Web and Mobile
Apps for Military
Behavioral Health
Dr. Julie Kinn
Deputy Director, Mobile Health Program, T2

31 OCT 2013
Military Behavioral Health
• Needs
– Care for service members and families
– Access to resources for providers
– Agility to respond to emergent crises

• Challenges to excellent care
– Costs
– Distance

2
Why Use Technology in
Military Health Care?
• Overcome barriers to care (e.g., Hoge et
al., 2004)
– Stigma:
• Web-based and mobile apps are anonymous
• User interfaces/ platforms familiar to service
members

– Logistics:
• “Hip pocket” availability
• 24/7 access to care, 365 days a year

3
After Deployment

4
After Deployment’s Provider Pro

5
MilitaryKidsConnect.org
Site Visits
• Since JAN 2012: 201K

Site tailored depending
on identified
deployment location
Features
identified by text
and graphics

Passport
“gamification”

Age-differentiated
message boards

Stampy the
Global Guide

6
MilitaryKidsConnect.org

PTS, Injury, and
Grief discussed
using graphic
novels and videos
of real military kids

7
Deployed T2 Mobile Apps

8
PTSD Coach
T2 collaborated with the VA's National
Center for PTSD to develop this app to
assist veterans and active duty
personnel (and civilians) who are
experiencing symptoms of PTSD. It is
intended to be used as an adjunct to
psychological treatment but can also
serve as a stand-alone education tool.
Features:
• Self-assessment of PTSD Symptoms
• Tracking of changes in symptoms
• Manage symptoms with coping tools
• Assistance in finding immediate support
• Customized support information

9
T2 Mood Tracker
Self-monitor, track and reference
emotional experiences over a period of
days, weeks and months.
Features:
•
•
•
•
•
•

10

Self-rating on pre-populated categories
Full note adding
Graphed results
Fully customizable categories
User-set reminders for self-rating
Send results to providers
Breathe2Relax
A portable stress management tool
utilizing hands-on diaphragmatic
breathing exercise. Breathe2Relax
uses state-of-the-art
graphics, animation, narration, and
videos to deliver a
sophisticated, immersive experience
for the user.
Features:
• Setup guide to assist with tailoring app
• Customizable backgrounds and music
• Immersive tutorial videos
• Body scanner to display effects of stress
• Graphing to track effectiveness
• Audio narration

11
Provider Resilience
Self-care tool for healthcare
providers who work with service
members and who may need
support in coping with burnout or
compassion fatigue
Features:
• Quick dashboard view
• Graphing to track resilience
progress
• Tools to assist increasing resilience
• Inspirational value cards
• User sets reminders

12
LifeArmor
A multi-topic application derived from
AfterDeployment.org to provide the
user with knowledge and tools to cope
with the many challenges faced by
today’s service members.
Features:
• 17 Self-assessments
• Multi-topic resource guide
• Ease to manage, customizable views and
favorites
• Manage symptoms with coping tools
• Video resources on topics

13
Prolonged Exposure (PE) Coach
The first mobile application that
supports the elements of an
evidence-based psychotherapy for
PTSD
Features:
•
•
•
•
•
•

14

Session homework
Confidential and convenient
Therapist guide
Session audio recording
Assessment result tracking
Disabled veteran accessible
Positive Activity Jackpot
Provides suggestions for daily positive
activities. Based on positive event
scheduling, the active component of
Behavior Activation. Helps with
depression, self-harming behaviors, and
individuals without any mental health
difficulties.
Features:
• “Jackpot” suggests random activities
• Users select from 376+ possible activities
• Augmented reality technology to identify
activities in immediate surroundings
• Ability to invite friends or post chosen
activity to social media

15
Stay Quit Coach
T2 collaborated with the VA's National
Center for PTSD to develop this app to
assist veterans and active duty personnel
(and civilians) to reduce addition to
nicotine. It is intended to be used as an
adjunct to substance use treatment but
can also serve as a stand-alone
education tool.

