Leveraging Implementation Science to Understand Factors Influencing Sustained Use of Mental Health Apps: a Narrative Rev
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Leveraging Implementation Science to Understand Factors Influencing Sustained Use of Mental Health Apps: a Narrative Review Samantha L. Connolly 1,2
&
Timothy P. Hogan 3,4 & Stephanie L. Shimada 3,5,6 & Christopher J. Miller 1,2
Received: 30 June 2020 / Revised: 10 August 2020 / Accepted: 31 August 2020 # This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2020
Abstract Mental health (MH) smartphone applications (apps), which can aid in self-management of conditions such as depression and anxiety, have demonstrated dramatic growth over the past decade. However, their effectiveness and potential for sustained use remain uncertain. This narrative review leverages implementation science theory to explore factors influencing MH app uptake. The review is guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and discusses the role of the innovation, its recipients, context, and facilitation in influencing successful implementation of MH apps. The review highlights critical literature published between 2015 and 2020 with a focus on depression and anxiety apps. Sources were identified via PubMed, Google Scholar, and Twitter using a range of keywords pertaining to MH apps. Findings suggest that for apps to be successful, they must be advantageous over alternative tools, relatively easy to navigate, and aligned with users’ needs, skills, and resources. Significantly more attention must be paid to the complex contexts in which MH app implementation is occurring in order to refine facilitation strategies. The evidence base is still uncertain regarding the effectiveness and usability of MH apps, and much can be learned from the apps we use daily; namely, simpler is better and plans to integrate full behavioral treatments into smartphone form may be misguided. Non-traditional funding mechanisms that are nimble, responsive, and encouraging of industry partnerships will be necessary to move the course of MH app development in the right direction. Keywords Smartphone . App . Mental health . Implementation science
Introduction The past decade has witnessed an explosion of mental health (MH) smartphone applications (apps). More than 10,000 MH * Samantha L. Connolly [email protected] 1
Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA, USA
2
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
3
Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
4
Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
5
Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
6
Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
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