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      Posttraumatic Stress Disorder and Mobile Health: App Investigation and Scoping Literature Review

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          Abstract

          Background

          Posttraumatic stress disorder (PTSD) is a prevalent mental health issue among veterans. Access to PTSD treatment is influenced by geographic (ie, travel distance to facilities), temporal (ie, time delay between services), financial (ie, eligibility and cost of services), and cultural (ie, social stigma) barriers.

          Objective

          The emergence of mobile health (mHealth) apps has the potential to bridge many of these access gaps by providing remote resources and monitoring that can offer discrete assistance to trauma survivors with PTSD and enhance patient-clinician relationships. In this study, we investigate the current mHealth capabilities relevant to PTSD.

          Methods

          This study consists of two parts: (1) a review of publicly available PTSD apps designed to determine the availability of PTSD apps, which includes more detailed information about three dominant apps and (2) a scoping literature review performed using a systematic method to determine app usage and efforts toward validation of such mHealth apps. App usage relates to how the end users (eg, clinicians and patients) are interacting with the app, whereas validation is testing performed to ensure the app’s purpose and specifications are met.

          Results

          The results suggest that though numerous apps have been developed to aid in the diagnosis and treatment of PTSD symptoms, few apps were designed to be integrated with clinical PTSD treatment, and minimal efforts have been made toward enhancing the usability and validation of PTSD apps.

          Conclusions

          These findings expose the need for studies relating to the human factors evaluation of such tools, with the ultimate goal of increasing access to treatment and widening the app adoption rate for patients with PTSD.

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          Most cited references61

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          mHealth for mental health: Integrating smartphone technology in behavioral healthcare.

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            Mobile mental health: a challenging research agenda

            The field of mobile health (“m-Health”) is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (“g-Health”). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools—targeting screening, assessment, prevention, and treatment—are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the “App Store” yesterday rather than tomorrow.
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              Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms.

              PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                October 2017
                26 October 2017
                : 5
                : 10
                : e156
                Affiliations
                [1] 1 Department of Industrial and Systems Engineering Texas A&M University College Station, TX United States
                [2] 2 Center for Research and Innovation in Systems Safety Department of Anesthesiology Vanderbilt University Medical Center Nashville, TN United States
                [3] 3 Health Science Center School of Public Health Louisiana State University New Orleans, LA United States
                [4] 4 Center for Remote Health Technologies and Systems Texas A&M University College Station, TX United States
                [5] 5 Department of Environmental and Occupational Health School of Public Health Texas A&M University College Station, TX United States
                [6] 6 VISN 17 Center of Excellence for Research on Returning War Veterans Central Texas Veterans Health Care System Waco, TX United States
                [7] 7 Department of Health Policy and Management School of Public Health Texas A&M University College Station, TX United States
                [8] 8 Department of Psychiatry Dell Medical School University of Texas Austin, TX United States
                Author notes
                Corresponding Author: Farzan Sasangohar sasangohar@ 123456tamu.edu
                Author information
                http://orcid.org/0000-0003-1330-9202
                http://orcid.org/0000-0003-0639-4736
                http://orcid.org/0000-0002-9027-3672
                http://orcid.org/0000-0001-9962-5470
                http://orcid.org/0000-0002-6582-1673
                http://orcid.org/0000-0002-6882-8053
                http://orcid.org/0000-0003-3925-2806
                http://orcid.org/0000-0001-5151-2127
                Article
                v5i10e156
                10.2196/mhealth.7318
                5680516
                29074470
                0d800ed1-2520-40c4-854b-c4a4a54be432
                ©Carolina Rodriguez-Paras, Kathryn Tippey, Elaine Brown, Farzan Sasangohar, Suzannah Creech, Hye-Chung Kum, Mark Lawley, Justin K Benzer. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 26.10.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 12 January 2017
                : 22 March 2017
                : 5 August 2017
                : 29 August 2017
                Categories
                Original Paper
                Original Paper

                posttraumatic stress disorders,ptsd,mobile health,mhealth,anxietys

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