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During the COVID-19 pandemic, people had to adapt their daily life routines to the currently implemented public health measures, which is likely to have resulted in a lack of in-person social interactions, physical activity, or sleep. Such changes can have a significant impact on mental health. Mobile sensing apps can passively record the daily life routines of people, thus making them aware of maladaptive behavioral adjustments to the pandemic.
This study aimed to explore the views of people on mobile sensing apps that passively record behaviors and their potential to increase awareness and helpfulness for self-managing mental health during the pandemic.
We conducted an anonymous web-based survey including people with and those without mental disorders, asking them to rate the helpfulness of mobile sensing apps for the self-management of mental health during the COVID-19 pandemic. The survey was conducted in May 2020.
The majority of participants, particularly those with a mental disorder (n=106/148, 72%), perceived mobile sensing apps as very or extremely helpful for managing their mental health by becoming aware of maladaptive behaviors. The perceived helpfulness of mobile sensing apps was also higher among people who experienced a stronger health impact of the COVID-19 pandemic (
Our findings highlight the potential of mobile sensing apps to assist in mental health care during the pandemic.
COVID-19 has currently affected over 213 countries [
The recent proliferation of mobile sensing apps offers novel opportunities to monitor people’s behavior, thus potentially holding great promise for the self-management of mental health during the COVID-19 pandemic. Based on their passively recorded mobile sensing data, people could become aware of how their behaviors changed during the pandemic. For example, based on the global positioning system, accelerometer, and phone usage data, people could infer whether they are socially isolated, sleeping poorly, physically inactive, or not leaving their homes [
We hypothesize that mobile sensing apps can increase self-awareness and thereby have a potential for limiting the adverse consequences of the pandemic on mental health. To test this hypothesis, we conducted a web-based survey to explore whether mobile sensing apps are perceived as helpful tools by people with and those without mental disorders for self-managing their mental health during the COVID-19 pandemic by increasing awareness for potential maladaptive behaviors.
We chose Amazon Mechanical Turk (AMT) as our web-based platform as it would facilitate rapid, large-scale participant recruitment [
Participants rated their agreement with the statement, “a mobile phone–based tracking application for health and well-being will be helpful in a pandemic or crisis situation like COVID-19,” on a 5-point Likert scale ranging from 1=“not at all” to 5=“extremely.” Answers to this question defined our outcome of interest; that is, the perceived helpfulness of mobile sensing apps. The concept of mobile sensing apps was introduced through multiple examples of what type of sensors might be used in mobile sensing apps and what behavioral insights might be obtained from these sensor data. In particular, we asked participants to rate the likeability and comfort with different mobile sensing features (
Participants provided further information on the predictors of perceived helpfulness such as basic demographics (age, gender, and education) and their mental health history (with responses of “yes,” “no,” or “prefer not to answer”). We also asked participants to rate their technology knowledge on a 5-point Likert scale ranging from 1=“poor” to 5=“excellent.” Finally, we asked participants to rate the extent to which the COVID-19 pandemic has impacted their overall health and well-being, on a 5-point Likert scale ranging from 1=“not at all” to 5=“extremely.” An overview of all questions is provided in
We set the type I error rate (Cronbach
After testing for homoscedasticity (determined using the Breusch–Pagan test [
All study procedures comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the tenets of the 2008 revision of the 1975 Helsinki Declaration. All procedures were approved by the research ethics board at Dalhousie University. Furthermore, this study complies with the General Data Protection Regulation.
Cleaning for incorrect and missing responses resulted in a survey sample of 474 participants, most of whom were from the United States (n=237, 50%) or India (n=175, 37%). Of them, 235 (50%) were aged 25-34 years, 170 (36%) were female, and 148 (31%) had a history of a mental disorders (
The majority of our participants (n=312, 66%) perceived mobile sensing apps as “very” or “extremely” helpful for managing mental health during the COVID-19 pandemic. In total, 106 of the 148 (72%) participants with a history of a mental disorder found mobile sensing “very” or “extremely” helpful, whereas only 206 of 326 (63%) participants without a history of a mental disorder provided such responses (
Specifically, participants with a history of a mental disorder reported experiencing a stronger health impact of the COVID-19 pandemic (
Participant characteristics (N=474).
