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Cited by 113Digital Mental Health InterventionsMobile Health and mHealth ApplicationsMental Health Research Topics

Uptake and usage of IntelliCare: A publicly available suite of mental health and well-being apps

Open access
Lattie, Emily G., Schueller, Stephen M., Sargent, Elizabeth, Stiles-Shields, Colleen, Tomasino, Kathryn Noth, Corden, Marya E., Begale, Mark, Karr, Chris J. +1 more·2016·Internet Interventions
DOI 10.1016/j.invent.2016.06.003PMC PMC4936531
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Abstract

BACKGROUND: Treatments for depression and anxiety have several behavioral and psychological targets and rely on varied strategies. Digital mental health treatments often employ feature-rich approaches addressing several targets and strategies. These treatments, often optimized for desktop computer use, are at odds with the ways people use smartphone applications. Smartphone use tends to focus on singular functions with easy navigation to desired tools. The IntelliCare suite of apps was developed to address the discrepancy between need for diverse behavioral strategies and constraints imposed by typical app use. Each app focuses on one strategy for a limited subset of clinical aims all pertinent to depression and anxiety. This study presents the uptake and usage of apps from the IntelliCare suite following an open deployment on a large app marketplace. METHODS: Thirteen lightweight apps, including 12 interactive apps and one Hub app that coordinates use across those interactive apps, were developed and made free to download on the Google Play store. De-identified app usage data from the first year of IntelliCare suite deployment were analyzed for this study. RESULTS: In the first year of public availability, 5,210 individuals downloaded one or more of the IntelliCare apps, for a total of 10,131 downloads. Nearly a third of these individuals (31.8%) downloaded more than one of these apps. The modal number of launches for each of the apps was 1, however the mean number of app launches per app ranged from 3.10 to 16.98, reflecting considerable variability in the use of each app. CONCLUSIONS: The use rate of the IntelliCare suite of apps is higher than public deployments of other comparable digital resources. Our findings suggest that people will use multiple apps and provides support for the concept of app suites as a useful strategy for providing diverse behavioral strategies.

AI snapshot

Written from the paper’s full text.

TL;DR

The IntelliCare suite—12 interactive mental health/well-being apps plus a Hub app—was freely deployed on Google Play, and first-year uptake and usage were analyzed. Many users downloaded multiple apps, and usage was higher than some prior public digital health deployments, but engagement varied widely and efficacy was not assessed.

Key findings

  • In the first year, 5,210 individuals downloaded one or more IntelliCare apps, totaling 10,131 downloads; 31.8% downloaded more than one app, mean apps downloaded was 1.94, and modal apps downloaded was 1.
  • The Hub app was installed by 1,613 users (30.9%); 965 users (18.5% of all users) downloaded the Hub plus at least one interactive app. Hub users typically downloaded more interactive apps than non-Hub users, χ²(11) = 1370.05, p < 0.001.
  • Mean app launches per app ranged from 3.10 for ME Locate to 16.98 for Daily Feats, while the modal number of launches for each app was 1. Active users (≥10 sessions) ranged from 4.69% for ME Locate to 35.70% for Daily Feats.
  • Sustained use varied by app: more-than-1-day use ranged from 38.67% for ME Locate to 70.19% for Daily Feats; at 28 days, table values ranged from 12.02% for Aspire to 23.30% for Daily Feats.

Methods

  • Open, naturalistic deployment: 13 lightweight apps (12 interactive apps plus one Hub app) were developed by Northwestern University’s Center for Behavioral Intervention Technologies and made free on the Google Play store; de-identified usage data from the first year were analyzed.
  • Outcomes were app downloads and launches. A launch session was defined as user-initiated action within the app separated by <5 minutes; users were deemed “active” if they used an app 10 or more times, based on Helander et al. (2015). Time between first and last use was extracted for continued engagement.
  • Analyses included descriptive statistics and comparisons between Hub users and non-Hub users, using chi-square and Mann-Whitney U tests.

