Users' Adoption of Mental Health Apps: Examining the Impact of Information Cues

Hsiao-Ying Huang, Masooda Bashir, Hsiao-Ying Huang, Masooda Bashir

Abstract

Background: Numerous mental health apps have been developed and made available to users on the current app market. Users may find it difficult and overwhelming to select apps from the hundreds of choices that are available in the app marketplace. Clarifying what information cues may impact a user's selection and adoption of mental health apps is now a critical and pressing issue.

Objective: The aim of this study was to investigate the impact of information cues on users' adoption of anxiety apps using observational data from the Android app market.

Methods: A systematic search of anxiety apps was conducted on the Android app store by using keywords search. The title and metadata information of a total of 274 apps that met our criteria were collected and analyzed. Three trained researchers recorded the app rankings from the search results page on different dates and Web browsers.

Results: Our results show that ratings (r=.56, P<.001) and reviews (r=.39, P<.001) have significant positive correlations with the number of installs, and app prices have significant negative correlations with installs (r=-.36). The results also reveal that lower-priced apps have higher ratings (r=-.23, P<.001) and a greater number of app permission requests (r=.18, P=.002) from the device. For app titles, we found that apps with titles related to symptoms have significantly lower installs than apps with titles that are not related to symptoms (P<.001).

Conclusions: This study revealed a relationship between information cues and users' adoption of mental health apps by analyzing observational data. As the first of its kind, we found impactful indicators for mental health app adoptions. We also discovered a labeling effect of app titles that could hinder mental health app adoptions and which may provide insight for future designs of mental health apps and their search mechanisms.

Keywords: anxiety; mental health; mobile app search; recommendation system; user interaction design.

Conflict of interest statement

Conflicts of Interest: None declared.

©Hsiao-Ying Huang, Masooda Bashir. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.06.2017.

Figures

Figure 1
Figure 1
Research framework.
Figure 2
Figure 2
Systematic search of anxiety-related apps on Google Play.
Figure 3
Figure 3
Anxiety apps in different categories on Google Play.
Figure 4
Figure 4
Number of app titles related to anxiety disorders, symptoms, treatment, self-help approaches, mindfulness activities, and self-tracking or management tools.
Figure 5
Figure 5
Correlational analysis of information cues and app adoption.
Figure 6
Figure 6
Generalized additive regression plots of information cues.

