Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students
Abstract
:1. Introduction
2. Methods
2.1. Development of App
2.1.1. Content Development
2.1.2. Content Validity Evaluation
2.1.3. Co-Design Workshops
2.2. Pilot Evaluation of the Developed App
2.2.1. Study Design and Participants
2.2.2. Measures
2.2.3. Data Collection
2.2.4. Data Analysis
3. Results
3.1. Developed App
3.2. Sample Characteristics
3.3. Usability
3.4. Quality
3.5. Effects on Psychological Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Seoul Mental Health Statistics. Mental Health Statistics. 2016. Available online: https://seoulmentalhealth.kr/ (accessed on 30 August 2022).
- Cuijpers, P.; Cristea, I.A.; Ebert, D.D.; Koot, H.M.; Auerbach, R.P.; Bruffaerts, R.; Kessler, R.C. Psychological Treatment of Depression in College Students: A Metaanalysis. Depress. Anxiety 2016, 33, 400–414. [Google Scholar] [CrossRef]
- Ribeiro, Í.J.S.; Pereira, R.; Freire, I.V.; de Oliveira, B.G.; Casotti, C.A.; Boery, E.N. Stress and Quality of Life Among University Students: A Systematic Literature Review. Health Prof. Educ. 2018, 4, 70–77. [Google Scholar] [CrossRef]
- Sharp, J.; Theiler, S. A Review of Psychological Distress Among University Students: Pervasiveness, Implications and Potential Points of Intervention. Int. J. Adv. Couns. 2018, 40, 193–212. [Google Scholar] [CrossRef]
- Lee, R.A.; Jung, M.E. Evaluation of an MHealth App (Destressify) on University Students’ Mental Health: Pilot Trial. JMIR Ment. Health 2018, 5, e2. [Google Scholar] [CrossRef]
- Situmorang, D.D.B. Online/Cyber Counseling Services in the COVID-19 Outbreak: Are They Really New? J. Pastoral Care Couns. 2020, 74, 166–174. [Google Scholar] [CrossRef] [PubMed]
- Rodriguez-Paras, C.; Tippey, K.; Brown, E.; Sasangohar, F.; Creech, S.; Kum, H.C.; Lawley, M.; Benzer, J.K.; Benzer, J.K. Posttraumatic Stress Disorder and Mobile Health: App Investigation and Scoping Literature Review. JMIR mHealth uHealth 2017, 5, e156. [Google Scholar] [CrossRef]
- Wang, K.; Varma, D.S.; Prosperi, M. A Systematic Review of the Effectiveness of Mobile Apps for Monitoring and Management of Mental Health Symptoms or Disorders. J. Psychiatr. Res. 2018, 107, 73–78. [Google Scholar] [CrossRef]
- Dimidjian, S.; Barrera Jr., M.; Martell, C.; Muñoz, R.F.; Lewinsohn, P.M. The Origins and Current Status of Behavioral Activation Treatments for Depression. Annu. Rev. Clin. Psychol. 2011, 7, 1–38. [Google Scholar] [CrossRef] [PubMed]
- Hopko, D.R.; Lejuez, C.W.; Ruggiero, K.J.; Eifert, G.H. Contemporary Behavioral Activation Treatments for Depression: Procedures, Principles, and Progress. Clin. Psychol. Rev. 2003, 23, 699–717. [Google Scholar] [CrossRef]
- Ekers, D.; Webster, L.; Van Straten, A.; Cuijpers, P.; Richards, D.; Gilbody, S. Behavioural Activation for Depression; an Update of Meta-Analysis of Effectiveness and Sub Group Analysis. PLoS ONE 2014, 9, e100100. [Google Scholar] [CrossRef] [Green Version]
- Hagen, P.; Collin, P.; Metcalf, A.; Nicholas, M.; Rahilly, K.; Swainston, N. Participatory Design of Evidence-Based Online Youth Mental Health Promotion, Intervention and Treatment. 2012. Available online: https://www.westernsydney.edu.au/__data/assets/pdf_file/0005/476330/Young_and_Well_CRC_IM_PD_Guide.pdf (accessed on 30 August 2022).
