemic has accelerated the creation and use of digital mental health resources across a variety of settings. As the veteran population in the United States is aging and their smartphone ownership is growing, they are also more successfully engaging with digital health products [ 23 ]. To our knowledge, this study is one of the first to document current smartphone ownership rates in the US veteran population, the majority of whom were older, and to examine predictors of uptake and usage of a mental health app focused on COVID-19–related stressors.…”

Section: Discussionmentioning

confidence: 99%

“…Although older adults in the United States may be somewhat less likely than their younger counterparts to use mobile devices, the majority (61%) own smartphones [ 21 ]. Older adults express interest in using mobile devices to support health [ 22 ], and in some cases their engagement with digital health products may exceed that of younger adults [ 23 ]. In general, prior research suggests that older adults are interested in apps for health, but uptake and usage continue to be relatively low [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

Jaworski¹,

Taylor²,

Ramsey³

et al. 2022

JMIR Ment Health

View full text Add to dashboard Cite

Background Although the COVID-19 pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of preexisting mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated; however, the uptake and usage of the app among older veterans have not been explored. Objective The purpose of this study was to characterize smartphone ownership rates among US veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app. Methods Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3078 US military veterans before and 1 year into the pandemic. The NHRVS sample was drawn from KnowledgePanel, a research panel of more than 50,000 households maintained by Ipsos, Inc. The median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peripandemic follow-up assessment on a mobile device (n=814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n=34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020, and November 7, 2021. Results We found that most US veterans (81.5%) own smartphones, and that veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related posttraumatic stress disorder symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach were relatively low (3.3% of eligible participants, n=34), 50% of the participants returned to the app for more than 1 day of use. The interactive tools for managing stress were used most frequently. Conclusions The COVID-19 pandemic has increased the need for and creation of digital mental health tools. However, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools such as apps to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.

show abstract

“…For example, older adults report willingness to engage with smartphone-based technologies for pain management ( 4 ). Moreover, recent research indicates that older adults show higher engagement with digital health programs than younger adults, contrary to conventional wisdom that older adults face too many barriers to engage with digital health programs at the same level as younger adults ( 5 ). The results from Graham and colleagues ( 5 ), comparing engagement in digital health programs of adults 35 to 64 years to those over 65, demonstrated that adults over 65 engaged in significantly more coaching conversations, logged more meals, and provided more connected device measurements than younger adults.…”

Section: Introductionmentioning

confidence: 81%

Engagement in Digital Health App-Based Prevention Programs Is Associated With Weight Loss Among Adults Age 65+

Auster‐Gussman¹,

Lockwood²,

Pitter³

et al. 2022

Front. Digit. Health

Self Cite

View full text Add to dashboard Cite

BackgroundDigital health programs have been shown to be feasible and effective for the prevention of chronic diseases such as diabetes. Contrary to expectations, findings also suggest that older adults have higher levels of engagement with digital health programs than younger adults. However, there is a paucity of research examining outcomes among older adults in digital health programs and whether higher engagement is related to better outcomes.MethodsWe examined weight loss outcomes for 538 users aged 65 and older participating in one of two app-based prevention programs called the Diabetes Prevention Program and the Prevention Program, respectively. Both programs were available on a single artificial intelligence (AI)-powered digital health platform and shared a common goal of weight loss. We also examined the relationship between key engagement metrics (i.e., conversing with the AI-powered coach, weigh-ins, and initiating educational lessons early in the program) and weight loss outcomes.ResultsThe average weight loss of all enrollees having a weight measurement after after the 9th week was 4.51%, and the average weight loss of the Diabetes Prevention Program enrollees meeting a minimum engagement level was 8.56%. Greater weight loss was associated with a greater number of days with AI-powered coaching conversations (p = 0.03), more weigh-ins (p = 0.00), and early educational lesson initiation (p = 0.02).ConclusionsDigital health programs powered by AI offer a promising solution for health management among older adults. The results show positive health outcomes using app-based prevention programs, and all three engagement metrics were independently associated with weight loss.

show abstract

Older Adults Engage With Personalized Digital Coaching Programs at Rates That Exceed Those of Younger Adults

Cited by 28 publications

References 39 publications

Human Support in App-Based Cognitive Behavioral Therapies for Emotional Disorders: Scoping Review

Human Support in App-Based Cognitive Behavioral Therapies for Emotional Disorders: Scoping Review

Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel

Engagement in Digital Health App-Based Prevention Programs Is Associated With Weight Loss Among Adults Age 65+

Contact Info

Product

Resources

About