A group project done by public health students at UNC-Chapel Hill assessing mobile health applications for anxiety reduction. Presentation was created in Spring 2016 for an mHealth course.

1. Anxiety
ZAINAB ALIDINA, SHAUNA AYRES,
LAURIE HURSTING, ANNE SCHMIDT, & LINDA YANG

2. “Cognitive BehaviorTherapy via the Internet:
a systematic review of applications,clinicalefficacy and cost–effectiveness”
Main objective: to determine the
applications, clinical efficacy, and cost-
effectiveness of Internet-based
Cognitive Behavior Therapy
108 articles reviewed
103 clinical efficacy studies
8 cost-effectiveness studies
APPLICATIONS
Depression and Anxiety (used with 25
disorders)
CLINICAL EFFICACY
Large effects sizes
At least as good as traditional CBT
COST EFFECTIVENESS
Yes, as compared to wait lists and/or no
treatment
Hedman, E., Ljótsson, B., & Lindefors, N. (2012). Expert review of pharmacoeconomics & outcomes research, 12(6), 745-764.

3. “Smartphones forSmarter Delivery of Mental
Health Programs: ASystematicReview”
Main objective: to systematically
review the efficacy of mental health
apps for mobile devices (such as
smartphones and tablets) for all ages
4997 abstracts examined
8 papers (5 apps) met inclusion
criteria
4 apps provided support from a
mental health professional
APPLICATIONS
Depression (3)
Anxiety (3)
Substance use (1)
RESULTS
Significant reduction in depression,
anxiety, substance use
Large effect sizes
Donker, T., Petrie, K., Proudfoot, J., Clarke, J., Birch, M. R., & Christensen, H. (2013). Journal of medical Internet research, 15(11), e247.

4. Limitations (generally)
Technical problems
Limited, low-quality
studies
Outdated technology
by end of study
Isolate one disorder
or componenet at a
time

5. SamApp
1. Working with SAM
2. Help for anxiety NOW
3. How’s my anxiety right now?
4. Self-help with SAM
5. Things that make me anxious
6. My Anxiety Toolkit
7. Anxiety Tracker
8. Social Cloud

6. SamApp
Pros
Can set reminders for “Things that
make me anxious”
Self-help section provides exercises
that range in activity type
Can save favorite exercises to a
personal tool-kit for quick access
Cons
Must register for social cloud from
within the app
Some external links are broken
Many tabs that are not self-
explanatory
No prompts to use

7. Koko
Started at the MIT Media
Lab as a web-based version
that was evaluated in a RCT
Anonymous crowdsourcing
Based in cognitive
behavioral therapy

8. KoKo
Pros
Simple to use
Reading and re-thinking others’
problems helps provide perspective
Anonymous postings
Community suggestions can be
upvoted or flagged
Provides positive feeling in knowing
that you’re helping others
Cons
No prompts to use; easy to forget
The name

9. What’sUp
Start up tutorial
1. Help Right Now
2. Coping Strategies
3. Information
4. Personal

10. What’sUp
 Pros
Has a help right now feature
Tracking ability of anxiety level
Many self-help tools and
educational information
Get grounded games are quite fun
Can set a password
 Cons
No easy opt out mid-game
Lots of text
No prompts to use the app
Difficult to navigate
No feedback

11. KOKO
-Solely positive
reappraisal, monitored
-w/o Registration
only info
-Registration for posting
-Anonymous social forum
-Self-reflection focus
-Evidence/Practice based
-Guided
tutorial
WHAT’S UP-Education based
-Mood tracker
-Exercises
-Personal
Toolkit
SAMAPP
Compare Contrast

12. And theWinner is…
Simplicity
Different options
Low health literacy
level required
Intensity of self-help 1
2 3

13. Recommendations for Future Mental HealthApps
Comprehensive:
 self-monitoring
 social forum
 education
 exercises
Text messaging prompts
(instead of push notifications)
Aesthetically pleasing
(non-clinical)
Simplicity
Tutorials