Running head: MENTAL HEALTH APP

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Mental Health Application in Anxiety
Annie Jacob
Arizona State University

MENTAL HEALTH APP

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Abstract

The shortage of providers, therapists, and long waiting times for appointments in the United
States is growing. Mental health technology applications (apps) expand the strategies available to
people with mental health conditions to achieve their goals for well being through selfmanagement of symptoms. A project was undertaken at an outpatient behavioral setting in urban
Arizona to determine the use and effectiveness of a mental health app called insight timer to
reduce anxiety symptoms. Adult clients with anxiety symptoms were provided with the insight
timer app to use over a period of eight weeks. Anxiety was evaluated with the GAD-7 scale
initially and after the eight weeks of app use. Usability and the quality of the app were assessed
with an app rating scale at the end of the eight weeks. Findings of the Wilcoxon Signed Ranks
test indicated changes in pre and posttest assessment scores as significant in all the seven clients
who completed the app use. Besides, Cohen’s effect size value suggested large clinical
significance in these same assessment parameters. Evidence suggests that the use of an evidencebased app can effectively reduce anxiety symptoms and improve the quality of life. The use of
mental health apps like insight timer could reduce health care costs associated with unnecessary
hospital admissions as well as re-hospitalizations. The routine use of apps such as the insight
timer may also be beneficial to all the clients who have anxiety symptoms in outpatient as well
as inpatient settings.
Keywords: mental health, apps, insight timer, anxiety, anxiety symptoms

MENTAL HEALTH APP

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Mental disorders are one of the most common health conditions in the United States
(U.S.) (Centers for Disease Control and Prevention [CDC], 2018). World Health Organization
(WHO, 2018) reports anxiety as the most common mental disorder globally. It affects not only
the individual but also the homeostasis of the family and community. Anxiety disorders are
highly treatable, but only 36.9% receive treatment (ADAA, 2018). Anxiety disorders cost the
global economy, the equivalent of 1 trillion U.S. dollars annually (WHO, 2018). The purpose of
this project was to evaluate the effectiveness of evidence-based mental health apps to reduce
anxiety among adult clients in an outpatient health care setting.
Background and Significance
The disability experienced with mental disorders is continuing to grow with crucial
impacts on health globally (World Health Organization [WHO], 2020). According to the
Anxiety and Depression Association of America (ADAA, 2018), about 40 million adults above
the age of 18 are affected by this disorder. It is a debilitating disorder as it affects the ability to
function and also impacts the quality of life. The impact on the economy from mental illness is
multifactorial, including the cost of treatment, employment loss, as well as indirect costs due to
chronic disability. There are many treatment options available for anxiety, including
psychotherapy and medications. Stigma, limited access to treatment, and financial issues are
some reasons provided for lack of care. Stress management techniques and meditation help cope
and manage anxiety (American Psychiatric Association [APA], 2017).
Talk therapy, including a combination of cognitive and behavior therapy (Cognitive
Behavior Therapy [CBT]), is the most effective nonpharmacological treatment for anxiety
(NAMI, 2018). However, evidence suggests that CBT, meditation, and other relaxation

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techniques can reduce anxiety symptoms, access to these interventions constrained by cost and
feasibility (Chandrasekhar, 2018).
In this instance, the use of mobile apps to introduce these interventions garners attention
as an adjunct to in-person therapy. This project is discussing the growing epidemic of anxiety in
adults and learning the outcome benefits of using mental health apps in treating anxiety
disorders. There is no internal evidence of the use of a mental health app by psychiatric providers
at the proposed site of this project.
The gaps mentioned above in mental health has led to the clinically relevant PICOT
question: In adults with anxiety symptoms (P) how does use of an evidence-based app (I)
compared to no app use (C) affect anxiety score (O) after eight weeks of app use (T)?
Evidence Synthesis
The PICOT question led to an exhaustive search of the literature to find evidence to
support the use of mental health app in reducing/relieving anxiety. A thorough review of the
most current evidence was completed to answer the PICOT question. An extensive search was
done on three databases, like the Cumulative Index of Nursing and Allied Health Literature
(CINAHL), PsycInfo, and Pub Med. These databases selected for their relevance to the topics of
mental health app and anxiety. All databases accessed through the Arizona State University
library website via an advanced search option. The databases searched using combinations of the
key terms that addressed all aspects of the PICOT question: anxiety, adults, mobile app, and
mental health app. The outcome was specified using the words: better quality of life and
reduction in anxiety. Filters applied included date of publication (2015 to 2019), English
language, and peer-reviewed journal articles. Mesh and Boolean terms were used to broaden the