References

    1. Bernard R, Sabariego C, Cieza A. Barriers and facilitation measures related to people with mental disorders when using the web: a systematic review. J Med Internet Res. 2016;18(6):e157. doi: 10.2196/jmir.5442.
    1. Collins PY, Patel V, Joestl SS, March D, Insel TR, Daar AS. Grand challenges in global mental health. Nature. 2011 Jul 06;475(7354):27–30. doi: 10.1038/475027a.
    1. Thomas K, Ellis A, Konrad T, Holzer C, Morrissey J. County-level estimates of mental health professional shortage in the United States. Psychiatr Serv. 2009 Oct;60(10):1323–8. doi: 10.1176/ps.2009.60.10.1323.
    1. Smith A. Pewinternet. 2015. [2017-06-09]. US smartphone use in 2015
    1. Deloitte. 2015 Global Mobile Consumer Survey: US Edition .
    1. Matthews M, Doherty G, Coyle D, Sharry J. Designing mobile applications to support mental health interventions. Handbook of research on user interface design and evaluation for mobile technology. 2008:635–656.
    1. Kapp K. The Gamification of Learning and Instruction: Game-based Methods and Strategies for Training and Education. 1st edition. San Francisco, CA: Pfeiffer; 2012.
    1. Kenny R, Dooley B, Fitzgerald A. Feasibility of “CopeSmart”: A Telemental Health App for Adolescents. JMIR Ment Health. 2015 Aug 10;2(3):e22. doi: 10.2196/mental.4370.
    1. Wilson CJ, Rickwood DJ, Bushnell JA, Caputi P, Thomas SJ. The effects of need for autonomy and preference for seeking help from informal sources on emerging adults’ intentions to access mental health services for common mental disorders and suicidal thoughts. Advances in Mental Health. 2011;10(1):29–38. doi: 10.5172/jamh.2011.10.1.29.
    1. Simon GE, Ludman EJ. It's time for disruptive innovation in psychotherapy. Lancet. 2009 Aug 22;374(9690):594–595. doi: 10.1016/S0140-6736(09)61415-X.
    1. Watts S, Andrews G. Internet access is NOT restricted globally to high income countries: so why are evidenced based prevention and treatment programs for mental disorders so rare? Asian J Psychiatr. 2014 Aug;10:71–4. doi: 10.1016/j.ajp.2014.06.007.
    1. Boulos M, Brewer A, Karimkhani C, Buller D, Dellavalle R. Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online J Public Health Inform. 2014;5(3):229. doi: 10.5210/ojphi.v5i3.4814.
    1. Donker T, Petrie K, Proudfoot J, Clarke J, Birch M, Christensen H. Smartphones for smarter delivery of mental health programs: a systematic review. J Med Internet Res. 2013 Nov 15;15(11):e247. doi: 10.2196/jmir.2791.
    1. Bakker D, Kazantzis N, Rickwood D, Rickard N. Mental health smartphone apps: review and evidence-based recommendations for future developments. JMIR Ment Health. 2016 Mar 01;3(1):e7. doi: 10.2196/mental.4984.
    1. Luxton D, McCann RA, Bush NE, Mishkind MC, Reger GM. mHealth for mental health: integrating smartphone technology in behavioral healthcare. Prof Psychol Res Pr. 2011;42(6):505. doi: 10.1037/a0024485.
    1. Lannin DG, Vogel DL, Brenner RE, Abraham WT, Heath PJ. Does self-stigma reduce the probability of seeking mental health information? J Couns Psychol. 2015;63(3):351–358. doi: 10.1037/cou0000108.
    1. Corrigan P. How stigma interferes with mental health care. Am Psychol. 2004 Oct;59(7):614–625. doi: 10.1037/0003-066X.59.7.614.
    1. Kenny R, Dooley B, Fitzgerald A. Developing mental health mobile apps: exploring adolescents' perspectives. Health Informatics J. 2016 Jun;22(2):265–75. doi: 10.1177/1460458214555041.
    1. Cummings E, Borycki E, Roehrer E. Enabling Health and Healthcare Through ICT: Available, Tailored and Closer. Amsterdam: IOS PRESS; 2013. Consumers Using Mobile Applications; p. 227.
    1. Dogruel L, Joeckel S, Bowman N. Choosing the right app: An exploratory perspective on heuristic decision processes for smartphone app selection. Mobile Media & Communication. 2015;3(1):125–144. doi: 10.1177/2050157914557509.
    1. Walther J. The handbook of interpersonal communication. USA: SAGE; 2011. Theories of computer-mediated communication and interpersonal relations; pp. 443–479.
    1. Simon H. A behavioral model of rational choice. Q J Econ. 1955;69(1):99–118.
    1. Marewski J, Galesic M, Gigerenzer G. Media choice: a theoretical and empirical overview. London: Routledge; 2009. Fast and frugal media choices; pp. 107–128.
    1. Gigerenzer G. Fast and frugal heuristics: The tools of bounded rationality. Blackwell handbook of judgment and decision making. 2004:62–88. doi: 10.1002/9780470752937.ch4.
    1. Gigerenzer G, Gaissmaier W. Heuristic decision making. Annu Rev Psychol. 2011;62:451–82. doi: 10.1146/annurev-psych-120709-145346.
