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Exploring Usage of COVID Coach, a Public Mental Health App Designed for the COVID-19 Pandemic: Evaluation of Analytics Data

Authors
  • Jaworski, Beth K1
  • Taylor, Katherine1
  • Ramsey, Kelly M1
  • Heinz, Adrienne1, 2
  • Steinmetz, Sarah1
  • Pagano, Ian3
  • Moraja, Giovanni4
  • Owen, Jason E1
  • 1 US Department of Veterans Affairs, Menlo Park, CA , (United States)
  • 2 Stanford University, Stanford, CA , (United States)
  • 3 University of Hawaii Cancer Center, Honolulu, HI , (United States)
  • 4 Vertical Design, LLC, Berkeley, CA , (United States)
Type
Published Article
Journal
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Publication Date
Mar 01, 2021
Volume
23
Issue
3
Identifiers
DOI: 10.2196/26559
PMID: 33606656
PMCID: PMC7924218
Source
PubMed Central
Keywords
License
Green
External links

Abstract

Background The COVID-19 pandemic has significantly impacted mental health and well-being. Mobile mental health apps can be scalable and useful tools in large-scale disaster responses and are particularly promising for reaching vulnerable populations. COVID Coach is a free, evidence-informed mobile app designed specifically to provide tools and resources for addressing COVID-19–related stress. Objective The purpose of this study was to characterize the overall usage of COVID Coach, explore retention and return usage, and assess whether the app was reaching individuals who may benefit from mental health resources. Methods Anonymous usage data collected from COVID Coach between May 1, 2020, through October 31, 2020, were extracted and analyzed for this study. The sample included 49,287 unique user codes and 3,368,931 in-app events. Results Usage of interactive tools for coping and stress management comprised the majority of key app events (n=325,691, 70.4%), and the majority of app users tried a tool for managing stress (n=28,009, 58.8%). COVID Coach was utilized for ≤3 days by 80.9% (n=34,611) of the sample whose first day of app use occurred within the 6-month observation window. Usage of the key content in COVID Coach predicted returning to the app for a second day. Among those who tried at least one coping tool on their first day of app use, 57.2% (n=11,444) returned for a second visit; whereas only 46.3% (n=10,546) of those who did not try a tool returned ( P <.001). Symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) were prevalent among app users. For example, among app users who completed an anxiety assessment on their first day of app use (n=4870, 11.4% of users), 55.1% (n=2680) reported levels of anxiety that were moderate to severe, and 29.9% (n=1455) of scores fell into the severe symptom range. On average, those with moderate levels of depression on their first day of app use returned to the app for a greater number of days (mean 3.72 days) than those with minimal symptoms (mean 3.08 days; t 1=3.01, P =.003). Individuals with significant PTSD symptoms on their first day of app use utilized the app for a significantly greater number of days (mean 3.79 days) than those with fewer symptoms (mean 3.13 days; t 1=2.29, P =.02). Conclusions As the mental health impacts of the pandemic continue to be widespread and increasing, digital health resources, such as apps like COVID Coach, are a scalable way to provide evidence-informed tools and resources. Future research is needed to better understand for whom and under what conditions the app is most helpful and how to increase and sustain engagement.

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