National Center for Posttraumatic Stress Disorder, Dissemination and Training Division, Department of Veterans Affairs, Menlo Park, CA, United States.
Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States.
JMIR Mhealth Uhealth. 2022 Nov 4;10(11):e38951. doi: 10.2196/38951.
Barriers to accessing in-person care can prevent veterans with posttraumatic stress disorder (PTSD) from receiving trauma-focused treatments such as exposure therapy. Mobile apps may help to address unmet need for services by offering tools for users to self-manage PTSD symptoms. Renew is a mobile mental health app that focuses on exposure therapy and incorporates a social support function designed to promote user engagement.
We examined the preliminary efficacy of Renew with and without support from a research staff member compared with waitlist among 93 veterans with clinically significant PTSD symptoms. We also examined the impact of study staff support on participant engagement with the app.
In a pilot randomized controlled trial, we compared Renew with and without support from a research staff member (active use condition) with waitlist (delayed use condition) over 6 weeks. Participants were recruited through online advertisements. The Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) was used to measure PTSD symptoms at pre, post, and 6-week follow-up. Usage data were collected to assess engagement with Renew.
Results indicated a small effect size (d=-0.39) favoring those in the active use conditions relative to the delayed use condition, but the between-group difference was not significant (P=.29). There were no differences on indices of app engagement between the 2 active use conditions. Exploratory analyses found that the number of support persons users added to the app, but not the number of support messages received, was positively correlated with app engagement.
Findings suggest Renew may hold promise as a self-management tool to reduce PTSD symptoms in veterans. Involving friends and family in mobile mental health apps may help bolster engagement with no additional cost to public health systems.
ClinicalTrials.gov NCT04155736; https://clinicaltrials.gov/ct2/show/NCT04155736.
由于无法获得面对面的护理，患有创伤后应激障碍（PTSD）的退伍军人可能无法接受以暴露疗法为重点的创伤治疗。移动应用程序可以通过为用户提供自我管理 PTSD 症状的工具来帮助满足未满足的服务需求。Renew 是一款专注于暴露疗法的移动心理健康应用程序，它结合了旨在促进用户参与的社交支持功能。
我们在 93 名患有临床显著 PTSD 症状的退伍军人中，比较了 Renew 在有和没有研究人员支持的情况下（主动使用条件）与候补组（延迟使用条件）的初步疗效。我们还研究了研究人员支持对参与者使用应用程序的影响。
在一项试点随机对照试验中，我们比较了 6 周内有和没有研究人员支持的 Renew（主动使用条件）与候补组（延迟使用条件）。参与者通过在线广告招募。使用《精神障碍诊断与统计手册，第五版（DSM-5）创伤后应激障碍检查表》在预、后和 6 周随访时测量 PTSD 症状。收集使用数据以评估与 Renew 的互动情况。
结果表明，主动使用条件相对于延迟使用条件，效果大小较小（d=-0.39），但组间差异无统计学意义（P=.29）。在 2 种主动使用条件之间，应用程序参与度的指数没有差异。探索性分析发现，用户添加到应用程序中的支持人员数量与应用程序参与度呈正相关，但与收到的支持消息数量无关。
研究结果表明，Renew 可能是一种用于减少退伍军人 PTSD 症状的自我管理工具。让朋友和家人参与移动心理健康应用程序可能有助于提高参与度，而不会给公共卫生系统增加额外的成本。
ClinicalTrials.gov NCT04155736；https://clinicaltrials.gov/ct2/show/NCT04155736。
