Ryan Stoll

Designing a mobile application to support the indicated prevention and early intervention of childhood anxiety

This paper presents the design of an mHealth application for prevention and early intervention of childhood anxiety. The application is based on REACH, a preventative-early intervention protocol for childhood anxiety. This paper describes the multidisciplinary design process, sharing lessons learned in developing an effective mHealth application. This mHealth application is unique due to participant age, preventive-early intervention focus, and utilization of mobile technology in a situated manner. A design process inspired by user-centered leveraging key informant interviews was used to identify application features, including game based strategies and an animated motivational avatar. Validation was performed through external review and a usability study performed with target end users of the application. Results suggest overall satisfaction, ease of use, and increased motivation.

Usability of a Smartphone Application to Support the Prevention and Early Intervention of Anxiety in Youth

Anxiety disorders are among the most common psychiatric problems in youth, fail to spontaneously remit, and place some youth at risk for additional behavioral and emotional difficulties. Efforts to target anxiety have resulted in evidence-based interventions but the resulting prevention effects are relatively small, often weakening over time. Mobile health (mHealth) tools could be of use to strengthen the effects of anxiety prevention efforts. Although a large number of mHealth apps have been developed, few have been evaluated in terms of usability prior to clinical effectiveness testing. Because usability is one of the main barriers to mHealth usage and adoption, the objective of this research was to evaluate the usability of a smartphone application (app) corresponding to an indicated prevention and early intervention targeting youth anxiety. To accomplish this, 132 children (M age = 9.65; 63% girls) and 45 service providers (M age = 29.13, 87% female) rated our app along five established dimensions of usability (ease of use, ease of learning, quality of support information, satisfaction, and stigma) using a standardized group-based testing protocol. Findings showed that the app was highly and positively rated by both youth and providers, with some variations (lower ratings when errors occurred). Path analyses findings also showed that system understanding was significantly related to greater system satisfaction, but that such relation occurred through the quality of support information offered by the app.

MHealth Games as Rewards: Incentive or Distraction?

Games may be employed for delivery of a clinical protocol, or as an incentive for protocol tasks. We focus on serious games in mHealth apps for pediatric patients with a chronic disease as an incentive for behavior modification. A patient is rewarded with enhanced gameplay in proportion to her/his compliance with a clinical protocol. The game-as-reward prevents fatigue and sustains patient engagement as the mHealth apps are used on a frequent basis when the affliction is a chronic disease. However, our experience shows a fine line between games that encourage engagement and ones that distract patients from protocol tasks.