Effectiveness of a Smartphone App (BioBase) for Reducing Anxiety and Increasing Mental Well-Being: Pilot Feasibility and Acceptability Study
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Abstract
Background: The prevalence of workplace-related stress and anxiety is high, resulting in stress-related physical and mental illness. Digital self-guided interventions aimed at key areas of workplace design may be able to provide remote anxiolytic effects. Objective: The aim of this feasibility study is to assess changes in anxiety and mental well-being after use of the BioBase programme, a mobile phone platform for psycho-educational modules, tools, and real-time feedback of physiological data. Methods: A 4-week observational study was carried out in 55 healthy adults who were screened for stress with the Depression Anxiety Stress Scale (DASS) Stress subscale. Participants completed anxiety (6-item State-Trait Anxiety Inventory [STAI]) and mental well-being (Warwick-Edinburgh Mental Well-being Scale [WEMWBS]) questionnaires at baseline and at 4 weeks. Feedback questionnaires were administered after 4 weeks. Results: After 4 weeks of using the programme and controlling for any effect of being paid to take part in the study, STAI significantly decreased (baseline mean 45.52 [SD 13.2]; 4-week mean 39.82 [SD 11.2]; t54=–3.51; P<.001; CI –8.88 to –2.52; Cohen d=0.96) and WEMWBS significantly increased (baseline mean 48.12 [SD 6.4]; 4-week mean 50.4 [SD 6.9]; t53=2.41; P=.019; CI 0.44-4.23; Cohen d=0.66). Further, higher baseline stress was significantly associated with a greater decrease in STAI (t53=–3.41; P=.001; CI –8.10 to –2.10; R2=0.180) and a greater increase in WEMWBS (t52=2.41; P=.019; CI 0.38-4.11, R2=0.101). On feedback, participants found the programme easy to use/navigate, with the content being acceptable and relevant to workplace-related stressors; 70% (21/30) of participants would recommend the programme to a friend. Conclusions: The BioBase programme is a potentially effective intervention in decreasing anxiety and increasing mental well-being, with larger changes in those with higher baseline levels of stress.
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The BioBase app, previously containing content for workplace stressors, has been shown to increase well-being and decrease anxiety after 4 weeks of use.
“The BioBase app, previously containing content for workplace stressors, has been shown to increase well-being and decrease anxiety after 4 weeks of use [52,53].”
From Development and feasibility of a digital acceptance and commitment therapy⇓based intervention for generalized anxiety disorder: Pilot acceptability study (2021) · cites this paper as [53]
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Cites
The Job Demands‐Resources model: state of the art
Bakker, A. B., & Demerouti, E. (2007) · Journal of Managerial Psychology · doi:10.1108/02683940710733115 · Cited by 12,996 · see citing works
(1995) · Cited by 6,909 · see citing works
Henry, J. D., & Crawford, J. R. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466505x29657 · Cited by 5,801 · see citing works
The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation
Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-5-63 · Cited by 5,031 · see citing works
Marteau, T. M., & Bekker, H. (1992) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1992.tb00997.x · Cited by 3,238 · see citing works
POSNER, J., RUSSELL, J. A., & PETERSON, B. S. (2005) · Development and Psychopathology · doi:10.1017/s0954579405050340 · Cited by 2,602 · see citing works
Depression Anxiety Stress Scales
Lovibond, S. H., & Lovibond, P. F. (2011) · PsycTESTS Dataset · doi:10.1037/t01004-000 · Cited by 2,416 · see citing works
Smartphones for smarter delivery of mental health programs: A systematic review
Donker, T., Petrie, K., Proudfoot, J., Clarke, J., Birch, M.-R., & Christensen, H. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2791 · Cited by 1,136 · see citing works
Firth, J., Torous, J., Nicholas, J., Carney, R., Pratap, A., Rosenbaum, S., & Sarris, J. (2017) · World Psychiatry · doi:10.1002/wps.20472 · Cited by 1,097 · see citing works
Chronic stress at work and the metabolic syndrome: prospective study
