Effectiveness of Two Mobile Apps in Promoting Mental Health among University Students

Background: There is evidence of a high prevalence of depression, anxiety, mental health and difficulties in university students. Currently, the many mindfulness meditation and emotion management interventions delivered via a mobile app may be an appealing, effective way to reduce stress in college students. Objective: To evaluate the effectiveness of two mobile app interventions compared to a wait-list control in promoting health, resilience, mindfulness, emotion management and coping skills in first year university students enrolled in Health Sciences degree courses. Methods: The study design was a sample of 154 first-year undergraduates with a mean age of 19.82 years were assigned to one of three conditions: 1) unguided Internet-based mindfulness intervention app "Calm"; 2) unguided emotion management app "E-Trainer"; and 3) wait-list control condition. Participants were evaluated at pre-treatment and 7 months follow-up (post-treatment). For this purpose, we used the General Health Questionnaire-28 (GHQ-28), the Patient Health Questionnaire (PHQ-15), the short form of the State Trait Anxiety Inventory (STAI), the Five-Facet Mindfulness Questionnaire-Short Form (FFMQ-SF), the Connor-Davidson Resilience Scale (CD-RISC) and the Evaluation of the Need for Psychological Assistance Questionnaire (NPAQ). Results: There were no significant differences in any outcomes between the interventions and control groups. We identified one significant difference as regards whether they needed psychological assistance from the university at post-test. However, only 53 students completed the study (17 "Calm", 26 "E-Trainer", 10 controls). We analysed the 101 students that dropped out and did not continue to the post-test, comparing them with those that remained. We found that those continuing felt concern about their somatic symptoms, their study methods, and their academic performance. Additionally, the results of paired-sample pre-test-post-test measures showed these students presented higher levels of distress, anxiety, academic and interpersonal dysfunctions. Conclusions: Although the mobile app interventions were not effective, our study was able to determine the status of the students that completed the study, with post-test being when they presented most difficulties. Thus, in the case of these students, early strategies are needed for the prevention and treatment of psychological effects on the mental health of university students.