Limitations

  • Stated in the paper: the data are an early snapshot; users had to seek out IntelliCare and may be more motivated early adopters; there were no reliable efficacy data, and use may not directly relate to outcome; the Hub recommendation feature showed no evidence of effect; Hub use was not randomly assigned and the study was not a comparative trial.
  • Evident from the text: the sample is self-selected from a public app marketplace, with no demographic or clinical outcome data reported, so findings describe uptake/usage patterns rather than effectiveness or causal effects.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.invent.2016.06.003

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 30 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Of the 5210 users, 1613 (30.9%) installed the IntelliCare Hub.

    “Of the 5210 users included in these analyses, 1613 (30.9%) users installed the IntelliCare Hub on their mobile phones.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Nearly a third (31.8%) of individuals who downloaded IntelliCare apps downloaded more than one app.

    “Nearly a third of these individuals (31.8%) downloaded more than one of these apps.”
    • Also stated in: § Rate of download · plain
      “Nearly a third of these individuals (31.8%) downloaded more than one of these apps (see Table 2).”
    Quote in the paperNot a substantial claim
  • Findingown data

    For 648 users, the Hub app was the only app installed.

    “For 648 of these users, the Hub app was the only app installed.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Despite the novelty of an app suite method for mental healthcare, substantial numbers of people downloaded and used multiple apps.

    “Despite the novelty of an app suite method for mental healthcare, substantial numbers of people downloaded and used multiple apps.”
    Quote in the paperSubstantial claim
  • Findingown data

    The length of time between downloads was significantly greater for those who downloaded the Hub app compared to those who did not.

    “Results of a Mann-Whitney U test indicated that the length of time between downloads was significantly greater for those who downloaded the Hub app compared to those who did not (Z = 7.203, p < 0.001).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 17
  • Classified as probably not a substantial claim. 10

  • May combine two claims.

    Findingown data

    The modal number of apps downloaded per user was 1, and the mean number of apps downloaded was 1.94.

    “The modal number of apps downloaded per user was 1, and the mean number of apps downloaded was 1.94.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The modal number of launches for each app was 1, and the mean number of app launches per app ranged from 3.10 to 16.98.

    “The modal number of launches for each of the apps was 1, however the mean number of app launches per app ranged from 3.10 to 16.98, reflecting considerable variability in the use of each app.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the first year of public availability, 5210 individuals downloaded one or more IntelliCare apps, for a total of 10,131 downloads.

    “In the first year of public availability, 5210 individuals downloaded one or more of the IntelliCare apps, for a total of 10,131 downloads.”
    • Also stated in: § Rate of download · plain
      “By October 30, 2015, 5210 individuals downloaded one or more of the IntelliCare apps, for a total of 10,131 app downloads.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Use over 14 days ranged from 18.8% to 36.5% of users, while use over 28 or more days ranged from 13.1% to 23.3%.

    “Use over 14 days ranged from 18.8% to 36.5% of users, while use over 28 or more days ranged from 13.1% to 23.3%.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Users without the Hub were more likely to download all of their apps within a 24-hour period than Hub users; approximately 65.34% of non-Hub users vs 52.97% of Hub users did so.

    “Users without the Hub (i.e., non-Hub users) were more likely to download all of their apps within a 24 hour period, χ2(1) = 29.52, p < 0.001, with approximately two-thirds (65.34%) of non-Hub users having downloaded all of their apps within a 24-hour period compared to approximately half (52.97%) of Hub users having downloaded all of their apps within this same period.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Substantial numbers of users persisted in using the apps and engaged with the apps over extended periods of time.

    “Furthermore, substantial numbers of users persisted in using the apps and engaged with the apps over extended periods of time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Among users who downloaded multiple apps, the mean time between first and last app download was 3.84 days and the median time was 2.23 days.

    “Among users who downloaded multiple apps, the mean time in between first and last app download was 3.84 days and the median time in first and last app download was 2.23 days.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Those who downloaded the Hub app were more likely to download multiple apps from the suite, and use frequently and for longer periods of time.

    “Those who downloaded the Hub app were more likely to download multiple apps from the suite, and use frequently and for longer periods of time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    While the period of downloading multiple apps was significantly longer for Hub users, the difference did not appear to be meaningful.

    “While this period was significantly longer for Hub users, the difference did not appear to be meaningful.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Mental health apps have the potential to be effective but often lack scientific evidence about their efficacy.