Characteristic | Participants | |
|
||
|
18-24 | 90 |
|
25-34 | 235 |
|
35-44 | 75 |
|
≥45 | 74 |
|
||
|
Female | 170 |
|
Male | 304 |
|
||
|
High school | 51 |
|
Bachelor's degree | 336 |
|
Master's degree | 87 |
|
||
|
Yes | 148 |
|
No | 324 |
Health impacted by the COVID-19 pandemic, mean (SD) | 4.10 (0.70) | |
Have technology knowledge, mean (SD) | 3.29 (1.14) |
Perceived helpfulness ratings of mobile sensing apps during the COVID-19 pandemic.
Linear regression model of the perceived helpfulness of mobile sensing apps.
Parameter |
|
SE | |
Age | –0.07 | 0.05 | .13 |
Gender | 0.06 | 0.09 | .18 |
Education | 0.10 | 0.08 | .02 |
Technology knowledge | 0.17 | 0.06 | <.001 |
History of a mental disorder | 0.08 | 0.09 | .06 |
Health impact of the COVID-19 pandemic | 0.24 | 0.04 | <.001 |
Our findings indicate that mobile sensing apps that passively track the daily life behaviors of people are perceived as very helpful tools for the self-management of mental health during the COVID-19 pandemic. People with and those without mental disorders considered mobile sensing apps as helpful for the self-management of their mental health during the pandemic, although people with mental disorders found them slightly more helpful. Importantly, people with mental disorders are reportedly at a higher risk of severe clinical outcomes of COVID-19 [
Fringe events such as the COVID-19 pandemic provide opportunities to examine how mental health and behaviors deviate from baseline. Initial mobile sensing studies during the COVID-19 pandemic indicated that mobile sensing apps can identify maladaptive behaviors such as decreased physical activity and increased screen time [
An important of caveat of mobile sensing apps is that there are some limitations to the interpretation of the recorded data. When people stay at home, they may not have their mobile phones with them at all times, which could lead to the overestimation of their sedentary time. Additionally, people may be preferentially accessing larger screens such as tablets or laptops; therefore, mobile phone usage may underestimate the total amount of screen time. Such shortcomings will need to be considered in the design of mobile sensing apps for mental health care.
While our results indicate that gender and age do not seem to impact the perceived helpfulness of mobile sensing apps for self-management of mental health during the pandemic, participants with high technology knowledge were more likely to find mobile sensing apps helpful. Accordingly, increasing the technology knowledge of users would be a crucial step for the acceptance and usability of mobile sensing apps for mental health care. Future studies should aim to further the current understanding of additional characteristics that might determine perceived helpfulness in order to enable efficient integration of mobile sensing apps in current mental health care models.
A considerable limitation of our survey is that our sample, though well-stratified and diverse, was not randomly recruited; people who have an interest in mobile sensing technologies might have been more likely to take part in this web-based survey. Our data might further be slightly biased by social desirability. However, we assume that such effects should only have been minimal, considering the anonymity of participants maintained throughout the survey. Nevertheless, our data suggest that a substantial number of people perceive mobile sensing apps as helpful tools for managing their mental health during the pandemic-related lockdown.
Our findings indicate that the use of mobile sensing apps might have the potential to directly reduce the burden on the mental health care system during the COVID-19 pandemic by promoting better self-management. People with and those without mental disorders found mobile sensing apps as helpful to self-manage their mental health during the pandemic, although those with a mental disorder found such apps especially useful. By making users aware of maladaptive changes in their behaviors, mobile sensing apps can assist and motivate people to take better care of their mental health, preventing novel onsets or a worsening of mental disorders. Remote empowerment of people in mental health care must be considered especially valuable as standard ways of delivering care have been severely compromised during the COVID-19 pandemic. Finally, the ability of mobile sensing apps to increase self-awareness might have the potential to advance current health care models beyond the context of the current pandemic.
Survey Questions.
Amazon Mechanical Turk
BS, RO, LW, and SM designed the study. BS and RO recruited the participants. BS, KB, and SM conducted the analyses. BS, KB, and SM drafted the manuscript. AB, LW and PM assisted in the clinical presentation. All authors critically revised the manuscript.
None declared.