Features:
• Personalized reasons to quit smoking
• Manage cravings with coping tools
• Progress tools and savings chart
• Assistance in finding immediate support
• Customized support information

16
Biozen
Monitor, track and view biometric
data from Bluetooth enabled
devices to assist with biofeedback
therapies.
Features:
• Real-time tracking
• User tutorials for setup and learning
• Customizable graphical feedback
• Supports broad range of signal data
including:
EEG, EMG, GSR, EKG, respiratory
rate, and temp

17
Psychological First Aid (PFA) Mobile
T2 collaborated with the VA's
National Center for PTSD to develop
this app to assist responders who
provide psychological first aid (PFA)
to adults, families, and children as
part of an organized response effort.
Features:
• Summary of PFA fundamentals
• PFA interventions matched to specific
concerns and needs of survivors
• Mentor tips for applying PFA in the field
• Self-assessment tool for readiness to
conduct PFA
• Survivors’ needs form for simplified
data collection and easy referral
18
mTBI Pocket Guide
Clinical Practice Guidelines for
treatment of mild Traumatic Brain
Injury
Features:
• Quick results with coding guidance
• Symptom management lists
• Summary of clinical recommendations
• Patient education resources
• Clinical tools and resources

19
Navy Leader’s Guide to
Managing Sailors in Distress
[Pending Release]
T2 collaborated with the Navy Marine
Corps Public Health Center to develop
this app as a leadership tool to help
leaders understand the factors that can
cause distress among Sailors, assess and
identify Sailors’ psychological and social
needs, and improve awareness of local
helping agencies.
Features:





Case studies for reference examples
Guidance for identification and management strategies
Self-assessment of awareness of behavioral health
In-depth educational information about behavioral
health issues
 Links to resources for support
20
Mobile Apps: Metrics
Mobile App Metric
Lifetime Downloads
Lifetime Uses
Avg. Monthly Downloads
Avg. Monthly Uses
Avg Session Length
Use/Download Ratio

Total
637,681
3,328,420
21,961
112,089
6:04
5.2

FY 2013 Uses are up
147% over FY 2012

"I use T2 apps EVERYDAY with my patients and
they love them! And as a provider I really love
the PE Coach app it has made PE so much
easier and I have seen an increase in patients
actually doing their assignments :)"

"I'm more likely to use this than keep track manually. Doc
loves that result!! Thanks for creating this tool!!"
21
Resource Disc
T2’s Resource DVD is an easy
reference guide featuring easy-to-share
information about our websites,
mobile apps and special programs.
 Print-Ready posters and cards.
 Videos
 News stories about our products.

Request your T2 Resource DVD from publicaffairs@T2health.org
22
LinkedIn Group
Psychological Health Providers for the Military Community
Psychological Health Providers for the Military Community Private
LinkedIn group for all health care providers supporting the military
community with psychological health related issues.
Provides members a dynamic environment for sharing knowledge,
resources, tools, and best-practices with colleagues in the military
mental health community.
Delivers unique content and previews of new tools and technologies
focused on military mental health.
Over 500 members comprised of psychologists, psychiatrists,
physicians, nurses, therapists, counselors, chaplains, and other roles.

23
Contact Information

Julie T. Kinn, Ph.D.
Deputy Director, Mobile Health Program
National Center for Telehealth & Technology |T2|
9933 West Hayes Street, OMAMC
Joint Base Lewis-McChord
Tacoma, WA 98431
Julie.t.kinn.civ@mail.mil
www.t2health.org