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search. Studies included in the review related to the topic and evaluated the relationship between
specific PICOT question and the problem.
Given the shortage of mental health providers and therapists, mental health apps have
emerged as a beneficial tool to bridge the gap in mental health. Mobile apps have significant
potential to deliver effective mental health interventions (Chandrasekhar, 2018). Mobile phones
have become a desegregated part of the personal, social, and occupational life of the global
population. Numerous mental health apps have emerged in recent years and accessible to mobile
phone users (Hoffman et al., 2019).
Multiple databases were searched for articles for evidence and were analyzed and
synthesized to get a concrete foundation of evidence for the benefits of clients. A rapid critical
appraisal tool by Melnyk and Fineout-Overholt (2011) was used to evaluate the quality of the
collected articles and ten materials chosen for evidence synthesis. All the studies assessed in the
evidence synthesis were demonstrating the anxiety reduction by the use of a mental health app.
There was heterogeneity in the measurement tool; however, there were some commonalities as
well. The measurement tools used included Generalized Anxiety Disorder 7(GAD-7) in four of
the studies; Depression Anxiety Stress Scales (DASS) in one of the studies, and the rest were
questionnaire surveys. The symptoms of anxiety were the primary dependent variable assessed in
all of the reviews. The app- only intervention was demonstrated in the majority of the
synthesized article, whereas three of them had an add on intervention such as the use of anxiety
medication.
According to Chandrasekhar (2018), mental health apps use has significantly reduced
anxiety and consequently improved quality of life. A study shows that among BH providers,
83% of providers use mental health app for anxiety, and 66% of participants reported that the

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app was useful in managing stress and anxiety (Hoffman et al., 2019). Another study
demonstrated high feasibility and accessibility of the app, and stress ratings significantly reduced
among app users (Payne, Lister, West, & Bernhardt, 2015).
Theoretical Framework &Implementation Framework
The John Hopkins Nursing Evidence-Based Practice (JHNEBP) model is a powerful
problem-solving perspective and has available tools to direct clinical decision making (Reavy,
2016). The goal of this Evidence-Based Practice (EBP) is to promote effective nursing
interventions, efficient care, and patient outcome. Moreover, to provide the best available
evidence for clinical, administrative, and educational decision making. JHNEBP is explicitly
designed to meet the needs of the nurse who is practicing and also to incorporate the best
practices to patient care. A three-step process structures this EBP model, which are Practice
question (P), Evidence (E), and Translation (T). The translation phase is transforming knowledge
into an action plan and evaluation of the process. JHNEBP model is useful for practicing nurses
and students in implementing EBP process (Reavy, 2016). This framework fits with the current
setting and population. On the other hand, the tools in the frame focus on stakeholders, which is
beneficial for patient outcomes and providers. Moreover, the evidence supports clinical decision
making and meets the needs of the patient effectively, safely, and promptly.
Dorothea Orem’s self-care theory is the theoretical framework that underpins the project.
The primary assumption of this theory is that people are distinct individuals, and they should be
self-reliant and responsible for their care. A person’s knowledge of health care problems is
necessary for promoting self-care behaviors. Orem’s theory is based on self-care requisites,
which are the basic needs of individuals at all stages of life. Orem identifies that specific

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technology developed by members of the health profession with or without the use of
instruments.
Moreover, Orem describes the health care needs to be met by a nurse in specific
situations (Nursing theories, 2012). The concept of the current project is using a mental health
meditation app daily via smart phone for eight weeks. To perform this, patients need to be selfreliant and be responsible for their care. The client is taught on the importance of self-monitoring
of anxiety and practicing meditation daily. Clients are reminded daily electronically about the
meditation via phone, which encourages the client.
Methods
Collaborative Institutional Training Initiative (CITI) completed on 6/17/2019 as a
foundational training in human subjects’ research, which includes the historical development of
human subject protections, ethical issues, and current regulatory and guidance information.
Approval received from the integrated healthcare at South mountain location in fall 2018, which
was the clinical site to conduct this project. The targeted population included in this project was
20 adults who are 18 years or older, able to speak, read, and write English. The other inclusion
criteria were that they have to own mobile phones to download the app and have anxiety
symptoms with a possible diagnosis of generalized anxiety disorder, panic disorder, or
unspecified anxiety disorder. There were no physical risks associated with participating in this
project. Some participants may experience some psychological discomfort when answering the
survey questions. It was informed that they could skip any questions they wish not to respond,
and their responses will be kept confidential. The student collected data from the participant’s
self-report and the charts (medical records). Project data collected via questionnaires was saved
and managed in a secure computer accessible by only the mentor and the student.

