@Article{info:doi/10.2196/51932,
author="Edge, Daniel
and Watkins, Edward
and Newbold, Alexandra
and Ehring, Thomas
and Frost, Mads
and Rosenkranz, Tabea",
title="Evaluating the Effects of a Self-Help Mobile Phone App on Worry and Rumination Experienced by Young Adults: Randomized Controlled Trial",
journal="JMIR Mhealth Uhealth",
year="2024",
month="Aug",
day="13",
volume="12",
pages="e51932",
keywords="worry; rumination; repetitive negative thinking; prevention-mechanism; well-being; depression; anxiety; mobile-based interventions; mobile phone; mobile health application; app; application",
abstract="Background: Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT). Objective: This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being. Methods: A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks. Results: Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference --2.92, 95{\%} CI --5.57 to --0.28; P=.03; $\eta$p2=0.02) and worry (mean difference --3.97, 95{\%} CI --6.21 to --1.73; P<.001; $\eta$p2=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point. Conclusions: The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated. Trial Registration: ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257 International Registered Report Identifier (IRRID): RR2-10.1186/s12888-021-03536-0 ",
issn="2291-5222",
doi="10.2196/51932",
url="https://mhealth.jmir.org/2024/1/e51932",
url="https://doi.org/10.2196/51932"
}