Table 3. Peer-reviewed studies of VA mobile mental health apps, by app.
| First author [year] | Study population (n) | Research design | Results & key findings |
|---|---|---|---|
| PTSD Coach | |||
| Kuhn [2014] | Veterans in a residential PTSD treatment program (n=45) | Observational treatment study (no control group) | 89% of those who used PTSD Coach were at least moderately satisfied with the app |
| Qualitative analysis suggests that the app is used as intended by the developers | |||
| Miner [2016] | Adults with moderate to high PTSD symptoms (n=49) | Randomized controlled trial (wait-list control) | No time × condition interaction effects for PTSD symptoms |
| Significant reduction in PTSD symptoms for those in PTSD Coach group, but no significant reduction in PTSD symptoms for wait-list control | |||
| Qualitative analyses suggest high levels of perceived helpfulness of PTSD Coach, particularly the app’s self-management tools | |||
| Kuhn [2017] | Adults with high PTSD symptoms (n=120) | Randomized controlled trial (wait-list control) | Significant time × condition interaction effects benefiting PTSD Coach for: |
| PTSD symptoms | |||
| Depression symptoms | |||
| Interpersonal functioning | |||
| No interaction effects for PTSD coping self-efficacy | |||
| Keen [2017] | Undergraduates with PTSD symptoms (n=382) | Observational treatment study (no control group) |
Use of the PTSD Coach app predicted change in PTSD symptoms |
| PTSD symptoms at baseline did not predict PTSD Coach app use | |||
| Owen [2015] | Users of the PTSD Coach mobile app (n=153,834) and public reviewers (n=156) | Cross-sectional and qualitative | PTSD Coach reached over 10,600 active monthly users |
| The app is associated with relatively high rates of retention, with over 10% continuing to use the app 1-year post-download | |||
| Users average 6 sessions and over 5 minutes of time spent using the app | |||
| First-time and return users differ in how they use the app, with first-time users being more likely to explore multiple content areas of the app and return users more likely to use one key feature of the app | |||
| Momentary distress scores decrease significantly for those who use a symptom management tool and rate distress before and after using the tool | |||
| Possemato [2016] | Veterans with moderate to high PTSD symptoms (n=20) | Pilot randomized controlled trial (alternative treatment control) | High levels of provider satisfaction with clinician-supported (CS)-PTSD Coach |
| High levels of PTSD Coach use among veterans | |||
| No significant difference between treatment conditions on PTSD symptoms across time | |||
| Those in the CS-PTSD Coach condition were significantly more likely to accept a mental health referral | |||
| Trends benefiting CS-PTSD Coach for clinically significant improvement in PTSD symptoms, psychological quality of life, and social quality of life | |||
| Possemato [2017] | Providers delivering clinician-supported PTSD Coach (CS-PTSD; n=3); Veterans who have completed CS-PTSD Coach (n=9) | Qualitative | 100% of veterans reported good to excellent satisfaction with CS-PTSD Coach |
| 78% of veterans reported that CS-PTSD Coach met all or most of their needs | |||
| Providers had generally positive perceptions of CS-PTSD Coach but identified a number of potential improvements, including collaborative goal-setting and accommodating personal needs of each Veteran | |||
| PE Coach | |||
| Kuhn [2014] | VA mental health providers trained in Prolonged Exposure therapy (PE) (n=163) | Cross-sectional study | Provider perceptions were modestly positive towards the PE Coach app, although the full app was not yet available for providers to download |
| Providers were willing to use the PE Coach app and to recommend it to colleagues | |||
| Kuhn [2015] | VA providers delivering Prolonged Exposure therapy (PE) | Cross-sectional study | 50% of PE providers reported using the PE Coach app in treatment and reported favorable perceptions of the app. 94% of providers who use the app intended to continue using the app |
| Providers who used PE Coach used it with 33% of their patients | |||
| 76% of providers who did not use PE Coach reported intending to use it in the future | |||
| Reger [2015, 2017] | VA providers who have used PE Coach as part of Prolonged Exposure therapy (n=25) | Qualitative | Facilitators of use of the PE Coach app: |
| PE materials available from a single, convenient source | |||
| Convenience for patients | |||
| Ease of delivering PE treatment | |||
| Barriers to use of the PE Coach app: | |||
| Technical challenges | |||
| Specific knowledge about how to best use the app | |||
| Time to learn all of the app’s features | |||
| CBT-i Coach | |||
| Babson [2015] | Veterans with sleep disturbance, cannabis use disorder, and interest in making a quit attempt (n=4) | Pilot randomized trial (attention placebo control) | Veterans reported daily use of the CBTi Coach app, with an average session duration of 5–10 minutes |
| Veterans reported the app to be helpful for improving sleep | |||
| Veterans were most satisfied with the app’s sleep logs and exercises for improving sleep | |||
| Koffel [2018] | Veterans referred for Cognitive Behavioral Therapy for Insomnia (CBT-i; n=18) | Pilot randomized trial (active treatment control) and qualitative | Very high levels of satisfaction with the CBT-i Coach app |
| High levels of use of the sleep diary, educational materials, relaxation exercises, and reminders | |||
| No significant effects of app on homework completion or completion of sleep diaries | |||
| Trend benefiting CBT-i Coach group for adherence and completed sleep diaries | |||
| Kuhn [2016] | VA providers trained to deliver CBT-i (n1=138, n2=176) | Cohort study, pre-post release of CBT-i Coach app | High levels of interest in CBT-i Coach app among providers, with 96% expressing relative advantage, 70% reporting time-saving, compared with no app |
| After release of the app, 45% of providers were actively using the CBT-i Coach app. Providers who use the app, use it with over half of their patients | |||
| Miller [2017] | VA providers trained to deliver CBT-i (n=163) | Cross-sectional study and qualitative | 47% of providers are using the CBT-i Coach app, and nearly all of the providers intended to continue using CBT-i Coach. |
| 83% of providers not using CBT-i Coach intended to use the app in the future | |||
| Providers identified key benefits of the app, including patient motivation and improved treatment compliance | |||
| Barriers to use included access to technology & information about how to best use the app | |||
| Stay Quit Coach | |||
| Hicks [2017] | Adult smokers with PTSD (n=11) | Randomized controlled trial (alternative treatment control) | Smokers who received the Stay Quit Coach app trended towards improved adherence |
| No effects of Stay Quit Coach on post-treatment abstinence from tobacco use | |||
| Smokers were satisfied with the Stay Quit Coach app, particularly the tools for helping to quit smoking, to remain quit, and for providing support and education relevant to quitting | |||
| Herbst [2018] | Veteran smokers with PTSD (n=20) | Observational treatment study (no control group) | Veterans used Stay Quit Coach between 2 and 3 times per week during the observation period |
| Veterans’ ratings of the usability of the app was consistent with “moderate usability” | |||
| Veterans were more engaged in face-to-face care than in previous samples that did not receive the Stay Quit Coach app |