BackgroundPrevention and management of work-related stress and related mental problems is a great challenge. Mobile applications are a promising way to integrate prevention strategies into the everyday lives of citizens.ObjectiveThe objectives of this study was to study the usage, acceptance, and usefulness of a mobile mental wellness training application among working-age individuals, and to derive preliminary design implications for mobile apps for stress management.MethodsOiva, a mobile app based on acceptance and commitment therapy (ACT), was designed to support active learning of skills related to mental wellness through brief ACT-based exercises in the daily life. A one-month field study with 15 working-age participants was organized to study the usage, acceptance, and usefulness of Oiva. The usage of Oiva was studied based on the usage log files of the application. Changes in wellness were measured by three validated questionnaires on stress, satisfaction with life (SWLS), and psychological flexibility (AAQ-II) at the beginning and at end of the study and by user experience questionnaires after one week’s and one month’s use. In-depth user experience interviews were conducted after one month’s use to study the acceptance and user experiences of Oiva.ResultsOiva was used actively throughout the study. The average number of usage sessions was 16.8 (SD 2.4) and the total usage time per participant was 3 hours 12 minutes (SD 99 minutes). Significant pre-post improvements were obtained in stress ratings (mean 3.1 SD 0.2 vs mean 2.5 SD 0.1, P=.003) and satisfaction with life scores (mean 23.1 SD 1.3 vs mean 25.9 SD 0.8, P=.02), but not in psychological flexibility. Oiva was perceived easy to use, acceptable, and useful by the participants. A randomized controlled trial is ongoing to evaluate the effectiveness of Oiva on working-age individuals with stress problems.ConclusionsA feasibility study of Oiva mobile mental wellness training app showed good acceptability, usefulness, and engagement among the working-age participants, and provided increased understanding on the essential features of mobile apps for stress management. Five design implications were derived based on the qualitative findings: (1) provide exercises for everyday life, (2) find proper place and time for challenging content, (3) focus on self-improvement and learning instead of external rewards, (4) guide gently but do not restrict choice, and (5) provide an easy and flexible tool for self-reflection.

BackgroundCommon risk factors such as obesity, poor nutrition, physical inactivity, stress, and sleep deprivation threaten the wellness and work ability of employees. Personal health technologies may help improve engagement in health promotion programs and maintenance of their effect.ObjectiveThis study investigated personal health technologies in supporting employee health promotion targeting multiple behavioral health risks. We studied the relations of usage activity to demographic and physiological characteristics, health-related outcomes (weight, aerobic fitness, blood pressure and cholesterol), and the perceived usefulness of technologies in wellness management.MethodsWe conducted a subgroup analysis of the technology group (114 subjects, 33 males, average age 45 years, average BMI 27.1 kg/m2) of a 3-arm randomized controlled trial (N=352). The trial was organized to study the efficacy of a face-to-face group intervention supported by technologies, including Web services, mobile applications, and personal monitoring devices. Technology usage was investigated based on log files and questionnaires. The associations between sustained usage of Web and mobile technologies and demographic and physiological characteristics were analyzed by comparing the baseline data of sustained and non-sustained users. The associations between sustained usage and changes in health-related outcomes were studied by repeated analysis of variance, using data measured by baseline and end questionnaires, and anthropometric and laboratory measurements. The experienced usability, usefulness, motivation, and barriers to using technologies were investigated by 4 questionnaires and 2 interviews.Results111 subjects (97.4%) used technologies at some point of the study, and 33 (29.9%) were classified as sustained users of Web or mobile technologies. Simple technologies, weight scales and pedometer, attracted the most users. The sustained users were slightly older 47 years (95% CI 44 to 49) versus 44 years (95% CI 42 to 45), P=.034 and had poorer aerobic fitness at baseline (mean difference in maximal metabolic equivalent 1.0, 95% Cl 0.39 to 1.39; P=.013) than non-sustained users. They succeeded better in weight management: their weight decreased -1.2 kg (95% CI -2.38 to -0.01) versus +0.6 kg (95% CI -0.095 to 1.27), P=.006; body fat percentage -0.9%-units (95% CI -1.64 to -0.09) versus +0.3%-units (95% CI -0.28 to 0.73), P=.014; and waist circumference -1.4 cm (95% CI -2.60 to -0.20) versus +0.7 cm (95% CI -0.21 to 1.66), P=.01. They also participated in intervention meetings more actively: median 4 meetings (interquartile range; IQR 4–5) versus 4 meetings (IQR 3–4), P=.009. The key factors in usefulness were: simplicity, integration into daily life, and clear feedback on progress.ConclusionsDespite active initial usage, less than 30% of subjects continued using Web or mobile technologies throughout the study. Sustained users achieved better weight-related outcomes than non-sustained users. High non-usage attrition and modest outcomes cast dou...