    “These apps have the potential to be effective but often lack scientific evidence about their efficacy (Donker et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Donker et al., 2013 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Chorpita et al. (2005) have described diverse strategies found in evidence-based treatments as practice elements.

    “Chorpita et al. (2005) have described these diverse strategies found in evidence-based treatments as practice elements.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chorpita et al., 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Years of research have identified a multitude of behavioral and psychological components that contribute to depression and anxiety and many effective strategies for treatment and prevention.

    “Years of research have identified a multitude of behavioral and psychological components (including activity, cognition, and emotion regulation) that contribute to depression and anxiety and many effective strategies for treatment and prevention (e.g. activity tracking, cognitive restructuring, seeking social support).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chorpita et al., 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study procedures were approved by the Northwestern University Institutional Review Board (IRB).

    “These procedures were approved by the Northwestern University Institutional Review Board (IRB)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Feasibility and early testing commonly focuses on use of specific tools.

    “Feasibility and early testing commonly focuses on use of specific tools (Klasnja et al., 2011, Muñoz et al., 2015).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Klasnja et al., 2011

      Not checked in the free run.

    • cites Muñoz et al., 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    The lightweight, easy to use nature of these streamlined, yet integrated, apps may increase the accessibility and willingness to engage with different methods for mood management.

    “The lightweight, easy to use nature of these streamlined, yet integrated, apps may increase the accessibility and willingness to engage with different methods for mood management.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Use of an integrated suite of mobile phone apps for behavior change and mental health care is a novel concept.

    “To our knowledge, use of an integrated suite of mobile phone apps for behavior change and mental health care is a novel concept.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    People respond to different components of treatment and are likely to benefit from exposure to multiple practice elements.

    “People respond to different components of treatment and are therefore likely to benefit from exposure to multiple practice elements”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Chorpita et al., 2005 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    When given directions, the majority of people (72%) follow through with downloading recommended apps.

    “When given directions, the majority of people (72%) follow through with downloading recommended apps (IMS Institute for Healthcare Informatics, 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites IMS Institute for Healthcare Informatics, 2015

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    The study was not a comparative trial and use of the Hub app was not randomly assigned to users.

    “However, this was not a comparative trial and use of the Hub app was not randomly assigned to users.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning

    The recommendations were at random, and therefore not likely to be useful.

    “First, the recommendations were at random, and therefore not likely to be useful.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    For those who downloaded multiple apps, all apps tended to be downloaded within a few days, which suggests that there is a brief period during which users of the IntelliCare suite explore and make app selections.

    “for those who downloaded multiple apps, all apps tended to be downloaded within a few days, which suggests that there is a brief period during which users of the IntelliCare suite explore and make app selections.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    App utilization is an important metric in evaluating the potential reach of the intervention, but it does not present a full picture of the effectiveness of the IntelliCare suite.

    “App utilization, as presented in this study, is an important metric in evaluating the potential reach of the intervention, but it does not present a full picture of the effectiveness of the IntelliCare suite.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Effectiveness of the behavioral strategies depends in part on sustained engagement in the behaviors over time.

  • May combine two claims.

    Interpretationown data

    Uptake and continued usage of these apps were higher than has been seen in previous publicly available BITs, suggesting the feasibility of such an approach.

    “Uptake and continued usage of these apps were higher than has been seen in previous publicly available BITs, suggesting the feasibility of such an approach.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    The IntelliCare app suite is novel in that it provides users with access to multiple apps, each of which targets a specific behavioral strategy through lightweight apps.

    “The IntelliCare app suite is novel in that it provides users with access to multiple apps, each of which targets a specific behavioral strategy through lightweight apps.”
    Quote in the paperNot a substantial claim
24 of 24

  • The paper relies on this without support.

    Smartphone use tends to focus on singular functions with easy navigation to desired tools.

    “Smartphone use tends to focus on singular functions with easy navigation to desired tools.”

  • The paper relies on this without support.

    Many apps that are presented in scientific journals are not publically available.

    “On the other hand, many apps that are presented in scientific journals are not publically available.”

  • The paper relies on this without support.

    Apps are generally downloaded directly by consumers through public marketplaces.

