4 - (SYM 109) Evaluating Our Assumptions: Is Engagement with and Perceived Quality of Mental Health Apps Associated with Improvements in Symptoms and Support?

Heather D. Quirk and Page L Anderson

Background: To realize the potential of mental health applications (apps), we must better understand the relations between app quality engagement with an app and symptom severity over time. This study tests the hypotheses that engagement with the app will be positively related to symptom severity at Time 1 (H1), to improvement in symptoms and support (H2) and app quality ratings at Time 2 (H3), and that app quality ratings will be positively associated with improvement in symptoms and support (H4).

Methods: Participants (N=259) completed PROMIS measures for symptoms (depression, anxiety, social isolation) and support (information and emotional). Participants downloaded a free-to-use mental health app and used it at will for 2 weeks, completed the PROMIS measures again and rated the quality of the app using the uMARS, which assesses the app’s credibility, aesthetics, entertainment, and usefulness of the information provided. Engagement with the app was objectively measured by time spent within the app and the number of days the participant used the app.

Results: Participants identified as heterosexual (68.8%), African American/Black (39.9%), female (70.8%), assigned female at birth (71.2%), and without physical disabilities (85.5%). The mean reported age was 22 (SD = 7.988). Overall, results did not support hypotheses. Symptom severity was not related to engagement with the app (H1). Time spent on the app was positively associated with improvement in information support (r=.204, p =.008; (H2). Time spent on the app was positively associated with the app’s credibility, and the numbers of days using the app was positively associated with app’s entertainment value, as well as plans to use the app in the future (r=.245, p=.020 and r-.324, p=.003, respectively). Ratings of the app’s quality were associated with changes in symptoms and support, sometimes in unexpected ways (H4). Ratings of the app’s performance were positively associated with increases in depressive symptoms, (r=.218, p=.038) and in the importance of addressing stressors (r=.208, p=.049).

Conclusions: The mostly null (but sometimes unexpected) results add to a growing body of literature evaluating the relation between app engagement and app quality to improvement in symptoms – which, increasingly, is mixed. Future research using experimental designs is essential to determine the extent to which app engagement, app quality, and other related factors lead to benefits for mobile app users.