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

Emily Lattie, Katherine A Cohen, Nathan Winquist, David C Mohr, Emily Lattie, Katherine A Cohen, Nathan Winquist, David C Mohr

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://ichgcp.net/clinical-trials-registry/NCT04035577.

Keywords: anxiety; college students; depression; mHealth; mobile phone.

Conflict of interest statement

Conflicts of Interest: DM has an ownership interest in Adaptive Health Inc, which has a license from Northwestern University to commercialize IntelliCare. EL has received consulting fees from Actualize Therapy, LLC (last in June 2018), a company that formerly held the license to IntelliCare. DM has also received consulting fees from Apple Inc.

©Emily Lattie, Katherine A Cohen, Nathan Winquist, David C Mohr. Originally published in JMIR Mental Health (http://mental.jmir.org), 10.10.2020.

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