    “Apps are generally downloaded directly by consumers through public marketplaces (e.g., Apple's App Store or the Google Play Store).”

  • The paper relies on this without support.

    The feature-rich nature of responsive websites is often counter to how individuals use apps.

    “While responsive websites can be accessed via multiple devices, including smartphones, the feature-rich nature of these sites is often counter to how individuals use apps.”

  • The paper relies on this without support.

    People are accustomed to using apps that focus on singular functions with easy navigation to desired tools.

    “but they are accustomed to using apps that focus on singular functions with easy navigation to desired tools.”

  • The paper relies on this without support.

    The Hub app is a novel method of managing multiple apps.

    “Because the Hub app is a novel method of managing multiple apps, app use was compared between those who downloaded the Hub app, and those who did not.”

  • The paper relies on this without support.

    Most people do not know which apps could be helpful to them.

    “While interest in mental health apps appears to be growing, most people do not know which apps could be helpful to them.”

  • The paper relies on this without support.

    Effectiveness of the behavioral strategies depends in part on sustained engagement in the behaviors over time.

    “This is an important metric, given that effectiveness of the behavioral strategies depends in part on sustained engagement in the behaviors over time.”

  • The paper relies on this without support.

    The IntelliCare suite does not appear early in app store searches using common search terms such as “depression” or “anxiety.”

    “The current set of users had to seek out IntelliCare, as the IntelliCare suite does not appear early in app store searches using common search terms such as “depression” or “anxiety.””
9 of 9

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Duplicating a design originally intended to be accessed via email or on a PC may well result in lower engagement when accessed through mobile platforms if appropriate modifications for mobile delivery are not made.

    “Duplicating a design originally intended to be accessed via email or on a PC may well result in lower engagement when accessed through mobile platforms if appropriate modifications for mobile delivery are not made (Lattie et al., 2016).”

    From Comparing usage of a web and app stress management intervention: An observational study (2018) · cites this paper as Lattie et al., 2016

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentχ²(11) = 1370.05reported p < .001 · recomputed p < .001

    “χ2(11) = 1370.05, p < .001”

  • Consistentz = 7.203reported p < .001 · recomputed p < .001

    “(Z = 7.203, p < .001”

  • Consistentχ²(1) = 29.52reported p < .001 · recomputed p < .001

    “χ2(1) = 29.52, p < .001”

3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • MyMantra 28-day percentage is miscalculated

    Minor

    Table 6 lists 97 of 484 MyMantra users at 28 days, which is 20.04%, not 22.35%.

    Reported 22.35 · recomputed 20.041322

  • Reported 28-day usage range excludes Aspire

    Minor

    The discussion gives 13.1% as the low end, but Table 6 reports 12.02% for Aspire at 28 days.

  • Share downloading multiple apps conflicts with Table 2

    Minor

    Table 2 says 69.12% downloaded exactly one app, leaving 30.88% who downloaded more than one-not 31.8%.

3 of 3

Cites

Flagged first, then by citations

1 of the 33 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Lattie, E. G., Schueller, S. M., Sargent, E., Stiles-Shields, C., Tomasino, K. N., Corden, M. E., Begale, M., Karr, C. J., & Mohr, D. C.
Affiliations
Northwestern University (US)
Corresponding author
Mohr, David C.
ORCID
Venue
Internet Interventions
Publisher
Elsevier BV
Published
2016-05
Volume
4
Issue
2
Pages
152-158
ISSN
2214-7829 (ISSN-L)
DOI
10.1016/j.invent.2016.06.003
PMC
PMC4936531
OpenAlex
W2437255077
Semantic Scholar
a874434205dff87477c28e6ae4c01ac838867ef6
Cited by
113
References
33
Citations by year
2026: 5 · 2025: 9 · 2024: 5 · 2023: 10 · 2022: 8 · 2021: 18 · 2020: 16 · 2019: 14 · 2018: 17 · 2017: 11
FWCI
21.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Internet Interventions (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eScholarship (California Digital Library) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
Funders
National Institute of Mental Health (K08 MH102336, F31 MH106321)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
mental health apps, depression, anxiety, app uptake, app usage patterns, mobile application, behavioral strategies, app downloads, Google Play Store

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