JMIR: Science or Snake Oil: Systematic Search of iPhone and Android Mobile Apps for Psychosocial Wellness and Stress Management

3 May, 2020

Only 2% of publicly available psychosocial wellness and stress management mobile apps have published, peer-reviewed evidence of feasibility and/or efficacy. This is the key finding of a paper in the Journal of Medical Internet Research. Citation, abstract and a comment from me below.

CITATION: JMIR Mhealth Uhealth. 2020 Mar 22. doi: 10.2196/17798. [Epub ahead of print]

Science or Snake Oil: Systematic Search of iPhone and Android Mobile Apps for Psychosocial Wellness and Stress Management.

Lau N et al.

ABSTRACT

BACKGROUND: In an oversaturated market of publicly available mobile apps for psychosocial self-care and stress management, health care providers, patients, and consumers interested in mental health-related apps may wonder which, if any, are efficacious. Readily available metrics for consumers include user popularity and media buzz rather than scientific evidence.

OBJECTIVE: This systematic review aimed to (1) examine the breadth of therapeutic contents and features of psychosocial wellness and stress management apps available to self-help seekers for public download and (2) determine which of these apps have original research support.

METHODS: First, we conducted a systematic review of publicly available apps on the iPhone App Store (Apple Inc) and Android Google Play (Google LLC) platforms using conventional self-help-seeking search terms related to wellness and stress. The results were limited to English-language apps available for free download. In total, 2 reviewers independently evaluated all apps and discussed the findings to reach 100% consensus regarding inclusion. Second, a literature review was conducted on the included apps to identify supporting studies with original data collection.

RESULTS: We screened 3287 apps and found 1009 psychosocial wellness and stress management apps. Content varied widely. The most common evidence-based strategy was mindfulness-meditation, followed by positive psychology and goal setting. Most apps were intended to be used as self-help interventions, with only 1.09% (11/1009) involving an electronic therapist and 1.88% (19/1009) designed as a supplement to in-person psychotherapy. Only 4.66% (47/1009) of apps targeted individuals with psychological disorders, and less than 1% of apps (6/1009, 0.59%) targeted individuals with other chronic illnesses. Approximately 2% (21/1009, 2.08%) were supported by original research publications, with a total of 25 efficacy studies and 10 feasibility studies. The Headspace mindfulness app had the most evidence, including 8 efficacy studies. Most other scientifically backed apps were supported by a single feasibility or efficacy study.

CONCLUSIONS: Only 2.08% (21/1009) of publicly available psychosocial wellness and stress management mobile apps discoverable to self-help seekers have published, peer-reviewed evidence of feasibility and/or efficacy. Clinicians and investigators may use these findings to help patients and families navigate the volume of emerging digital health interventions for stress management and wellness.

COMMENT (Neil PW): This finding will not be a surprise to many of us and especially to members of the Mobile Healthcare Information For All (mHIFA) working group. I point you to Geoff Royston's work: Rapid Methods to Assess the Potential Impact of Digital Health Interventions, and their Application to Low Resource Settings: http://www.hifa.org/sites/default/files/publications_pdf/DH%202017%20Rap... This rapid methods approach has the potential to prevent ineffective (or even harmful) apps from even coming onto the market.

Best wishes, Neil

Coordinator, mHIFA Project (Mobile Healthcare Information For All) - Supported by HIFA members

http://www.hifa.org/projects/mobile-hifa-mhifa

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org