Updating the Development of Mobile Computing Technology & the Delivery of Psychological Interventions

Research Paper Title

Ecological momentary interventions for mental health: A scoping review.

Background

The development of mobile computing technology has enabled the delivery of psychological interventions while people go about their everyday lives. The original visions of the potential of these “ecological momentary interventions” were presented over a decade ago, and the widespread adoption of smartphones in the intervening years has led to a variety of research studies exploring the feasibility of these aspirations. However, there is a dearth of research describing the different dimensions, characteristics, and features of these interventions, as constructed.

Therefore the aim of this study was to provide an overview of the definitions given for “ecological momentary interventions” in the treatment of common mental health disorders, and describe the set of technological and interaction possibilities which have been used in the design of these interventions.

Methods

A systematic search identified relevant literature published between 2009 and 2020 in the PubMed, PsycInfo, and ACM Guide to the Computing Literature databases. Following screening, data were extracted from eligible articles using a standardised extraction worksheet. Selected articles were then thematically categorised.

Results

The search identified 583 articles of which 64 met the inclusion criteria. The interventions target a range of mental health problems, with diverse aims, intervention designs and evaluation approaches. The studies employed a variety of features for intervention delivery, but recent research is overwhelmingly comprised of studies based on smartphone apps (30 of 42 papers that described an intervention). Twenty two studies employed sensors for the collection of data in order to provide just-in-time support or predict psychological states.

Conclusions

With the shift towards smartphone apps, the vision for EMIs has begun to be realised. Recent years have seen increased exploration of the use of sensors and machine learning, but the role of humans in the delivery of EMI is also varied. The variety of capabilities exhibited by EMIs motivates development of a more precise vocabulary for capturing both automatic and human tailoring of these interventions.

Reference

Balaskas, A., Schueller, S.M., Cox, A.L. & Doherty, G. (2021) Ecological momentary interventions for mental health: A scoping review. PLoS One. doi: 10.1371/journal.pone.0248152. eCollection 2021.

Can We Use Gamification in Mobile Mental Health Interventions?

Research Paper Title

Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial.

Background

40% of all general practitioner (GP) appointments are related to mental illness, although less than 35% of individuals have access to therapy and psychological care, indicating a pressing need for accessible and affordable therapy tools.

The ubiquity of smartphones offers a delivery platform for such tools. Previous research suggests that gamification-turning intervention content into a game format-could increase engagement with prevention and early-stage mobile interventions.

This study aimed to explore the effects of a gamified mobile mental health intervention on improvements in resilience, in comparison with active and inactive control conditions. Differences between conditions on changes in personal growth, anxiety and psychological wellbeing, as well as differences in attrition rates, were also assessed.

Methods

The eQuoo app was developed and published on all leading mobile platforms.

The app educates users about psychological concepts including emotional bids, generalisation, and reciprocity through psychoeducation, storytelling, and gamification.

In total, 358 participants completed in a 5-week, 3-armed (eQuoo, “treatment as usual” cognitive behavioural therapy journal app, no-intervention waitlist) randomized controlled trial. Relevant scales were administered to all participants on days 1, 17, and 35.

Results

Repeated-measures ANOVA revealed statistically significant increases in resilience in the test group compared with both control groups over 5 weeks.

The app also significantly increased personal growth, positive relations with others, and anxiety. With 90% adherence, eQuoo retained 21% more participants than the control or waitlist groups.

Intervention delivered via eQuoo significantly raised mental well-being and decreased self-reported anxiety while enhancing adherence in comparison with the control conditions.

Conclusions

Mobile apps using gamification can be a valuable and effective platform for well-being and mental health interventions and may enhance motivation and reduce attrition.

Future research should measure eQuoo’s effect on anxiety with a more sensitive tool and examine the impact of eQuoo on a clinical population.