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A Health Insurance Portability and Accountability Act (HIPAA) compliant and encrypted
server, multilevel password protection, Enterprise-level firewalls, and antivirus barriers will be
used to secure access to the data. Data will be retained for three years by the mentor and the
student. In keeping with the university IRB requirements, all personnel who have access to the
data have formally trained in the protection of human subjects before working with the
participants or having access to the data. The risk associated with breaches of confidentiality or
anonymity will be minimized by the precautions described above to protect the data. Although
the proposed project has minimal potential for adverse events, the student and the mentor was
monitoring participants very carefully during the study period. Patients who could not receive
timely treatments or have difficulty talking to a mental health provider, including counselor or
therapist, may find it useful as the app, accessible, and feasible. Given the shortage of mental
health providers and the long waiting list for treatments, mental health apps like “Insight Timer”
will help address the gaps in mental health care.
A flyer that described the purpose of the project, the procedure, benefits, and potential
risk of participating in this project was distributed at the clinical site to the potential participants.
The providers also gave project information to patients; patients contacted the student if they
were interested in participating in the project. The student got consent from eligible patients, and
participants created a “nickname” for themselves, which used as identification throughout the
project. Participants downloaded a free mental health app “Insight Timer” to their mobile phone
and tried it with the student to ensure it is functional. Each participant was instructed to practice
meditation by using the app for 5 minutes per day for eight weeks total. Participants filled out a
simple time log of the time and duration of using the app during the 8-week project period.
Besides a time log that helps participants track how much time they use this app during the eight

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weeks, participants filled out pretest (T1) and post-test (T2) surveys to evaluate their anxiety
symptoms and medication use. The questionnaire will take about 5-10 minutes to complete.
The pretest (T1) includes socio-demographic characteristics (birth year, race/ethnicity),
medication information (use of anti-anxiety medications), and evaluation of anxiety symptoms
using GAD7. The post-test (T2) includes evaluation using GAD7, the use of medicines, and
feedback on the app using an app rating scale. The student also gathered medication information
from participants’ charts before they start using the app, and after the project is completed.
Research synthesis for this project was from August 2018 to May 2019. IRB processing was
from June 2019 to October 2019. Recruitment and implementation started in October 2019, and
the post-test was done in December 2019. A non-parametric test was used due to the small
sample size. Wilcoxon Signed-Rank test utilized to describe key variables and to compare
scores over time.
Moreover, it was used to compare two correlated groups with ordinal data. The student
planned to pay an incentive to the participants from her fund upon completion of the project.
Each participant received a $5 gift card as a token of appreciation for participating after the
completion of the project.
Results
Twenty adult clients were successfully recruited to participate in the intervention and
completed the pretest (T1). Of the twenty clients enrolled, seven (35%) completed the eight
weeks intervention and post-test (T2). The other 65% did not respond with the completed posttest after the eight weeks of intervention for unknown reasons. Daily automatic reminders and
weekly follow up text was sent to every client regularly. The clients that completed the
intervention were from the age of 20-45, and two (28.6%) were male, and five (71.4%) were

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female. The educational level of the participants was as follows: one participant (14.3%) with
less than high school education, three (42.9%) has completed high school education, two
(28.6%) has completed associated degree, and one (14.3%) participant has master's degree. The
majority (6) of the participants (85.7%) had Generalized Anxiety Disorder (GAD), whereas one
participant (14.3%) had Panic disorder.
Pre and post mean scores on the GAD-7 Scale were compared to evaluate the
participant's anxiety level. The reported T1 score ranged from 6 to 20, and the frequency was 20,
whereas the T2 score ranged from 0 to 18. The T2 scores were significantly lower than T1, and
the frequency was seven. The mean pretest score of T1 was 15.57 (SD = 4.928), and the mean
post-test score of T2was 7.71 (SD = 5.707). The Wilcoxon Signed Ranks test indicated changes
in T1 and T2 scores as significant and showed a p-value of .028, which is statistically
significant.
Descriptive statistics utilized to examine the usability and acceptability of the 'Insight
timer app' measured by a Mobile App Rating Scale. All the participants were satisfied with the
performance and functionality of the app. The majority (85.7%) of participants agreed that the
app "works well," and 14.3% stated that the app is "mostly functional." All the participants
(100%) reported that the app was easy to learn and use, easy to access, and the guided
conversation was easy to follow. For the question, "will you recommend this app to other
patients?" clients agreed by stating, "definitely, and maybe." For the question "will you use the
app in the next 12 months," clients responded by saying, "definitely (71.4%) and maybe
(28.6%)". The majority of the clients (85.8%) rated four stars for the app, whereas 14.3% rated
three stars, and all (100%) clients stated that the app was "helpful." All the participants (100%)
agreed that it is good to incorporate this app into their service. Reduction in GAD-7 scores is