Chandola, T., Brunner, E., & Marmot, M. (2006) · BMJ · doi:10.1136/bmj.38693.435301.80 · Cited by 1,075 · see citing works
Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments
Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2016) · JMIR Mental Health · doi:10.2196/mental.4984 · Cited by 886 · see citing works
Cuijpers, P., Donker, T., van Straten, A., Li, J., & Andersson, G. (2010) · Psychological Medicine · doi:10.1017/s0033291710000772 · Cited by 832 · see citing works
Work stress precipitates depression and anxiety in young, working women and men
MELCHIOR, M., CASPI, A., MILNE, B. J., DANESE, A., POULTON, R., & MOFFITT, T. E. (2007) · Psychological Medicine · doi:10.1017/s0033291707000414 · Cited by 691 · see citing works
Using the Internet to provide cognitive behaviour therapy
Andersson, G. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.01.010 · Cited by 560 · see citing works
Workplace interventions for common mental disorders: A systematic meta-review
Joyce, S., Modini, M., Christensen, H., Mykletun, A., Bryant, R., Mitchell, P. B., & Harvey, S. B. (2016) · Psychological Medicine · doi:10.1017/s0033291715002408 · Cited by 525 · see citing works
mHealth: A Mechanism to Deliver More Accessible, More Effective Mental Health Care
Price, M., Yuen, E. K., Goetter, E. M., Herbert, J. D., Forman, E. M., Acierno, R., & Ruggiero, K. J. (2014) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.1855 · Cited by 488 · see citing works
Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being
Bostock, S., Crosswell, A. D., Prather, A. A., & Steptoe, A. (2019) · Journal of Occupational Health Psychology · doi:10.1037/ocp0000118 · Cited by 465 · see citing works
Preventing Depression: A Global Priority
Cuijpers, P., Beekman, A. T. F., & Reynolds, C. F. (2012) · JAMA · doi:10.1001/jama.2012.271 · Cited by 368 · see citing works
Evaluating mobile phone applications for health behaviour change: A systematic review
McKay, F. H., Cheng, C. C., Wright, A., Shill, J., Stephens, H., & Uccellini, M. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16673538 · Cited by 367 · see citing works
Mindfulness Goes to Work: Impact of an Online Workplace Intervention
Aikens, K. A., Astin, J., Pelletier, K. R., Levanovich, K., Baase, C. M., Park, Y. Y., & Bodnar, C. M. (2014) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000000209 · Cited by 338 · see citing works
Occupational Stress: Preventing Suffering, Enhancing Wellbeing
Quick, J. C., & Henderson, D. F. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13050459 · Cited by 288 · see citing works
Bhui, K. S., Dinos, S., Stansfeld, S. A., & White, P. D. (2012) · Journal of Environmental and Public Health · doi:10.1155/2012/515874 · Cited by 287 · see citing works
Proudfoot, J., Clarke, J., Birch, M.-R., Whitton, A. E., Parker, G., Manicavasagar, V., Harrison, V., Christensen, H., & Hadzi-Pavlovic, D. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-312 · Cited by 264 · see citing works
Howarth, A., Quesada, J., Silva, J., Judycki, S., & Mills, P. R. (2018) · DIGITAL HEALTH · doi:10.1177/2055207618770861 · Cited by 240 · see citing works
Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial
Heber, E., Lehr, D., Ebert, D. D., Berking, M., & Riper, H. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5112 · Cited by 213 · see citing works
Tan, L., Wang, M.-J., Modini, M., Joyce, S., Mykletun, A., Christensen, H., & Harvey, S. B. (2014) · BMC Medicine · doi:10.1186/1741-7015-12-74 · Cited by 208 · see citing works
Ebert, D. D., Heber, E., Berking, M., Riper, H., Cuijpers, P., Funk, B., & Lehr, D. (2016) · Occupational and Environmental Medicine · doi:10.1136/oemed-2015-103269 · Cited by 176 · see citing works
Phillips, E. A., Gordeev, V. S., & Schreyögg, J. (2019) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3839 · Cited by 148 · see citing works
Ly, K. H., Asplund, K., & Andersson, G. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.06.003 · Cited by 133 · see citing works
Carolan, S., & de Visser, R. O. (2018) · JMIR Mental Health · doi:10.2196/mental.9146 · Cited by 121 · cited 1× · see citing works
“Smartphone apps offer a practical, scalable, accessible, and cost-effective solution to promoting employee mental health [11-13].”
