Digital health resilience and well-being interventions for military members, Veterans, and public safety personnel: Environmental scan and quality review

Abstract: Background: Accessible mental health care, delivered via mobile apps or web-based services, may be essential for military members, public safety personnel (PSP), and veterans, as they report numerous barriers to seeking in-person care and are at an increased risk for a number of psychological disorders. Objective: We aimed to identify, describe, and evaluate apps, resource banks (RBs), and web-based programs (WBPs), referred to as digital mental health interventions (DMHIs), recommended for military members, PSP, and veterans. A multidimensional and multisystemic view of resilience and well-being were maintained throughout this environmental scan. Methods: Information was gathered from a comprehensive review of peer-reviewed literature, a Google search, and a targeted search of websites relevant to the study populations. DMHIs aimed at supporting resilience or well-being were included in the review, including those published in peer-reviewed articles, and those offered to these populations without research or literature backing their use. Results: In total, 69 DMHIs were identified in this study, including 42 apps, 19 RBs, and 8 WBPs, and were described based on 3 questions related to purpose, strategies, and evidence from the adapted Mobile App Rating Scale and the Mobile App Rating Scale. Each WBP and RB was then reviewed via the adapted Mobile App Rating Scale and each app via the Alberta Rating Index for Apps (ARIA). Overall, 24 (35%) of the DMHIs were recommended for military members, 20 (29%) for PSP, and 41 (59%) for veterans. The most common aim across apps, RBs, and WBPs was to increase happiness and well-being, and the most common strategies were advice, tips, and skills training. In total, 2 apps recommended for military members-PTSD Coach and Virtual Hope Box-received a high rating on the ARIA subscales and have also been trialed in pilot randomized control trial (RCT) and RCT evaluations, respectively, with positive initial Results:. Similarly, 2 apps recommended for PSP-PeerConnect and R2MR-have been trialed in non-RCT studies, with partially positive outcomes or little to no contradictory evidence and received a high rating on the ARIA. Finally, 2 apps recommended for veteran populations-PTSD Coach and VetChange-received high ratings on the ARIA and have been trialed via pilot-RCT and RCT studies, respectively, with positive outcomes. Conclusions: In conclusion, there is a need for efficacy and effectiveness trials for DMHIs for military members, PSP, and veterans to ensure that they are effectively meeting the population's needs. While there appears to be many promising DMHIs, further research is needed before these interventions continue to be promoted as effective and widely distributed.

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