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evidence showing that the clients are self-reliant and are responsible for their care, which is the
major assumption of the theoretical framework. All the participants except one were using
anxiety meds before and throughout the intervention.
On the other hand, they did not have an appointment with the provider during this eightweek intervention for a medicine change. The mental health provider in the outpatient setting
was made aware of this evidence-based app and the result of this project. The provider was
happy to recommend this app (insight timer) for his future clients. A flyer explaining how to use
this app was placed on the bulletin board in the outpatient setting
Discussion
Mental health apps provide compelling opportunities to look after the mental health and
wellbeing of the users. The number of mental health apps available for users has increased
tremendously due to the accessibility to mobile phones. Mental health apps must aim to prevent
emotional and mental health problems and sustain the wellbeing of the users. Moreover, these
apps must be customized for individual needs and have the ground of CBT techniques that are
evidence-based. Mental health apps and other technology-based solutions have the potential to
play a vital role in the future of mental health. This project intended to determine if the use of
the ‘insight timer’ app, enabled the clients to decrease their anxiety. The project also aimed to
determine the functionality, quality, and feasibility of the app among project participants.
Evidence suggests that the use of the ‘insight timer meditation app’ can reduce anxiety in
adult patients. The significantly large effect size of the GAD-7 scale score in assessing anxiety
shows the clinical significance of the app use in reducing anxiety. The majority of the clients
stated that the app was helpful, easy to use, and want to recommend the app to other patients.
The result shows the quality, functionality, and the feasibility of the app. Smartphone-based

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mental health apps portray an excellent opportunity to reveal the possibility and quality of mental
health treatment.
The findings of this project are timely and relevant as long as anxiety remains a global
mental health problem. Effective and consistent use of the app can reduce the symptoms of
psychological disturbances and improve quality of life. The reduction in symptoms eventually
brings forth positive outcomes in the client’s life, family, and the community. The utilization of
an evidence-based mental health app can also significantly reduce health care costs associated
with unnecessary hospital admissions as well as re-hospitalizations. Additionally, they are costeffective and address the gap in mental health treatment. Evidence-based mental health mobile
apps are beneficial for patients for empowerment and to reach therapeutic goals. In consideration
of the findings of this project, it is reasonable to suggest that the implementation of an evidencebased mental health app such as the ‘insight timer’ could be beneficial to additional inpatient and
outpatient behavioral health facilities. Though patients use the apps on their own time without
any clinical supervision, they are showing to be promising in the field of mental health.
Several strengths can be extracted from this project. The project demonstrated
statistically significant findings within an outpatient behavioral setting. It is a global struggle to
reduce anxiety in mental health patients. It is also reasonable to conclude that the use of the app
can be successful among inpatients and in other settings where clients are struggling with
anxiety. The clients who participated in this project stated that the use of the app is highly
beneficial, which promotes the routine use of this tool.
Although the results of this project are promising, it had a relatively small sample size of
seven participants. Further studies with large sample size are indicated to determine the
generalizability of the current findings. Besides, many participants suggested that the integration

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of the app into psychiatric services may help them as well as other clients with similar
symptoms. The mental health app should be integrated into the electronic medical record system
of the facility to promote consistency and sustainability.
Conclusion

The management of anxiety and other mental disorders are hard to handle due to the lack
of availability of providers and therapists. Current evidence suggests that the use of evidencebased mental health app like ‘insight timer’ can reduce the severity of anxiety. Although it is
difficult to choose an effective mental health app, it is crucial to select one which is evidencebased or one which was useful for another client who had similar symptoms. It is evident that
mobile apps have higher compliance rates and eventually have the potential to improve positive
patient outcomes. Reduction in anxiety symptoms can bring forth a better quality in personal and
social life.

