Watanabe Kazuhiro, Sato Mitsuhiro, Okusa Shoichi, Tsutsumi Akizumi
Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, 252-0374, Japan, 81 427789352.
Human Resources Unit, Fujitsu General Limited, Kawasaki, Japan.
JMIR Mhealth Uhealth. 2025 May 6;13:e70473. doi: 10.2196/70473.
Encouraging physical activity improves mental health and is recommended in workplace mental health guidelines. Although mobile health (mHealth) interventions are promising for physical activity promotion, their impact on mental health outcomes is inconsistent. Furthermore, poor user retention rates of mHealth apps pose a major challenge.
This study aimed to examine the effectiveness and implementation outcomes of the smartphone app ASHARE in Japanese workplace settings, leveraging a deep learning model to monitor depression and anxiety through physical activity.
This hybrid effectiveness-implementation trial was a 3-month nonrandomized controlled trial conducted from October 2023 to September 2024. Work units and employees were recruited and allocated to the intervention or active control group based on preference. The intervention group installed the ASHARE app, whereas the control group participated in an existing multicomponent workplace program promoting physical activity. Changes in physical activity and psychological distress levels were compared between the groups. User retention rates, participation rates, acceptability, appropriateness, feasibility, satisfaction, and potential harm were also assessed.
A total of 84 employees from 7 work units participated (67 from 5 units in the intervention group and 17 from 2 units in the control group). In total, 78 employees completed the 3-month follow-up survey (follow-up rate: 93%). Both groups showed increased physical activity, and the intervention group showed reduced psychological distress; however, the differences between groups were not statistically significant (P=.20; P=.36). In a sensitivity analysis of protocol-compliant employees (n=21), psychological distress levels were significantly reduced in the intervention group compared with the control group (coefficient=-3.68, SE 1.65; P=.03). The app's 3-month user retention rate was 20% (12/61), which was lower than the participation rate in each component of the control programs. Implementation outcomes evaluated by employees were less favorable in the intervention group than in the control group, whereas health promotion managers found them to be similar.
The ASHARE app did not show superior effectiveness compared with an existing multicomponent workplace program for promoting physical activity. An implementation gap may exist between health promotion managers and employees, possibly contributing to the app's low user retention rate. Future research should focus on examining the effectiveness of strategies to get engagement from managers and from segments of employees with favorable responses in the workplace at an early stage.
鼓励身体活动可改善心理健康，这在工作场所心理健康指南中得到推荐。尽管移动健康（mHealth）干预措施在促进身体活动方面前景广阔，但其对心理健康结果的影响并不一致。此外，mHealth应用程序的用户留存率低是一个重大挑战。
本研究旨在通过深度学习模型，利用智能手机应用程序ASHARE在日本工作场所环境中监测身体活动来检查抑郁和焦虑情况，从而考察其有效性和实施效果。
这项混合有效性 - 实施试验是一项为期3个月的非随机对照试验，于2023年10月至2024年9月进行。根据偏好招募工作单位和员工，并将其分配到干预组或积极对照组。干预组安装ASHARE应用程序，而对照组参加现有的促进身体活动的多成分工作场所计划。比较两组之间身体活动和心理困扰水平的变化。还评估了用户留存率、参与率、可接受性、适宜性、可行性、满意度和潜在危害。
来自7个工作单位的84名员工参与了研究（干预组5个单位的67名员工和对照组2个单位的17名员工）。共有78名员工完成了3个月的随访调查（随访率：93%）。两组的身体活动均有所增加，干预组的心理困扰有所减少；然而，两组之间的差异无统计学意义（P = 0.20；P = 0.36）。在符合方案的员工（n = 21）的敏感性分析中，与对照组相比，干预组的心理困扰水平显著降低（系数 = -3.68，标准误1.65；P = 0.03）。该应用程序的3个月用户留存率为20%（12/61），低于对照组各组成部分的参与率。员工评估的实施效果在干预组中不如对照组，而健康促进经理则认为两者相似。
与现有的促进身体活动的多成分工作场所计划相比，ASHARE应用程序未显示出卓越的有效性。健康促进经理和员工之间可能存在实施差距，这可能导致该应用程序的用户留存率较低。未来的研究应侧重于考察在早期阶段促使经理和工作场所中反应良好的部分员工参与的策略的有效性。
