Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics

BackgroundChronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. ObjectiveThis review aims to provide a...

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Main Authors: Sarah Paganini, Evelyn Meier, Yannik Terhorst, Ramona Wurst, Vivien Hohberg, Dana Schultchen, Jana Strahler, Max Wursthorn, Harald Baumeister, Eva-Maria Messner
Format: Article
Language:English
Published: JMIR Publications 2023-08-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2023/1/e42415
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author Sarah Paganini
Evelyn Meier
Yannik Terhorst
Ramona Wurst
Vivien Hohberg
Dana Schultchen
Jana Strahler
Max Wursthorn
Harald Baumeister
Eva-Maria Messner
author_facet Sarah Paganini
Evelyn Meier
Yannik Terhorst
Ramona Wurst
Vivien Hohberg
Dana Schultchen
Jana Strahler
Max Wursthorn
Harald Baumeister
Eva-Maria Messner
author_sort Sarah Paganini
collection DOAJ
description BackgroundChronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. ObjectiveThis review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores. MethodsSMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived. ResultsOf 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period. ConclusionsThe moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.
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spelling doaj.art-680a872da4c04ecb81f1ed341b7826af2023-08-29T13:45:50ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222023-08-0111e4241510.2196/42415Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and CharacteristicsSarah Paganinihttps://orcid.org/0000-0003-4593-6278Evelyn Meierhttps://orcid.org/0009-0009-7537-6639Yannik Terhorsthttps://orcid.org/0000-0003-4091-5048Ramona Wursthttps://orcid.org/0000-0001-6011-7268Vivien Hohberghttps://orcid.org/0000-0003-0652-8714Dana Schultchenhttps://orcid.org/0000-0001-5623-535XJana Strahlerhttps://orcid.org/0000-0002-0077-508XMax Wursthornhttps://orcid.org/0000-0003-0242-3376Harald Baumeisterhttps://orcid.org/0000-0002-2040-661XEva-Maria Messnerhttps://orcid.org/0000-0001-6100-8354 BackgroundChronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. ObjectiveThis review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores. MethodsSMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived. ResultsOf 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period. ConclusionsThe moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.https://mhealth.jmir.org/2023/1/e42415
spellingShingle Sarah Paganini
Evelyn Meier
Yannik Terhorst
Ramona Wurst
Vivien Hohberg
Dana Schultchen
Jana Strahler
Max Wursthorn
Harald Baumeister
Eva-Maria Messner
Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
JMIR mHealth and uHealth
title Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
title_full Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
title_fullStr Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
title_full_unstemmed Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
title_short Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics
title_sort stress management apps systematic search and multidimensional assessment of quality and characteristics
url https://mhealth.jmir.org/2023/1/e42415
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