Using mHealth to Support Mental Health Coaching for College Students: A Mixed Design Study (Preprint)
Authors: Markert Carl , Zahed Karim , Sasangohar Farzan , McDonald Anthony , Mehta Ranjana , McCord Carly 
Published: October 2022

BACKGROUND

Student mental health is an increasing concern among college student populations.

OBJECTIVE

To determine if college students could better self-manage their anxiety, stress, and depression symptomology by using automated mHealth to support health coaching for managing mental health.

METHODS

Students were provided with a mobile health self-management app called mHELP. The intervention group students had on-demand access to interactive mental health management tools on the app and completed weekly self-assessments of anxiety (GAD-7), perceived stress (PSS-10), and depression (PHQ-8) with immediate feedback of self-reported measurements during the first phase (five weeks) of the study. During the second five-week phase, students were additionally provided daily educational material in the form of videos, brochures, and articles related to the self-management of mental health issues. The educational material was developed in collaboration with the university’s Counseling and Psychological Services Department. Weekly self-reported measures of anxiety, perceived stress, and depression were compared in a pre-post analysis for each of the two phases as well as an analysis of variance of the changes in the outcome values for each phase to check for significance (within- and between-group). The control group did not receive or have access to any digital health coaching information from the mHELP app, but they did complete weekly assessments of self-reported measures of anxiety, perceived stress, and depression with immediate feedback on the results.

RESULTS

A total of 87 participants, 72.4% assigned randomly to the intervention group, completed the study with a mean age of 22.1 years (SD = 4.35, Range: 18-37). No significant improvements in outcomes over time were noted for the intervention group during the first phase of the study; however, during the second phase of the study, significant improvements were noted for anxiety (p = .002, d = .428) and perceived stress (p = .033, d = .306) over time. Over the duration of both phases of the study, the control and intervention groups both showed improvements in mean GAD-7, PSS-10 and PHQ-8 scores. The intervention group exhibited a statistically significant improvement in mean GAD-7 (M = 3.143, SE = 0.638, p < .001, d = .621), PSS-10 (M = 3.476, SE = 0.968, p = .001, d = .452) and PHQ-8 (M = 1.619, SE = 0.648, p = .041, d = .315). The control group only exhibited a statistically significant improvement in their GAD-7 score (M = 3.167, SE = 1.251, p = .019, d = .517). An ANOVA of the differences in improvements between groups did not find a significant effect of the mHELP intervention for GAD-7, PSS-10 or PHQ-8 scores.

CONCLUSIONS

Our study demonstrated that using mHealth to support health coaching may assist in the self-management of anxiety and stress among college students, while a self-measurement routine may also provide benefits for improving anxiety over time, perhaps due to improved self-awareness of mental health conditions.