Feasibility, Acceptability, and Preliminary Outcomes of a Cognitive Behavioral Therapy–Based Mobile Mental Well-being Program (Noom Mood): Single-Arm Prospective Cohort Study

Abstract

Background The prevalence of anxiety, depression, and general distress has risen in recent years. Mobile mental health programs have been found to provide support to nonclinical populations and may overcome some of the barriers associated with traditional in-person treatment; however, researchers have voiced concerns that many publicly available mobile mental health programs lack evidence-based theoretical foundations, peer-reviewed research, and sufficient engagement from the public. Objective This study aimed to evaluate the feasibility, acceptability, and preliminary outcomes of Noom Mood, a commercial mobile cognitive behavioral therapy– and mindfulness-based program. Methods In this single-arm prospective cohort study, individuals who joined Noom Mood between August and October 2021 completed surveys at baseline and 4-week follow-up. Per-protocol analyses included those who completed both surveys (n=113), and intention-to-treat analyses included all participants (N=185). Results A majority of the sample reported that the program is easy to use, they felt confident recommending the program to a friend, and they perceived the program to be effective at improving stress and anxiety. There were significant improvements in anxiety symptoms, perceived stress, depressive feelings, emotion regulation, and optimism in both the per-protocol and intention-to-treat analyses (all P<.001). Participants reported benefiting most from learning skills (eg, breathing and cognitive reframing techniques), interacting with the program features, and gaining awareness of their emotions and thought patterns. Participants also made a number of suggestions to improve product functionality and usability. Conclusions Results suggest that Noom Mood is feasible and acceptable to participants, with promising preliminary outcomes. Future studies should build on these results to evaluate the effects of Noom Mood using more rigorous designs.

Weight loss maintenance after a digital commercial behavior change program (Noom Weight): Observational cross‐sectional survey study

“…We did not measure factors like usability or acceptability of the program in this study, but these factors could also explain the high level of maintenance achieved, as research on another Noom program showed high levels of usability and acceptability. 48 The Noom programs have utilized user experience research and experimentation to increase usability, which could amplify engagement and weight loss management more than alternatives with less usability and acceptability. Future research should assess how usability and acceptability directly influence engagement and maintenance.…”

Long-Term Efficacy of a Mobile Mental Wellness Program: Prospective Single-Arm Study

“…The sample size was determined based on an estimated medium effect on post-intervention scores on our primary outcome, the GAD-7, from baseline to end of program, 95% power, and α set at 0.05. The effect size is based on an ITT analysis of the GAD-7 (d=0.70) from a previous Noom Mood feasibility study [24]. The sample size calculation was conducted using G*Power [29] matched pairs t tests.…”

“…All surveys were administered online via OpenClinica, a HIPAA-compliant electronic data capture platform [32]. 280 participants eligible [24].…”

“…In response to the scarcity of clinical validation among these programs, we previously evaluated the feasibility and short-term efficacy of Noom Mood [24], a commercially available, smartphone-based mental wellness program that provides educational content, skills-based activities, and non-clinical coaching support to help users manage stress and symptoms of anxiety. In the current study, we extend our initial findings (at 4 weeks) to the full length of the intervention (at 16 weeks) and postintervention (at 32 weeks) in a larger sample.…”