Abstract
BACKGROUND: Although the availability and use of mobile mental health apps has grown exponentially in recent years, little data are available regarding their efficacy. OBJECTIVE: This study aimed to evaluate the effectiveness of an app developed to promote stress management and well-being among working women compared with a control app. METHODS: Female employees at a private hospital were invited to participate in the study via mailing lists and intranet ads. A total of 653 individuals self-enrolled through the website. Eligible participants were randomized between control (n=240) and intervention (n=250) groups. The well-being mobile app provides an 8-week program with 4 classes per week (including a brief theoretical portion and a 15-min guided practice). The active control app also provided 4 assessments per week that encouraged participants to self-observe how they were feeling for 20 min. We also used the app to conduct Web-based questionnaires (10-item Perceived Stress Scale and 5-item World Health Organization Well-Being Index) and ask specific questions to assess subjective levels of stress and well-being at baseline (t(1)), midintervention (t(4)=4 weeks after t(1)) and postintervention (t(8)=8 weeks after t(1)). Both apps were fully automated without any human involvement. Outcomes from the control and intervention conditions at the 3 time points were analyzed using a repeated measures analysis of variance. RESULTS: Among the randomized participants (n=490), 185 participants were excluded at the 4-week follow-up and another 79 at the 8-week follow-up because of noncompliance with the experimental protocol. Participants who did not complete t(4) and t(8) assessments were equally distributed between groups (t(4): control group=34.6% [83/240] and intervention group=40.8% [102/250]; P=.16; t(8): control group=29.9% [47/157] and intervention group=21.6% [32/148]; P=.10). Both groups showed a significant increase in general well-being as a function of time (F(2,426)=5.27; P=.006), but only the intervention group presented a significant increase in work-related well-being (F(2,426)=8.92; P<.001), as well as a significant reduction in work-related and overall stress (F(2,426)=5.50; P=.004 and F(2,426)=8.59; P<.001, respectively). CONCLUSIONS: The well-being mobile app was effective in reducing employee stress and improving well-being. TRIAL REGISTRATION: Clinicaltrials.gov NCT02637414; https://clinicaltrials.gov/ct2/show/NCT02637414.