24

Web And Mobile Apps for Military Behavioral Health

  • 1.
    Web and Mobile Appsfor Military Behavioral Health Dr. Julie Kinn Deputy Director, Mobile Health Program, T2 31 OCT 2013
  • 2.
    Military Behavioral Health •Needs – Care for service members and families – Access to resources for providers – Agility to respond to emergent crises • Challenges to excellent care – Costs – Distance 2
  • 3.
    Why Use Technologyin Military Health Care? • Overcome barriers to care (e.g., Hoge et al., 2004) – Stigma: • Web-based and mobile apps are anonymous • User interfaces/ platforms familiar to service members – Logistics: • “Hip pocket” availability • 24/7 access to care, 365 days a year 3
  • 4.
  • 5.
  • 6.
    MilitaryKidsConnect.org Site Visits • SinceJAN 2012: 201K Site tailored depending on identified deployment location Features identified by text and graphics Passport “gamification” Age-differentiated message boards Stampy the Global Guide 6
  • 7.
    MilitaryKidsConnect.org PTS, Injury, and Griefdiscussed using graphic novels and videos of real military kids 7
  • 8.
  • 9.
    PTSD Coach T2 collaboratedwith the VA's National Center for PTSD to develop this app to assist veterans and active duty personnel (and civilians) who are experiencing symptoms of PTSD. It is intended to be used as an adjunct to psychological treatment but can also serve as a stand-alone education tool. Features: • Self-assessment of PTSD Symptoms • Tracking of changes in symptoms • Manage symptoms with coping tools • Assistance in finding immediate support • Customized support information 9
  • 10.
    T2 Mood Tracker Self-monitor,track and reference emotional experiences over a period of days, weeks and months. Features: • • • • • • 10 Self-rating on pre-populated categories Full note adding Graphed results Fully customizable categories User-set reminders for self-rating Send results to providers
  • 11.
    Breathe2Relax A portable stressmanagement tool utilizing hands-on diaphragmatic breathing exercise. Breathe2Relax uses state-of-the-art graphics, animation, narration, and videos to deliver a sophisticated, immersive experience for the user. Features: • Setup guide to assist with tailoring app • Customizable backgrounds and music • Immersive tutorial videos • Body scanner to display effects of stress • Graphing to track effectiveness • Audio narration 11
  • 12.
    Provider Resilience Self-care toolfor healthcare providers who work with service members and who may need support in coping with burnout or compassion fatigue Features: • Quick dashboard view • Graphing to track resilience progress • Tools to assist increasing resilience • Inspirational value cards • User sets reminders 12
  • 13.
    LifeArmor A multi-topic applicationderived from AfterDeployment.org to provide the user with knowledge and tools to cope with the many challenges faced by today’s service members. Features: • 17 Self-assessments • Multi-topic resource guide • Ease to manage, customizable views and favorites • Manage symptoms with coping tools • Video resources on topics 13
  • 14.
    Prolonged Exposure (PE)Coach The first mobile application that supports the elements of an evidence-based psychotherapy for PTSD Features: • • • • • • 14 Session homework Confidential and convenient Therapist guide Session audio recording Assessment result tracking Disabled veteran accessible
  • 15.
    Positive Activity Jackpot Providessuggestions for daily positive activities. Based on positive event scheduling, the active component of Behavior Activation. Helps with depression, self-harming behaviors, and individuals without any mental health difficulties. Features: • “Jackpot” suggests random activities • Users select from 376+ possible activities • Augmented reality technology to identify activities in immediate surroundings • Ability to invite friends or post chosen activity to social media 15
  • 16.
    Stay Quit Coach T2collaborated with the VA's National Center for PTSD to develop this app to assist veterans and active duty personnel (and civilians) to reduce addition to nicotine. It is intended to be used as an adjunct to substance use treatment but can also serve as a stand-alone education tool. Features: • Personalized reasons to quit smoking • Manage cravings with coping tools • Progress tools and savings chart • Assistance in finding immediate support • Customized support information 16
  • 17.
    Biozen Monitor, track andview biometric data from Bluetooth enabled devices to assist with biofeedback therapies. Features: • Real-time tracking • User tutorials for setup and learning • Customizable graphical feedback • Supports broad range of signal data including: EEG, EMG, GSR, EKG, respiratory rate, and temp 17
  • 18.
    Psychological First Aid(PFA) Mobile T2 collaborated with the VA's National Center for PTSD to develop this app to assist responders who provide psychological first aid (PFA) to adults, families, and children as part of an organized response effort. Features: • Summary of PFA fundamentals • PFA interventions matched to specific concerns and needs of survivors • Mentor tips for applying PFA in the field • Self-assessment tool for readiness to conduct PFA • Survivors’ needs form for simplified data collection and easy referral 18
  • 19.
    mTBI Pocket Guide ClinicalPractice Guidelines for treatment of mild Traumatic Brain Injury Features: • Quick results with coding guidance • Symptom management lists • Summary of clinical recommendations • Patient education resources • Clinical tools and resources 19
  • 20.
    Navy Leader’s Guideto Managing Sailors in Distress [Pending Release] T2 collaborated with the Navy Marine Corps Public Health Center to develop this app as a leadership tool to help leaders understand the factors that can cause distress among Sailors, assess and identify Sailors’ psychological and social needs, and improve awareness of local helping agencies. Features:     Case studies for reference examples Guidance for identification and management strategies Self-assessment of awareness of behavioral health In-depth educational information about behavioral health issues  Links to resources for support 20
  • 21.
    Mobile Apps: Metrics MobileApp Metric Lifetime Downloads Lifetime Uses Avg. Monthly Downloads Avg. Monthly Uses Avg Session Length Use/Download Ratio Total 637,681 3,328,420 21,961 112,089 6:04 5.2 FY 2013 Uses are up 147% over FY 2012 "I use T2 apps EVERYDAY with my patients and they love them! And as a provider I really love the PE Coach app it has made PE so much easier and I have seen an increase in patients actually doing their assignments :)" "I'm more likely to use this than keep track manually. Doc loves that result!! Thanks for creating this tool!!" 21
  • 22.
    Resource Disc T2’s ResourceDVD is an easy reference guide featuring easy-to-share information about our websites, mobile apps and special programs.  Print-Ready posters and cards.  Videos  News stories about our products. Request your T2 Resource DVD from publicaffairs@T2health.org 22
  • 23.
    LinkedIn Group Psychological HealthProviders for the Military Community Psychological Health Providers for the Military Community Private LinkedIn group for all health care providers supporting the military community with psychological health related issues. Provides members a dynamic environment for sharing knowledge, resources, tools, and best-practices with colleagues in the military mental health community. Delivers unique content and previews of new tools and technologies focused on military mental health. Over 500 members comprised of psychologists, psychiatrists, physicians, nurses, therapists, counselors, chaplains, and other roles. 23
  • 24.
    Contact Information Julie T.Kinn, Ph.D. Deputy Director, Mobile Health Program National Center for Telehealth & Technology |T2| 9933 West Hayes Street, OMAMC Joint Base Lewis-McChord Tacoma, WA 98431 Julie.t.kinn.civ@mail.mil www.t2health.org 24

