Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany.
University of Education Freiburg, Freiburg, Germany.
JMIR Mhealth Uhealth. 2023 Aug 29;11:e42415. doi: 10.2196/42415.
Chronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life.
This review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores.
SMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived.
Of 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period.
The moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.
慢性压力会对身心健康造成风险。应激管理干预已被证明是有效的，而应激管理应用程序（SMAs）可能有助于将策略转移到日常生活中。
本综述旨在全面概述 SMA 的质量和特征，以便潜在用户或健康专业人员在常见应用商店中搜索 SMA 时提供指导。
通过在欧洲的 Google Play 商店和 Apple App Store 进行系统搜索来确定 SMA。根据纳入标准筛选和检查 SMA。使用德国移动应用程序评级量表（MARS-G）由 2 名独立评估员评估一般特征和质量。MARS-G 在以下四个维度上评估质量（范围 1 到 5）：（1）参与度，（2）功能性，（3）美观度，和（4）信息。此外，评估并得出了 5 个顶级 SMA 的基于理论的应激管理策略、证据基础、长期可用性和常见特征。
在 2044 个识别的应用程序中，有 121 个 SMA 被纳入。经常实施的策略（也在 5 个顶级 SMA 中）包括心理教育、呼吸和正念，以及使用监测和提醒功能。在 121 个 SMA 中，有 111 个（91.7%）提供了隐私政策，但只有 44 个（36.4%）要求主动确认同意。仅在 14.0%（17/121）的 SMA 中披露了与第三方的数据共享。纳入应用程序的平均质量高于 3.5 的截止分数（平均值 3.59，SD 0.50）。MARS-G 维度的得分高于此截止分数（功能性：平均值 4.14，SD 0.47；美观度：平均值 3.76，SD 0.73），低于此分数（信息：平均值 3.42，SD 0.46；参与度：平均值 3.05，SD 0.78）。大多数基于理论的应激管理策略都是再生性应激管理策略。有 9.1%（11/121）的 SMA 的证据基础可以被确定，表明在几个变量（例如，压力或抑郁症状）方面 SMA 存在显著的组间差异。此外，在 2 年后，有 38.0%（46/121）的 SMA 不再可用。
信息质量中等，证据基础稀缺，数据隐私和安全功能的限制，以及 SMA 的高波动性给用户、健康专业人员和研究人员带来了挑战。然而，由于 SMA 的可扩展性以及关于其有效性的为数不多但很有希望的结果，它们具有很高的潜力可以覆盖和帮助广大受众。为了实现全面的应激管理方法，SMA 可以从更广泛的策略组合中受益，例如更多的工具性和精神应激管理策略。具有顶级质量的 SMA 的共同特征可以用作潜在用户和健康专业人员的指导，但由于 SMA 的高波动性，需要增强评估框架。