The prevalence of lifestyle-related health problems is increasing rapidly. Many of the diseases and health risks could be prevented or alleviated by making changes toward healthier lifestyles. We have developed the Wellness Diary (WD), a concept for personal and mobile wellness management based on Cognitive-Behavioral Therapy (CBT). Two implementations of the concept were made for the Symbian Series 60 (S60) mobile phone platform, and their usability, usage, and acceptance were studied in two 3-month user studies. Study I was related to weight management and study II to general wellness management. In both the studies, the concept and its implementations were well accepted and considered as easy to use and useful in wellness management. The usage rate of the WD was high and sustained at a high level throughout the study. The average number of entries made per day was 5.32 (SD = 2.59, range = 0-14) in study I, and 5.48 (SD = 2.60, range = 0-17) in study II. The results indicate that the WD is well suited for supporting CBT-based wellness management.

BackgroundWork-related stress is a significant problem for both people and organizations. It may lead to mental illnesses such as anxiety and depression, resulting in increased work absences and disabilities. Scalable interventions to prevent and manage harmful stress can be delivered with the help of technology tools to support self-observations and skills training.ObjectiveThe aim of this study was to assess the feasibility of the P4Well intervention in treatment of stress-related psychological problems. P4Well is a novel intervention which combines modern psychotherapy (the cognitive behavioral therapy and the acceptance and commitment therapy) with personal health technologies to deliver the intervention via multiple channels, includinggroup meetings, Internet/Web portal, mobile phone applications, and personal monitoring devices.MethodsThis pilot study design was a small-scale randomized controlled trial that compared the P4Well intervention with a waiting list control group. In addition to personal health technologies for self-assessment, the intervention consisted of 3 psychologist-assisted group meetings. Self-assessed psychological measures through questionnaires were collected offline pre- and post-intervention, and 6 months after the intervention for the intervention group. Acceptance and usage of technology tools were measured with user experience questionnaires and usage logs.ResultsA total of 24 subjects were randomized: 11 participants were followed up in the intervention group (1 was lost to follow-up) and 12 participants did not receive any intervention (control group). Depressive and psychological symptoms decreased and self-rated health and working ability increased. All participants reported they had benefited from the intervention. All technology tools had active users and 10/11 participants used at least 1 tool actively. Physiological measurements with personal feedback were considered the most useful intervention component.ConclusionsOur results confirm the feasibility of the intervention and suggest that it had positive effects on psychological symptoms, self-rated health, and self-rated working ability. The intervention seemed to have a positive impact on certain aspects of burnout and job strain, such as cynicism and over-commitment. Future studies need to investigate the effectiveness, benefits, and possible problems of psychological interventions which incorporate new technologies.Trial RegistrationThe Finnish Funding Agency for Technology and Innovation (TEKES), Project number 40011/08

BackgroundObesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes.Methods/Design339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations.DiscussionThis study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value–based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions.Trial registrationCurrent Clinical Trials NCT01738256, Registered 17 August, 2012.