BackgroundRuwaard, J., Lange, A., Bouwman, M., Broeksteeg, J., & Schrieken, B. (2007) · Cognitive Behaviour Therapy · doi:10.1080/16506070701381863 · Cited by 99 · see citing works
Heber, E., Ebert, D. D., Lehr, D., Nobis, S., Berking, M., & Riper, H. M. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-655 · Cited by 89 · see citing works
Weber, S., Lorenz, C., & Hemmings, N. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02745 · Cited by 74 · see citing works
Self-citationDeady, M., Johnston, D., Milne, D., Glozier, N., Peters, D., Calvo, R., & Harvey, S. (2018) · JMIR mHealth and uHealth · doi:10.2196/11661 · Cited by 72 · see citing works
Total Worker Health and Work–Life Stress
Hammer, L. B., & Sauter, S. L. (2013) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000000043 · Cited by 71 · see citing works
Whitton, A. E., Proudfoot, J., Clarke, J., Birch, M.-R., Parker, G., Manicavasagar, V., & Hadzi-Pavlovic, D. (2015) · JMIR Mental Health · doi:10.2196/mental.3573 · Cited by 69 · see citing works
Internet-based stress management for distressed managers: results from a randomised controlled trial
Asplund, R. P., Dagöö, J., Fjellström, I., Niemi, L., Hansson, K., Zeraati, F., Ziuzina, M., Geraedts, A. S., Ljótsson, B., Carlbring, P., et al. (2017) · Occupational and Environmental Medicine · doi:10.1136/oemed-2017-104458 · Cited by 67 · see citing works
Lehr, D., Geraedts, A. S., Asplund, R. P., Khadjesari, Z., Heber, E., de Bloom, J., Ebert, D. D., Angerer, P., & Funk, B. (2016) · Springer eBooks · doi:10.1007/978-3-319-32331-2_19 · Cited by 64 · see citing works
Muuraiskangas, S., Harjumaa, M., Kaipainen, K., & Ermes, M. (2016) · JMIR Mental Health · doi:10.2196/mental.4465 · Cited by 63 · see citing works
From Mobile Mental Health to Mobile Wellbeing: Opportunities and Challenges
Gaggioli, A., & Riva, G. (2013) · Studies in health technology and informatics · doi:10.3233/978-1-61499-209-7-141 · Cited by 52 · see citing works
Adoption of technology‐enhanced treatments: Conceptual and practical considerations.
Anton, M. T., & Jones, D. J. (2017) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12197 · Cited by 46 · see citing works
Weisel, K. K., Lehr, D., Heber, E., Zarski, A., Berking, M., Riper, H. M., & Ebert, D. D. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9387 · Cited by 29 · see citing works
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Sorted by citations
Eisenstadt, M., Liverpool, S., Infanti, E., Ciuvat, R. M., & Carlsson, C. (2021) · JMIR Mental Health · doi:10.2196/31170 · Cited by 185 · see citing works
Ponzo, S., Morelli, D., Kawadler, J. M., Hemmings, N. R., Bird, G., & Plans, D. (2020) · JMIR mHealth and uHealth · doi:10.2196/17767 · Cited by 100 · see citing works
Self-citationYeo, G., Reich, S. M., Liaw, N. A., & Chia, E. Y. M. (2023) · Journal of Medical Internet Research · doi:10.2196/51268 · Cited by 131 · see citing works
An Overview of Tools and Technologies for Anxiety and Depression Management Using AI
Pavlopoulos, A., Rachiotis, T., & Maglogiannis, I. G. (2024) · Applied Sciences · doi:10.3390/app14199068 · Cited by 81 · see citing works
Catuara-Solarz, S., Skorulski, B., Estella-Aguerri, I., Avella-Garcia, C. B., Shepherd, S., Stott, E., Hemmings, N. R., de Villa, A. R., Schulze, L., & Dix, S. (2021) · JMIR mhealth and uhealth · doi:10.2196/30976 · Cited by 44 · see citing works
Self-citationBlodgett, J. M., Birch, J., Musella, M., Harkness, F., & Kaushal, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192315845 · Cited by 40 · see citing works
Hemmings, N. R., Kawadler, J. M., Whatmough, R., Ponzo, S., Rossi, A., Morelli, D., Bird, G., & Plans, D. (2021) · JMIR Formative Research · doi:10.2196/21737 · Cited by 19 · see citing works
“These narratives were based on the psychologist’s experience of user feedback from previous BioBase studies with individuals with high anxiety [52,53] in conjunction with the aforementioned review of the literature.”