- Chon, K.; Kim, K.H.; Yi, J.S. Development of the Revised Life Stress Scale for College Students. Korean J. Health Psychol. 2000, 5, 316–335. [Google Scholar]
- Lee, E.H.; Kim, S.J. Validity and Application of the Life Stress Scale for University Students. J. Educ. Res. 2012, 10, 69–93. [Google Scholar] [CrossRef]
- Davis, M.; Eshelman, E.R.; McKay, M. The Relaxation and Stress Reduction Workbook; New Harbinger Publications: Oakland, CA, USA, 2008. [Google Scholar]
- Polit, D.F.; Beck, C.T. The Content Validity Index: Are You Sure You Know What’s Being Reported? Critique and Recommendations. Res. Nurs. Health 2006, 29, 489–497. [Google Scholar] [CrossRef] [PubMed]
- Jeong, Y.W.; Chang, H.J.; Kim, J.A. Development and Feasibility of a Safety Plan Mobile Application for Adolescent Suicide Attempt Survivors. Comput. Inform. Nurs. 2020, 38, 382–392. [Google Scholar] [CrossRef]
- Brooke, J. SUS: A ‘Quick and Dirty’ Usability Test. In Usability Evaluation in Industry; Jordan, P.W., Thomas, B., McClelland, I.L., Weerdmeester, B., Eds.; Taylor & Francis: London, UK, 1996; pp. 189–194. [Google Scholar]
- Bangor, A.; Kortum, P.; Miller, J. Determining What Individual SUS Scores Mean: Adding an Adjective Rating Scale. J. Usability Stud. 2009, 4, 114–123. [Google Scholar]
- Stoyanov, S.R.; Hides, L.; Kavanagh, D.J.; Wilson, H. Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS). JMIR mHealth uHealth 2016, 4, e72. [Google Scholar] [CrossRef]
- Lee, E.H.; Moon, S.H.; Cho, M.S.; Park, E.S.; Kim, S.Y.; Han, J.S.; Cheio, J.H. The 21-Item and 12-Item Versions of the Depression Anxiety Stress Scales: Psychometric Evaluation in a Korean Population. Asian Nurs. Res. 2019, 13, 30–37. [Google Scholar] [CrossRef]
- Henry, J.D.; Crawford, J.R. The Short-Form Version of the Depression Anxiety Stress Scales (DASS-21): Construct Validity and Normative Data in a Large Non-Clinical Sample. Br. J. Clin. Psychol. 2005, 44, 227–239. [Google Scholar] [CrossRef] [PubMed]
- Evans, C.; Robertson, W. The Four Phases of the Digital Natives Debate. Hum. Behav. Emerg. Technol. 2020, 2, 269–277. [Google Scholar] [CrossRef]
- Grant, C.; Widnall, E.; Cross, L.; Simonoff, E.; Downs, J. Informing the Development of an E-Platform for Monitoring Wellbeing in Schools: Involving Young People in a Co-Design Process. Res. Involv. Engagem. 2020, 6, 51. [Google Scholar] [CrossRef]
- Khademian, F.; Aslani, A.; Bastani, P. The Effects of Mobile Apps on Stress, Anxiety, and Depression: Overview of Systematic Reviews. Int. J. Technol. Assess. Health Care 2020, 37, e4. [Google Scholar] [CrossRef] [PubMed]
- Dahne, J.; Lejuez, C.W.; Diaz, V.A.; Player, M.S.; Kustanowitz, J.; Felton, J.W.; Carpenter, M.J. Pilot Randomized Trial of a Self-Help Behavioral Activation Mobile App for Utilization in Primary Care. Behav. Ther. 2019, 50, 817–827. [Google Scholar] [CrossRef] [PubMed]
- Furukawa, T.A.; Imai, H.; Horikoshi, M.; Shimodera, S.; Hiroe, T.; Funayama, T.; Akechi, T.; FLATT Investigators. Behavioral Activation: Is It the Expectation or Achievement, of Mastery or Pleasure That Contributes to Improvement in Depression? J. Affect. Disord. 2018, 238, 336–341. [Google Scholar] [CrossRef] [PubMed]
- Yoon, J.S. Smartphone Ownership South Korea 2020, by Age Group. 2021. Available online: https://www.statista.com/statistics/897195/south-korea-smartphone-ownership-by-age-group/ (accessed on 30 August 2022).
