Catuara-Solarz S, Skorulski B, Estella-Aguerri I, Avella-Garcia C, Shepherd S, Stott E, Hemmings N, Ruiz de Villa A, Schulze L, Dix S. The Efficacy of “Foundations,” a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial. JMIR Mhealth Uhealth 2022;10(7):e30976 DOI: 10.2196/30976
This study aimed to evaluate the efficacy of a mobile app, “Foundations”, to reduce self-reported symptoms of anxiety and stress in a randomized control trial during the COVID-19 pandemic in the United Kingdom. Adults (N=136) with mild to severe anxiety and moderate to high levels of perceived stress were randomly assigned to four weeks of the Foundations app or a waitlist control. The Foundations app includes cognitive behavioral therapy interventions and psychoeducation aimed at reducing stress and promoting mental well-being. Activities consist of reading articles, journaling, meditation, and relaxation. Resilience, anxiety, well-being, and sleep were assessed at baseline, weeks 2 and 4. Perceived stress was assessed weekly. The intervention group (n=62) showed significant improvement in anxiety (p=0.04), resilience (p<0.001), sleep (p=0.01), and mental well-being (p=0.02) compared to the control group (n=74). This improvement was observed within 2 weeks of the intervention and sustained at week 4. There was no significant difference in perceived stress between the intervention and control groups (p=0.20). Overall, this study provides a proof of principle that the Foundations app may improve mental well-being, anxiety, resilience, and sleep. Future research should evaluate the long-term effects of the Foundations app and the scalability and cost-effectiveness of the intervention. The passive nature of the control group in this study does not rule out placebo effects in the digital intervention group and future research would benefit from an active control condition.