Health App Use Among Individuals With Symptoms of Depression and Anxiety: A Survey Study With Thematic Coding
Open accessAbstract
Background: Researchers have largely turned to commercial app stores, randomized trials, and systematic reviews to make sense of the mHealth landscape. Few studies have approached understanding by collecting information from target end users. The end user perspective is critical as end user interest in and use of mHealth technologies will ultimately drive the efficacy of these tools. Objective: The purpose of this study was to obtain information from end users of mHealth technologies to better understand the physical and mental health apps people use and for what purposes. Methods: People with depressive or anxious symptoms (N=176) seeking entry into a trial of mental health and well-being apps for Android devices completed online questionnaires assessing depression and anxiety (Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7), past and current mental health treatment-seeking behavior, overall mobile device use, and use of mobile health apps. Participants reported the physical health and mental health apps on their devices and their reasons for using them. Data were extracted from the participant self-reports and apps and app purposes were coded in order to categorize them. Results: Participants were largely white, middle-aged females from the Midwest region of the United States recruited via a health care organization and Web-based advertising (135 female, 41 male, mean age 38.64 years, age range 19-75 years.) Over three-quarters (137/176, 77.8%) of participants indicated having a health app on their device. The top 3 kinds of apps were exercise, fitness, and pedometers or heart rate monitoring apps (93/176, 52.8%); diet, food, or calorie counting apps (65/177, 36.9%); and mental health/wellness apps (46/177, 26.1%). The mean number of mobile physical and mental health apps on a participant’s phone was 2.15 (SD 3.195). Of 176 participants, 107 (60.8%) specifically reported the top 5 health apps that they used and their purposes. Across the 107 participants, a total of 285 apps were reported, with 139 being unique apps. The majority of these apps were free (129/139, 92.8%). Almost two-thirds of participants (67/107, 62.6%) reported using health apps at least on a daily basis. Conclusions: Among those seeking support for their well-being via physical and mental health apps, people are using a variety of health apps. These people use health apps on a daily basis, especially free apps. The most common reason for using a health app is to track some health-related data; for mental health apps specifically, training or habit building was the most popular reason. Understanding the end user perspective is important because it allows us to build on the foundation of previously established mHealth research and may help guide future work in mHealth. Trial Registration: Clinicaltrials.gov NCT02176226; https://clinicaltrials.gov/ct2/show/NCT02176226 (Archived by WebCite at http://www.webcitation.org/6rGc1MGyM)
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To accurately appraise the quality of apps adopted by people with BD in real-world contexts, researchers must directly ask the individuals in question to describe their mHealth use.
“To accurately appraise the quality of apps adopted by people with BD in real-world contexts, we must directly ask the individuals in question to describe their mHealth use (Rubanovich et al. 2017).”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Rubanovich et al. 2017
The Introduction identifies a gap in understanding app use from the end-user perspective, and the Discussion (Principal Findings) says self-reports better capture how people use health apps than app-store information alone. But the study surveyed people with symptoms of depression or anxiety, not specifically people with bipolar disorder (BD), and it did not establish that directly asking users is necessary to appraise app quality. Page numbers were not supplied in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPeople with mental health conditions (including those in the present study) primarily rely on word of mouth or app store ratings/reviews to identify apps.
“People with mental health conditions (including those in the present study) primarily rely on word of mouth or app store ratings/reviews to identify apps (Rubanovich et al. 2017; Morton et al. 2022; Schueller et al. 2018), which may have contributed to the popularity of generic health and wellbeing apps seen here.”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Rubanovich et al. 2017
The Introduction (page unavailable) reports that users in an earlier general health-app survey learned about apps through app stores, family or friends, and Web searches. That supports word of mouth and app stores as discovery routes, but not a primary reliance on ratings or reviews among people with mental health conditions. The Methods > Measures section (page unavailable) shows that this paper’s participants were asked which apps they used, not how they found them. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMarketplace searches alone may not reflect the apps used in real-world contexts.
“it has been noted that marketplace searches alone may not reflect the apps used in real-world contexts (Rubanovich et al. 2017).”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Rubanovich et al. 2017
People with mental health needs have reported using wellbeing apps designed for the general population, not necessarily those targeting their diagnosed conditions.
“people with mental health needs have reported using wellbeing apps designed for the general population, not necessarily those targeting their diagnosed conditions (Rubanovich et al. 2017; Beard et al. 2019).”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Rubanovich et al. 2017
A survey of physical and mental health apps used by people with depression and anxiety found similar trends to the present study.
“Although use of specific apps by people with BD has not previously been investigated, a survey of physical and mental health apps used by people with depression and anxiety found similar trends (Rubanovich et al. 2017).”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Rubanovich et al. 2017
Of the 139 unique health apps mentioned in the Rubanovich et al. survey, 92.8% had less than 5 mentions, and 69.8% had only one mention.
“Of note, of the 139 unique health apps mentioned, 92.8% had less than 5 mentions, and 69.8% had only one mention.”
From Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self-management (2022) · cites this paper as Rubanovich et al. 2017
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Self-citation
- Authors
- Rubanovich, C. K., Mohr, D. C., & Schueller, S. M.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Schueller, Stephen M
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2017-06-23
- Volume
- 4
- Issue
- 2
- Pages
- e22
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC5501925
- OpenAlex
- W2694642487
- Cited by
- 63
- References
- 34
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 12 · 2019: 12 · 2018: 9
- FWCI
- 10.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UL1TR000150)
- National Institute of Mental Health (R01MH100482, K08MH102336)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › Health Information Management › Health, Technology, Consumer Behavior
- Keywords
- mobile health apps, end-user perspective, depressive symptoms, anxiety symptoms, mental health apps, pedometers, heart rate monitoring, app usage frequency, Android devices, free apps
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