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References

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engagement with a mobile app and its effects on confidence in coping skills, depression,
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10.2196/mhealth.9612
Anxiety and Depression Association of America (ADAA). (2018). Facts and statistics. Retrieved
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American Psychiatric Association. (2017). Anxiety disorders. Retrieved from
https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxietydisorders
Centers for Disease Control and Prevention. (2018). Learn about mental health. Retrieved from
https://www.cdc.gov/mentalhealth/learn/
Center for evidence based practice. (2017). Johns Hopkins nursing evidence based practice
model. Retrieved from https://www.hopkinsmedicine.org/evidence-basedpractice/ijhn_2017_ebp.html
Chandrashekar P. (2018). Do mental health mobile apps work: evidence and recommendations
for designing high-efficacy mental health mobile apps. mHealth, 4(6).
doi: 10.21037/mhealth.2018.03.02
Nursing theories. (2012). A companion to nursing theories and models. Retrieved from
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
Firth, J., Torous, J., Nicholas, J., Carney, R., Rosenbaum, S., & Sarris, J. (2017). Can
smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of

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randomized controlled trials. Journal of Affective Disorders. Retrieved from
https://doi.org/10.1016/j.jad.2017.04.046
Hoffman, L., Benedetto, E., Huang, H., Grossman, E., Kaluma, D., Mann, Z., & Torous, J.
(2019). Augmenting mental health in primary care: A 1-year study of deploying
smartphone apps in a multi-site primary care/behavioral health integration
program. Frontiers in psychiatry, 10(94). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404548/
Lee, R.A., & Jung, M.A. (2018). Evaluation of an mhealth app (DeStressify) on university
students’ mental health: pilot trial. JMIR menthealth, 5(1). doi: 10.2196/mental.8324
Linardon, J., Cuijpers, P., Carlbring, P., Messer, M., & Fuller-Tyszkiewicz, M. (2019). The
efficacy of app-supported smartphone interventions for mental health problems: a metaanalysis of randomized controlled trials. World Psychiatry 18(3), 325-336. Retrieved
from https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20673
Melnyk, B. M., & Fineout-Overhold, E. (2011). Evidence-based practice, step by step: asking the
clinical question. American Journal of Nursing 110(3), 58-61. Retrieved from
https://journals.lww.com/ajnonline/Fulltext/2010/03000/Evidence_Based_Practice,_Step
_by_Step__Asking_the.28.aspx
Mohr, D.C., Tomasino, K.N., Lattie, E.G., Palac, H.L., Kwasny, M.J., Weinganrdt, K., …
Schueller,S.M. (2017). Intellicare: an eclectic, skills-based app suite for the treatment of
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Payne, H. E., Lister, C., West, J. H., & Bernhardt, J. M. (2015). Behavioral functionality of
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design evaluation. Games for Health Journal 5(1), 50-67. Retrieved from
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Rathbone, A. L., & Prescott, J. (2017). The use of mobile apps and sms messaging as physical
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Reavy, K. (2016). Inquiry and leadership: A resource for the DNP project. Philadelphia, PA:
F.A.Davis
Rubanovich, K.C., Mohr, D.C., &Schueller, S.M. (2017). Health app use among individuals with
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Appendix A
Database Search Strategy

CINAHL

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Appendix B
Database Search Strategy

PsycInfo

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Appendix C
Database Search Strategy

PubMed

Running head: MENTAL HEALTH APP

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Appendix D

Table 1
Synthesis Table
Author

Firth

Pham

Hoffman

Payne

Rathbone

Linardon

Lee

Rubanovich

Mohr

Almodovar

Year

2017

2016

2019

2015

2017

2019

2018

2019

2017

2018

Design/LOE

SR/I

RCT/II

PS/II

SR/I

SR/I

RCT/II

PS/VI

SS/II

PS/II

RLS/II

Study characteristics
Demographics
Age

18-60

18-60

18-70

NA

NA

NA

15-24

19-75

>18

>18

Health Center

Internet

Internet

x

Internet

Internet

Internet

x

x

x

x

Sample Size/ # of
Studies

9

63

56

24

27

66

206

176

99

34

Measuring Tools

GAD-7,

Questionnaire

Feedback
survey

Review

DASS

Meta analysis

PSS

GAD-7

GAD-7

GAD-7

4 weeks

2 months

10 weeks

6 months

11 weeks

8 weeks

8weeks

6 weeks

Setting

DASS
Duration of study

2 months

12 weeks

IV -Intervention
App only

x

x

x

x

x

x

x

Key: DASS-Depression Anxiety Stress Scale GAD-7-Generalized Anxiety Disorder-7 NA-Not Applicable PS-Pilot Study PSS-Perceived Stress Scale RCT-Randomized
Controlled trial RLS-Retrospective Longitudinal Study SR-Systematic Review SS-Survey Study Y-Yes