- Mani, M.; Kavanagh, D.J.; Hides, L.; Stoyanov, S.R. Review and Evaluation of Mindfulness-Based IPhone Apps. JMIR mHealth uHealth 2015, 3, e82. [Google Scholar] [CrossRef] [PubMed]
- McKay, F.H.; Wright, A.; Shill, J.; Stephens, H.; Uccellini, M. Using Health and Well-Being Apps for Behavior Change: A Systematic Search and Rating of Apps. JMIR mHealth uHealth 2019, 7, e11926. [Google Scholar] [CrossRef] [PubMed]
- Ward, M.E.; De Brún, A.; Beirne, D.; Conway, C.; Cunningham, U.; English, A.; Fitzsimons, J.; Furlong, E.; Kane, Y.; Kelly, A.; et al. Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture. Int. J. Environ. Res. Public Health 2018, 15, 1182. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Characteristic | n (%) | Mean (SD) | Median | IQR [Q1–Q3] | |
---|---|---|---|---|---|
Gender | |||||
Male | 12 (34.29) | ||||
Female | 23 (65.71) | ||||
Age | 21.66 (1.70) | ||||
Usage time (min/day) | |||||
<10 | 17 (48.57) | 28.53 (48.81) | 12.50 | 10.0 [10–20] | |
10–30 | 14 (40.0) | ||||
>30 | 4 (11.43) | ||||
Usage frequency (per week) | |||||
1–5 | 17 (48.6) | 5.6 (2.17) | 4 | 3 [4–7] | |
>5 | 18 (51.4) |
Category | Mean (SD) |
---|---|
Usability | 74.21 (13.99) |
Quality | |
App quality a | 3.72 (0.36) |
Engagement | 3.15 (0.44) |
Functionality | 4.17 (0.48) |
Aesthetics | 3.67 (0.60) |
Information | 3.88 (0.54) |
App subjective quality | 2.99 (0.61) |
Perceived impact of application use | 3.98 (0.46) |
Variables | Mean (SD) | t | p | 95% CI | |
---|---|---|---|---|---|
Pre | Post | ||||
Depression | 5.89 (4.16) | 4.17 (2.81) | 2.75 | <0.001 | 0.45 to 2.99 |
Anxiety | 4.66 (3.76) | 2.83 (3.05) | 2.94 | <0.001 | 0.56 to 2.98 |
Stress | 9.94 (5.70) | 6.89 (4.60) | 4.27 | 0.001 | 1.60 to 4.51 |
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Na, H.; Jo, M.; Lee, C.; Kim, D. Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students. Healthcare 2022, 10, 1880. https://doi.org/10.3390/healthcare10101880
Na H, Jo M, Lee C, Kim D. Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students. Healthcare. 2022; 10(10):1880. https://doi.org/10.3390/healthcare10101880
Chicago/Turabian StyleNa, Hyunjoo, Minjeong Jo, Chaerin Lee, and Doyoon Kim. 2022. "Development and Evaluation: A Behavioral Activation Mobile Application for Self-Management of Stress for College Students" Healthcare 10, no. 10: 1880. https://doi.org/10.3390/healthcare10101880