title: Mobile mental wellness training for stress management: feasibility and design implications based on a one-month field study.
abstract: BACKGROUND
  Prevention 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.
  
  
  OBJECTIVE
  The 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.
  
  
  METHODS
  Oiva, 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.
  
  
  RESULTS
  Oiva 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.
  
  
  CONCLUSIONS
  A 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.
authors.affiliation: VTT Technical Research Centre of Finland, Tampere, Finland.
authors.forename: Aino
authors.initials: A
authors.lastname: Ahtinen
authors.forename: Elina
authors.initials: E
authors.lastname: Mattila
authors.forename: Pasi
authors.initials: P
authors.lastname: Välkkynen
authors.forename: Kirsikka
authors.initials: K
authors.lastname: Kaipainen
authors.forename: Toni
authors.initials: T
authors.lastname: Vanhala
authors.forename: Miikka
authors.initials: M
authors.lastname: Ermes
authors.forename: Essi
authors.initials: E
authors.lastname: Sairanen
authors.forename: Tero
authors.initials: T
authors.lastname: Myllymäki
authors.forename: Raimo
authors.initials: R
authors.lastname: Lappalainen
keywords: acceptance and commitment therapy; design; field studies; mental health; mobile phone; stress; user experience
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