Perceptions of Mobile Health Apps and Features to Support Psychosocial Well-being Among Frontline Health Care Workers Involved in the COVID-19 Pandemic Response: Qualitative Study (Preprint)
Authors: Yoon Sungwon , Goh Hendra , Nadarajan Gayathri Devi , Sung Sharon , Teo Irene , Lee Jungup , Ong Marcus E H , Graves Nicholas , Teo Tess Lin 
Published: December 2020

BACKGROUND

Frontline health care workers are experiencing a myriad of physical and psychosocial challenges amid the COVID-19 pandemic. There is growing recognition that digital technologies have the potential to improve the well-being of frontline workers. However, there has been limited development of wellness interventions using mobile health (mHealth) technology. More importantly, little research has been conducted on how frontline workers perceive mHealth-based support to promote their well-being.

OBJECTIVE

This study aimed to explore frontline workers’ experience of conventional psychological wellness programs and their perceptions of the usefulness of mHealth apps and features for promoting well-being. It also sought to identify factors that could potentially influence uptake and retention of an mHealth-based wellness program.

METHODS

We conducted semistructured interviews using purposive sampling with frontline workers involved in the COVID-19 response. Various visual materials, collated from existing mHealth app features, were presented to facilitate discussion. Interviews were audio-recorded and transcribed verbatim. Thematic analysis based on grounded theory was undertaken. Themes were subsequently mapped to key nudge strategies—those commonly used for mHealth development—to assess participants’ preferences for particular features and their reasoning.

RESULTS

A total of 42 frontline workers participated in 12 one-on-one interviews or focus group discussions. Frontline workers generally had a limited ability to identify their own psychological problems and liked the <i>reminders</i> functionality of the app to track their mood over time. A personalized goal-setting feature (ie, <i>tailoring</i>) and in-app <i>resources</i> were generally valued, while frequent coaching and messages (ie, <i>framing</i>) were seen as a distraction. The majority of participants desired a built-in chat function with a counselor (ie, <i>guidance</i>) for reasons of accessibility and protection of privacy. Very few participants appreciated a <i>gamification</i> function. Frontline workers commonly reported the need for ongoing social support and desired access to an in-app peer support community (ie, <i>social influence</i>). There were, however, concerns regarding potential risks from virtual peer interactions. Intrinsic motivational factors, mHealth app technicality, and tangible rewards were identified as critical for uptake and retention.

CONCLUSIONS

Our study highlights the potential of mHealth apps with relevant features to be used as wellness tools by frontline health care workers. Future work should focus on developing a nonintrusive and personalized mHealth app with in-app counseling, peer support to improve well-being, and tangible and extrinsic rewards to foster continued use.