    1. Shah A, Oppenheimer D. Heuristics made easy: an effort-reduction framework. Psychol Bull. 2008 Mar;134(2):207–22. doi: 10.1037/0033-2909.134.2.207.
    1. Bellur S, Sundar S. How can we tell when a heuristic has been used? Design and analysis strategies for capturing the operation of heuristics. Commun Methods Meas. 2014;8(2):116–137. doi: 10.1080/19312458.2014.903390.
    1. Nikou S, Mezei J. Evaluation of mobile services and substantial adoption factors with Analytic Hierarchy Process (AHP) Telecomm Policy. 2013 Nov 30;37(10):915–929. doi: 10.1016/j.telpol.2012.09.007.
    1. Kelley PG, Cranor LF, Sadeh N. Privacy as part of the app decision-making process. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, ACM; 2013, April; Paris. 2013. Apr, pp. 3393–3402.
    1. Kim GS, Park SB, Oh J. An examination of factors influencing consumer adoption of short message service (SMS) Psychol Mark. 2008;25(8):769–786. doi: 10.1002/mar.20238.
    1. Wang T, Oh L, Wang K, Yuan Y. User adoption and purchasing intention after free trial: an empirical study of mobile newspapers. Inf Syst E-Bus. 2013;11(2):189–210. doi: 10.1007/s10257-012-0197-5.
    1. Krasnova H, Eling N, Abramova O, Buxmann P. Dangers of Facebook Login for Mobile Apps: Is There a Price Tag for Social Information?. International Conference on Information Systems; 2014; Auckland, New Zealand. 2014.
    1. Xu H, Teo H, Tan B, Agarwal R. The role of push-pull technology in privacy calculus: the case of location-based services. JMIS. 2009;26(3):135–174. doi: 10.2753/MIS0742-1222260305.
    1. Xu H, Teo HH, Tan B. Predicting the adoption of location-based services: the role of trust and perceived privacy risk. Proceedings of 26th Annual International Conference on Information Systems; International Conference on Information Systems; 2005; Las Vegas, NV. 2005. p. 71.
    1. Felt A, Ha E, Egelman S, Haney A, Chin E, Wagner D. Android permissions: User attention, comprehension,behavior. Symposium on Usable Privacy Security (SOUPS); July 11-13, 2012; Washington DC, USA. 2012.
    1. Dehling T, Gao F, Schneider S, Sunyaev A. Exploring the far side of mobile health: information security and privacy of mobile health apps on iOS and Android. JMIR Mhealth Uhealth. 2015 Jan 19;3(1):e8. doi: 10.2196/mhealth.3672.
    1. NIMH NIMH.NIH. [2016-10-15]. Any Anxiety Disorder Among Adults .
    1. Statista Statista. 2016. [2016-10-15]. Number of apps available in leading app stores as of June
    1. Ramo D, Popova L, Grana R, Zhao S, Chavez K. Cannabis mobile apps: a content analysis. JMIR Mhealth Uhealth. 2015 Aug 12;3(3):e81. doi: 10.2196/mhealth.4405.
    1. American Psychiatric Association . Diagnostic and statistical manual of mental disorders (DSM-5) Arlington, VA: American Psychiatric Association Publishing; 2013.
    1. Granka L, Joachims T, Gay G. Eye-tracking analysis of user behavior in WWW search. Proceedings of the 27th annual international ACM SIGIR conference on Research development in information retrieval; 2004 Jul 25-29; Sheffield, UK. 2004. Jul, pp. 478–479.
    1. Hastie T, Tibshirani R. Generalized additive models. Boca Raton, Florida: Chapman and Hall/CRC; 1990.
    1. Larsen K. Multithreaded.stitchfix. 2015. [2017-06-09]. GAM: The Predictive Modeling Silver Bullet
    1. Craven P, Wahba G. Smoothing noisy data with spline functions. Numerische Mathematik. 1978;31(4):377–403. doi: 10.1007/BF01404567.
    1. Acquisti A, Grossklags J. Privacy and rationality in individual decision making. IEEE Secur Priv. 2005;2:24–30.
    1. Moses T. Self-labeling and its effects among adolescents diagnosed with mental disorders. Soc Sci Med. 2009 Feb;68(3):570–578. doi: 10.1016/j.socscimed.2008.11.003.
    1. Mani M, Kavanagh D, Hides L, Stoyanov S. Review and evaluation of mindfulness-based iPhone apps. JMIR Mhealth Uhealth. 2015 Aug 19;3(3):e82. doi: 10.2196/mhealth.4328.
    1. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol. 2006;10(2):144–156. doi: 10.1093/clipsy.bpg016.
    1. Slade M. Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Serv Res. 2010 Jan 26;10:26. doi: 10.1186/1472-6963-10-26.
    1. Irving J, Dobkin P, Park J. Cultivating mindfulness in health care professionals: a review of empirical studies of mindfulness-based stress reduction (MBSR) Complement Ther Clin Pract. 2009 May;15(2):61–6. doi: 10.1016/j.ctcp.2009.01.002.
    1. Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, Chapleau MA, Paquin K, Hofmann SG. Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013 Aug;33(6):763–71. doi: 10.1016/j.cpr.2013.05.005.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する