Reference

Litvin, S., Saunders, R., Maier, M.A. & Luttke, S. (2020) Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial. PLoS One. 15(9), pp.e0237220. doi: 10.1371/journal.pone.0237220. eCollection 2020.

Gamification & Mobile Mental Health Interventions

Research Paper Title

Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial.

Background

40% of all general-practitioner appointments are related to mental illness, although less than 35% of individuals have access to therapy and psychological care, indicating a pressing need for accessible and affordable therapy tools.

The ubiquity of smartphones offers a delivery platform for such tools.

Previous research suggests that gamification-turning intervention content into a game format-could increase engagement with prevention and early-stage mobile interventions.

This study aimed to explore the effects of a gamified mobile mental health intervention on improvements in resilience, in comparison with active and inactive control conditions. Differences between conditions on changes in personal growth, anxiety and psychological wellbeing, as well as differences in attrition rates, were also assessed.

Methods

The eQuoo app was developed and published on all leading mobile platforms. The app educates users about psychological concepts including emotional bids, generalisation, and reciprocity through psychoeducation, storytelling, and gamification.

In total, 358 participants completed in a 5-week, 3-armed (eQuoo, “treatment as usual” cognitive behavioral therapy journal app, no-intervention waitlist) randomized controlled trial. Relevant scales were administered to all participants on days 1, 17, and 35.

Results

Repeated-measures ANOVA revealed statistically significant increases in resilience in the test group compared with both control groups over 5 weeks.

The app also significantly increased personal growth, positive relations with others, and anxiety.

With 90% adherence, eQuoo retained 21% more participants than the control or waitlist groups.

Conclusions

Intervention delivered via eQuoo significantly raised mental well-being and decreased self-reported anxiety while enhancing adherence in comparison with the control conditions.

Mobile apps using gamification can be a valuable and effective platform for well-being and mental health interventions and may enhance motivation and reduce attrition.

Future research should measure eQuoo’s effect on anxiety with a more sensitive tool and examine the impact of eQuoo on a clinical population.

Reference

Litvin, S., Saunders, R., Maier, M.A. & Luttke, S. (2020) Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial. PLoS One. 15(9), pp.e0237220. doi: 10.1371/journal.pone.0237220. eCollection 2020.

Primary Healthcare & Categories of Mental Health Programmes

Research Paper Title

Innovative Mental Health Initiatives in India: A Scope for Strengthening Primary Healthcare Services.

Background

Mental health burden is a major health concern worldwide.

In the last few decades, we are witnessing innovations that are successfully addressing gaps in the mental health service delivery in Indian context.

This is an opportune time to explore existing innovative mental health initiatives in the country and integrate viable interventions to primary healthcare facilities to strengthen public mental healthcare delivery.

Methods

A descriptive review of literature on innovative mental health programs in India was carried out.

The initial search from google scholar and PubMed database yielded 1152 articles, of which 1,114 were excluded that did not meet inclusion criteria.

Full texts of 38 articles were reviewed and finally 22 studies were included for the study.

Results

Based on the review, most innovations are broadly summarised into five categories:

  1. Quality improvement mental health programmes;
  2. Community-based mental health programmes;
  3. Non-specialist mental health programmes;
  4. Mobile technology-based mental health programmes; and
  5. Tele-mental health programmes.

These promising innovations in treatment and care can be customised as per the context for scale up and integrated into the primary healthcare system through the District Mental Health Programme.

Conclusions

The innovative approach not only makes mental health services more accessible and affordable but also empowering in nature by encouraging community members in early detection, prevention of mental illness and appropriate treatment referral to existing primary health care services.

Reference

Pandya, A., Shah, K., Chauhan, A. & Saha, S. (2020) Innovative Mental Health Initiatives in India: A Scope for Strengthening Primary Healthcare Services. Journal of Family Medicine and Primary Care. 9(2), pp.502-507. doi: 10.4103/jfmpc.jfmpc_977_19. eCollection 2020 Feb.