A Brief, Mobile Intervention to Decrease Depression and Loneliness and Improve Relationship Quality During the Covid-19 Pandemic

Introduction: Effective, scalable interventions to address depression and loneliness and improve the quality of social relationships are needed for public health in pandemic and non-pandemic contexts. Towards this end, a randomized, controlled trial tested a mobile-based intervention, derived from social psychological and relationship science, for improving relational well-being and decreasing depression and loneliness. Methods: Participants were randomly assigned to either intervention (n = 719) or assessment only (n = 701) conditions and completed daily diary surveys for 28 days in the midst of the first wave of the Covid-19 pandemic. In the middle 14 days of the study, intervention participants received daily text-message suggestions for improving relational and mental well-being. Results: Results indicated that the intervention decreased depression and loneliness and improved relationships during the intervention period but these changes were not sustained when the intervention ceased. Discussion: Results are encouraging in that evidence-based suggestions can be scaled effectively but additional efforts are required to sustain improvements over time.

Healthy Management of Menopause: Exploring Issues and User Requirements for Mobile Intervention

Designing and developing a mobile health intervention that focuses on menopausal symptom management and emotional support for women should be grounded by some knowledge about their problems and needs. Therefore, to gather information about the issues surrounding women in their menopausal phase, review of literatures pertaining to the topic was conducted, followed by a brief preliminary investigation (PI) using online survey method which was administered to Malaysian women for two weeks. The purpose of PI was to examine their awareness about menopause, namely its phases and symptoms management, as well as methods of information searching on menopause. Respondents were also inquired about their requirements from mobile app to support management of menopause. A total of 30 respondents answered the survey, with majority of them were between the ages of 40 and 59 years old. It was discovered that menopausal women had experienced variety of symptoms, some could be intense more often than the others, and they use diary or book to record these symptoms, which is deemed ineffective. It is imperative to help Malaysian women to manage this unavoidable phase of their lives in a more convenient approach. Therefore, a mobile app that supports symptoms management, and provides educational and motivational tips in Malay language is proposed.

Applying User-Centered Design Methods to Understand Users' Day-to-Day Experiences Can Inform a Mobile Intervention for Binge Eating and Weight Management

Introduction: Weight loss apps to date have not directly addressed binge eating. To inform the design of a new mobile behavioral intervention that addresses binge eating and weight management, we applied user-centered design methods to qualitatively assess how target intervention consumers experience these conditions in their day-to-day lives.Methods: The participants were 22 adults with self-reported obesity (body mass index ≥30) and recurrent binge eating (≥12 episodes in 3 months) who were interested in losing weight and reducing binge eating. The participants completed a digital diary study, which is a user-centered design technique for capturing individuals' day-to-day experiences in relevant contexts. Qualitative data describing the participants' experiences with binge eating and obesity were analyzed using thematic analysis. The results were then used to create personas (i.e., character archetypes of different intervention consumers).Results: The participants described triggers for binge eating and indicated that binge eating and excess weight negatively impact their mental health, physical health, and quality of life. The resulting personas reflected five different struggles individuals with these health problems experience in managing their binge eating and weight.Conclusions: Individuals with binge eating and obesity have varying precipitants of problematic eating as well as varying motivations for and challenges to behavior change. To meet the needs of all who seek intervention, an ideal intervention design will account for variations in these factors and be relevant to diverse experiences. Insights from the diary study and resulting personas will inform the next phases of the user-centered design process of iteratively designing prototypes and testing the intervention in practice.

Effectiveness of an App-Based Mobile Intervention for Precision Oral Self-Care in Patients with Periodontitis from Initial Therapy to Re-Evaluation

Good oral hygiene is essential to oral health and oral disease prevention. Strengthening the adherence of patients with periodontitis to oral hygiene behaviors (OHBs) is crucial for the success of periodontal treatment. This study aims to investigate the intervention effectiveness of a novel mobile app for precision oral self-care, which was developed to help patients with periodontitis improving their oral hygiene through daily oral self-care. One-hundred and fifty eligible patients were recruited into this study and randomly allocated to the control (n = 75) or intervention group (n = 75), and their oral hygiene status (OHS) and OHBs were recorded at baseline and re-evaluation. The participants in the intervention group were required to perform daily oral self-care using our oral self-care app (OSCA) and the functional preferences and overall likeability of the OSCA were evaluated through a questionnaire survey. In total, 39 patients from the control group and 49 from the intervention group completed clinical examinations at baseline and re-evaluation. The results demonstrated that there was no significant difference in OHS improvement between the two groups. However, OHS improvement significantly differed between low-, moderate-, and high-frequency users, with frequency of use being positively correlated to the likeability of the app. Further investigation of the effectiveness of the OSCA intervention revealed that behavioral change in oral hygiene, frequency of OSCA use, and smoking affected OHS improvement. These outcomes indicate that our app-based mobile intervention may be of value for precision oral self-care in patients with periodontitis.

A Mobile Intervention to Promote Low-risk Drinking Habits in Young Adults: Study Protocol for A Randomized Controlled Trial (Preprint)

BACKGROUND Young adults’ drinking habits commonly exceed recommendations for low risk drinking. Exceeding these guidelines may have a negative effect on young adults’ mental, social, and physical health. As smartphones are highly accessible to young adults, mobile applications could be used to support them to develop low-risk drinking habits and to improve their general health. We designed a study protocol for the evaluation of a self-guided mobile application based on healthy lifestyle-related components that aim to develop and maintain low-risk drinking habits among young adults. OBJECTIVE The objective of this study is to assess the effectiveness of Boozebuster, a mobile phone–based app on drinking behavior in young adults. METHODS This is a two-arm, parallel group randomized controlled trial to investigate whether a 6-week self-guided mobile intervention (Boozebuster) targeting drinking behavior is more effective than a minimal intervention consisting of an educational website on the effects and consequences of drinking. To assess the effectiveness of Boozebuster we will recruit 506 young adults aged between 18 and 30 years via an open recruitment strategy in the Netherlands from an open access website. All outcomes are self-assessed through questionnaires. The primary outcome is the quantity and frequency of alcohol consumption in standard drinks (10g ethanol per standard drink) per month (TLFB). Secondary outcomes include binge-drinking sessions per month, alcohol-related problem severity (RAPI), cannabis use frequency and quantity in grams (TLFB), depressive symptoms (CES-D), perceived stress (PSS), engagement (TWEETS), readiness to change (RCQ), mental wellbeing (WEMBIS), trauma and COVID-related trauma (PCL-5-SF), impulsivity (UPPS-P), study and work performance (IWPQ), and treatment adherence. The assessments will be conducted at baseline, 6-week (post-baseline), and 3-months post-baseline, and will be analyzed on the basis of the intention-to-treat principle using multilevel mixed modelling analyses. RESULTS The study is still in progress. Results will be reported in 2021 and 2022. CONCLUSIONS Self-guided mobile interventions based on a lifestyle approach might be an attractive approach for young adults due to their preference on self-reliance, healthy living, and increased perceived anonymity. This type of intervention are yet understudied while it is known that interventions addressing solely problem drinking are less appealing to young adults. We hypothesize that the Boozebuster mobile application will effectively reduce drinking levels compared to a brief alcohol educational website condition. If effective, our intervention could be an inexpensive and scalable public health intervention to improve drinking habits in young adults. CLINICALTRIAL Trial registration: www.trialregister.nl/trial/8828