The Effects of a Digital Well-Being Intervention on Patients With Chronic Conditions: Observational Study (Preprint)

Abstract

BACKGROUND Chronic conditions account for 75% of health care costs, and the impact of chronic illness is expected to grow over time. Although subjective well-being predicts better health outcomes, people with chronic conditions tend to report lower well-being. Improving well-being might mitigate costs associated with chronic illness; however, existing interventions can be difficult to access and draw from a single theoretical approach. Happify, a digital well-being intervention program drawing from multiple theoretical traditions to target well-being, has already been established as an efficacious means of improving well-being in both distressed and nondistressed users. OBJECTIVE This study aimed to compare change in well-being over time after using Happify for users with and without a chronic condition. METHODS Data were obtained from Happify users, a publicly available digital well-being program accessible via website or mobile phone app. Users work on tracks addressing a specific issue (eg, conquering negative thoughts) composed of games and activities based on positive psychology, cognitive behavioral therapy, and mindfulness principles. The sample included 821 users receiving at least 6 weeks’ exposure to Happify (ranging from 42 to 179 days) who met other inclusion criteria. As part of a baseline questionnaire, respondents reported demographic information (age and gender) and whether they had any of the prespecified chronic conditions: arthritis, diabetes, insomnia, multiple sclerosis, chronic pain, psoriasis, eczema, or some other condition (450 reported a chronic condition, whereas 371 did not). Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction. To evaluate changes in well-being over time, a mixed effects linear regression model was fit for subjective well-being, controlling for demographics and platform usage. RESULTS At baseline, users with a chronic condition had significantly lower subjective well-being (mean 38.34, SD 17.40) than users without a chronic condition (mean 43.65, SD 19.13). However, change trajectories for users with or without a chronic condition were not significantly different; both groups experienced equivalent improvements in well-being. We also found an effect for time from baseline (<italic>b</italic>=0.071; SE=0.010; <italic>P</italic><.01) and number of activities completed (<italic>b</italic>=0.03; SE=0.009; <italic>P</italic><.01), and a 2-way interaction between number of activities completed and time from baseline (<italic>b</italic>=0.0002; SE=0.00006; <italic>P</italic><.01), such that completing more activities and doing so over increasingly longer periods produced improved well-being scores. CONCLUSIONS Data from this study support the conclusion that users with a chronic condition experienced significant improvement over time. Despite reporting lower subjective well-being on the whole, their change trajectory while using Happify was equivalent to those without a chronic condition. Consistent with past research, users who completed more activities over a longer period showed the most improvement. In short, the presence of a chronic condition did not prevent users from showing improved well-being when using Happify.

Surgeons Attitude toward Psychosocial Aspects of Trapeziometacarpal Osteoarthritis

“…There is strong evidence that biopsychosocial interventions can help patients with chronic illnesses including OA to adapt and improve their overall well-being. 11 22 Screening for psychological factors and assessing patient's interest in help with adaptation, may help surgeons to discuss psychosocial topics more often. Future studies could focus on lowering surgeon barriers to refer by increasing the direct availability of psychosocial workers in surgeons' offices.…”

“…Evidence suggests that attention to mental and social health might help people adapt to symptoms of TMC OA, 8 9 10 11 12 22 but not all surgeons are comfortable to discuss psychosocial issues or offer psychosocial care. 15 16 23 More education and knowledge about the influence and presentation of psychological symptoms may contribute to greater awareness and a more positive attitude among surgeons.…”