Editor's Notes

  • #10 iOS and AndroidReleasedOCT 2011Co-branded with VA National Center for PTSDTotal Downloads: 112,871 Total Sessions: 683,782 Use/Download ratio: 6.06
  • #12 iOS and AndroidFirst released MAR 2011 (iOS) and OCT 2011 (Android)Total Downloads: 255,246Total Sessions: 1,060,444 Use/Download ratio: 4.15
  • #13 iOS and AndroidReleased MAR 2013Total Downloads: 2,822 Total Sessions: 14,818Use/Download ratio: 5.25
  • #14 iOS and AndroidReleased FEB 2012Total Downloads: 6,771 Total Sessions: 26,806Use/Download ratio: 3.96
  • #15 iOS and AndroidReleased MAR 2012Co-branded with VA National Center for PTSDTotal Downloads: 12,209 Total Sessions: 69,938 Use/Download ratio: 5.73
  • #16 Android onlyReleased MAR 2012Total Downloads: 1,976Total Sessions: 6,283Use/Download ratio: 3.18
  • #18 Android OnlyReleased JAN 2013Total Downloads: 1,196Total Sessions: 7,478Use/Download ratio: 6.25
  • #20 iOS and AndroidFirst released MAY 2011 (Android) and NOV 2011 (iOS)Total Downloads: 15,287 Total Sessions: 47,309Use/Download ratio: 3.09
  • #22 Adding in more thorough metrics from Shirley