MethodSelf-citationJin, S., Kim, B., & Han, K. (2025) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3706598.3713732 · Cited by 15 · see citing works
Moulaei, K., Bahaadinbeigy, K., Mashoof, E., & Dinari, F. (2023) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-023-02308-y · Cited by 11 · see citing works
Amer, N. A., Abdelrazek, S., Eladrosy, W., El-bakry, H., & Shohieb, S. M. (2024) · International Journal of Cognitive Therapy · doi:10.1007/s41811-024-00225-0 · Cited by 12 · see citing works
Wilson, H. S., Hayward, P., & Donkin, L. (2023) · Frontiers in Digital Health · doi:10.3389/fdgth.2023.1008564 · Cited by 10 · see citing works
McCallum, M., Ho, A. S., Mitchell, E. S., May, C. N., Behr, H., Ritschel, L. A., Mochrie, K. D., & Michaelides, A. P. (2022) · JMIR Formative Research · doi:10.2196/36794 · Cited by 10 · see citing works
Safaei, M., Mahdavi, A., & Mehdipour‐Rabori, R. (2024) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-024-02703-z · Cited by 7 · see citing works
Chen, S., Chen, W., Li, Y., Yu, Y., Chen, Q., Jiao, L., Huang, K., Tong, X., Geldsetzer, P., Bunker, A., et al. (2024) · Digital Health · doi:10.1177/20552076241277650 · Cited by 6 · see citing works
Leveraging Causal Inference to Measure the Impact of a Mental Health App on Users’ Well-being
de Villa, A. R., Sottocornola, G., Çoba, L., Maffei, G., Lucchesi, F., Guerreiro, J., & Skorulski, B. (2023) · ACM Conference on User Modeling, Adaptation and Personalization (UMAP) · doi:10.1145/3565472.3592967 · Cited by 2 · see citing works
Dinari, F., Bashiri, A., Raufi, R., Moulai, K., & Moulai, R. (2024) · Journal of Health and Biomedical Informatics · doi:10.34172/jhbmi.2024.20 · Cited by 1 · see citing works
Warwick-Edinburgh Mental Well-being Scale
Kinman, G. (2025) · Occupational Medicine · doi:10.1093/occmed/kqae117
Using an app to promote emotional regulation and well-being in young adults. A pilot study
Colombo, B., Cohen, J., Currier, R., & Caravita, S. C. S. (2026) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2026.100573
Kunas, B., Jung, O., Schranz, C., Schmoigl-Tonis, M., Mehlis, J., & Laireiter, A. (2026) · JMIR mhealth and uhealth · doi:10.2196/79642
Yin, X. (2026) · PeerJ Computer Science · doi:10.7717/peerj-cs.3983
- Authors
- Kawadler, J. M., Hemmings, N. R., Ponzo, S., Morelli, D., Bird, G., & Plans, D.
- Affiliations
- University of Oxford (GB)
- University of Exeter (GB)
- Corresponding author
- Kawadler, Jamie M
- Venue
- JMIR Formative Research
- Publisher
- JMIR Publications Inc.
- Published
- 2020-11-10
- Volume
- 4
- Issue
- 11
- Pages
- e18067
- ISSN
- 2561-326X (ISSN-L)
- PMC
- PMC7685925
- OpenAlex
- W3012108685
- Cited by
- 20
- References
- 42
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 2
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Formative Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
- 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 › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- mobile application, occupational stress, anxiety reduction, psychological well-being, psychoeducation, physiological feedback, feasibility, acceptability, workplace mental health, user feedback, cost-effectiveness, cost-benefit analysis, cost-effectiveness ratio, cost per quality-adjusted life year
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