MENTAL HEALTH APP
App& meds

21

x

x

x

DV
Anxiety
Symptoms
Feasibility &
Accessibility

NA

Y

Y

Y

Y

NA

Y

NA

NA

NA

Key: DASS-Depression Anxiety Stress Scale GAD-7-Generalized Anxiety Disorder-7 NA-Not Applicable PS-Pilot Study PSS-Perceived Stress Scale RCT-Randomized
Controlled trial RLS-Retrospective Longitudinal Study SR-Systematic Review SS-Survey Study Y-Yes

Running head: MENTAL HEALTH APP

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Appendix E

Figure 1

Dorothea Orem’s Self Care Deficit Theory (Nursing Theories, 2011).

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Appendix F

Figure 2

Figure 2. The model is designed for implementation in smaller settings, making it ideal for use in
this particular project (Center for evidence based practice, 2017).

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Appendix G

Table 1
Results of pre and post GAD-7 anxiety score

Descriptive Statistics
N

Mean

Std. Deviation

Minimum

Maximum

T1 total anxiety score

7

15.57

4.928

6

20

T2 total anxiety score

7

7.71

5.707

0

18

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Appendix G
Table 2
T2 total anxiety
score - T1 total
anxiety score
Z
Asymp. Sig. (2-tailed)

-2.197b
.028

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Appendix G
Table 3
Descriptive Statistics
N

Minimum

Maximum

Mean

Std. Deviation

id

7

4

10

7.00

2.160

posttest

7

03-JAN-20

30-JAN-20

17-JAN-20

12 18:16:52.240

age

7

20

45

32.14

8.513

participant's gender

7

0

1

.71

.488

education level

7

0

4

1.57

1.272

main diagnosis

7

1

2

1.14

.378

T1 Feeling nervous, anxious,

7

1

3

2.57

.787

7

0

3

1.57

1.272

7

0

3

2.14

1.215

7

0

2

1.00

.816

7

2

3

2.86

.378

7

0

3

.86

1.215

T1 Trouble relaxing

7

0

3

2.43

1.134

T2 Trouble relaxing

7

0

3

1.00

1.414

T1 Being so restless that it's

7

0

3

1.71

.951

or on edge
T2 Feeling nervous, anxious,
or on edge
T1 Not being able to stop or
control worrying
T2 Not being able to stop or
control worrying
T1 Worrying too much about
different things
T2 Worrying too much about
different things

hard to sit still

MENTAL HEALTH APP

T2 Being so restless that it's

27

7

0

2

1.29

.756

7

1

3

2.00

1.000

7

0

2

.86

.900

7

0

3

1.86

1.215

7

0

3

1.14

1.345

T1 total anxiety score

7

6

20

15.57

4.928

T2 total anxiety score

7

0

18

7.71

5.707

how was performance of the

7

2

3

2.86

.378

7

3

3

3.00

.000

7

3

3

3.00

.000

7

3

3

3.00

.000

functionality mean

7

3

3

2.96

.094

will you recommend this app

7

2

3

2.57

.535

7

2

3

2.71

.488

7

3

5

4.29

.756

hard to sit still
T1 Becoming easily annoyed
or irritable
T2 Becoming easily annoyed
or irritable
T1 Feeling afraid as if
something awful might
happen
T2 Feeling afraid as if
something awful might
happen

app
How easy was the app to
learn and use?
How accessible was the
app?
Guidance conversation was
easy to follow?

to other patients
Will you use the app in the
next 12 months?
What is the overall rating of
the app?

MENTAL HEALTH APP

28

0 "not helpful" 1 "helpful"

7

Valid N (list wise)

7

1

1

1.00

.000

GAD7 total score: Scores of 5, 10, and 15 represent cut-points for mild, moderate, and severe
anxiety.