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      Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

      research-article
      , PhD 1 , 2 , , , MA 3 , , MS 2 , , PhD 2
      (Reviewer), (Reviewer)
      JMIR Mental Health
      JMIR Publications
      mHealth, college students, depression, anxiety, mobile phone

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          Abstract

          Background

          In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation.

          Objective

          This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study.

          Methods

          IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill–focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app.

          Results

          Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=−2.006; P=.045) and in the frequency with which participants used both cognitive (Z=−2.091; P=.04) and behavioral (Z=−2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time.

          Conclusions

          The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students.

          Trial Registration

          ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577

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          Most cited references29

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            A brief measure for assessing generalized anxiety disorder: the GAD-7.

            Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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                Author and article information

                Contributors
                Journal
                JMIR Ment Health
                JMIR Ment Health
                JMH
                JMIR Mental Health
                JMIR Publications (Toronto, Canada )
                2368-7959
                October 2020
                10 October 2020
                : 7
                : 10
                : e21075
                Affiliations
                [1 ] Department of Medical Social Sciences Northwestern University Chicago, IL United States
                [2 ] Department of Preventive Medicine Northwestern University Chicago, IL United States
                [3 ] Department of Psychiatry and Behavioral Sciences Northwestern University Chicago, IL United States
                Author notes
                Corresponding Author: Emily Lattie emily.lattie@ 123456northwestern.edu
                Author information
                https://orcid.org/0000-0002-3069-5996
                https://orcid.org/0000-0002-7668-0108
                https://orcid.org/0000-0001-8932-4746
                https://orcid.org/0000-0002-5443-7596
                Article
                v7i10e21075
                10.2196/21075
                7585772
                33037874
                d3e7570c-bf68-47f7-ad07-e2832d6e83a8
                ©Emily Lattie, Katherine A Cohen, Nathan Winquist, David C Mohr. Originally published in JMIR Mental Health (http://mental.jmir.org), 10.10.2020.

                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 Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/, as well as this copyright and license information must be included.

                History
                : 4 June 2020
                : 16 July 2020
                : 5 August 2020
                : 23 August 2020
                Categories
                Original Paper
                Original Paper

                mhealth,college students,depression,anxiety,mobile phone
                mhealth, college students, depression, anxiety, mobile phone

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