TY - JOUR
T1 - Evaluating a Smartphone App (MeT4VeT) to Support the Mental Health of UK Armed Forces Veterans: Feasibility Randomized Controlled Trial
AU - Parkes, Steven
AU - Croak, Bethany
AU - Brooks, Samantha
AU - Stevelink, Sharon
AU - Leightley, Daniel
AU - Fear, Nicola
AU - Rafferty, Laura
AU - Greenberg, Neil
N1 - Funding Information:
This study was funded by the Forces in Mind Trust (FiMT) using an endowment awarded by the National Lottery Community Fund (project FiMT17/1023K). The views expressed are those of the authors and not necessarily those of the FiMT, National Health Service, National Institute for Health and Care Research, Ministry of Defence, Society of Occupational Medicine, or Faculty of Occupational Medicine. For the purposes of open access, the authors have applied a Creative Commons attribution (CC-BY) license to any accepted author manuscript version arising from this submission.
Funding Information:
SAMS is supported by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust and the NIHR Advanced Fellowship (NIHR300592). DL is a reservist in the UK Armed Forces; this work has been undertaken as part of his civilian employment. NTF is a member of the Emergency Services Senior Leaders Board and is partly funded by a grant from the UK Ministry of Defence. NTF is also a trustee of Help for Heroes, a charity supporting the well-being of service personnel, veterans, and their families. NG is a trustee of the Society of Occupational Medicine and the Faculty of Occupational Medicine and is the military lead for the Royal College of Psychiatrists.
Publisher Copyright:
© 2023 JMIR Res Protoc 2023. All rights reserved.
PY - 2023/8/28
Y1 - 2023/8/28
N2 - Background: Previous research demonstrates that less than 50% of military veterans experiencing mental health difficulties seek formal support. Veterans often struggle to identify problems as mental health difficulties. In addition, they may fail to recognize the need for support before reaching a crisis point and face difficulties navigating care pathways to access support. Objective: A feasibility trial was conducted to assess a novel digital smartphone app (Mental Health Toolkit for Veterans Project [MeT4VeT]) for UK Armed Forces (UKAF) veterans experiencing mental health difficulties. The trial aimed to explore the feasibility and acceptability of trial procedures for a later randomized controlled trial (RCT) and to assess the acceptability of the MeT4VeT app. Methods: Participants were recruited at UK military medical centers, by advertising on social media, and through veteran third-sector organizations between February and November 2021, and assessed for eligibility (male, owned a smartphone, served at least 2 years in the UKAF, left the UKAF within the last 2 years, not undertaking formal mental health treatment). Eligible participants were assigned, on a 1:1 ratio, to either the intervention group (full app) or a control group (noninteractive app with signposting information). Three key objectives were determined a priori to assess the practicality of running an RCT including an assessment of recruitment and retention, evaluation of the technical app delivery and measurement processes, and acceptability and usability of the intervention. Results: In total, 791 individuals completed the participant information sheet, of which 261 (33%) were ineligible, 377 (48%) declined or were unable to be contacted for consent, and 103 (13%) did not download the app or complete the baseline measures. Of this, 50 participants completed baseline measures and were randomly assigned to the intervention group (n=24) or the control group (n=26). The trial was effective at enabling both the technical delivery of the intervention and collection of outcome measures, with improvements in mental health demonstrated for the intervention group from baseline to the 3-month follow-up. Recruitment and retention challenges were highlighted with only 50 out of the 530 eligible participants enrolled in the trial. The acceptability and usability of the MeT4VeT app were generally supported, and it was reported to be a useful, accessible way for veterans to monitor and manage their mental health. Conclusions: The results highlighted that further work is needed to refine recruitment processes and maintain engagement with the app. Following this, an RCT can be considered to robustly assess the ability of the app to positively affect mental health outcomes indicated within this trial.
AB - Background: Previous research demonstrates that less than 50% of military veterans experiencing mental health difficulties seek formal support. Veterans often struggle to identify problems as mental health difficulties. In addition, they may fail to recognize the need for support before reaching a crisis point and face difficulties navigating care pathways to access support. Objective: A feasibility trial was conducted to assess a novel digital smartphone app (Mental Health Toolkit for Veterans Project [MeT4VeT]) for UK Armed Forces (UKAF) veterans experiencing mental health difficulties. The trial aimed to explore the feasibility and acceptability of trial procedures for a later randomized controlled trial (RCT) and to assess the acceptability of the MeT4VeT app. Methods: Participants were recruited at UK military medical centers, by advertising on social media, and through veteran third-sector organizations between February and November 2021, and assessed for eligibility (male, owned a smartphone, served at least 2 years in the UKAF, left the UKAF within the last 2 years, not undertaking formal mental health treatment). Eligible participants were assigned, on a 1:1 ratio, to either the intervention group (full app) or a control group (noninteractive app with signposting information). Three key objectives were determined a priori to assess the practicality of running an RCT including an assessment of recruitment and retention, evaluation of the technical app delivery and measurement processes, and acceptability and usability of the intervention. Results: In total, 791 individuals completed the participant information sheet, of which 261 (33%) were ineligible, 377 (48%) declined or were unable to be contacted for consent, and 103 (13%) did not download the app or complete the baseline measures. Of this, 50 participants completed baseline measures and were randomly assigned to the intervention group (n=24) or the control group (n=26). The trial was effective at enabling both the technical delivery of the intervention and collection of outcome measures, with improvements in mental health demonstrated for the intervention group from baseline to the 3-month follow-up. Recruitment and retention challenges were highlighted with only 50 out of the 530 eligible participants enrolled in the trial. The acceptability and usability of the MeT4VeT app were generally supported, and it was reported to be a useful, accessible way for veterans to monitor and manage their mental health. Conclusions: The results highlighted that further work is needed to refine recruitment processes and maintain engagement with the app. Following this, an RCT can be considered to robustly assess the ability of the app to positively affect mental health outcomes indicated within this trial.
KW - military
KW - veteran
KW - mental health
KW - military to civilian transition
KW - digital health
KW - mobile applications
KW - smartphone
KW - mobile health
KW - mHealth
KW - digital intervention
UR - http://www.scopus.com/inward/record.url?scp=85175058615&partnerID=8YFLogxK
U2 - 10.2196/46508
DO - 10.2196/46508
M3 - Article
SN - 2368-7959
VL - 10
JO - JMIR Mental Health
JF - JMIR Mental Health
M1 - e46508
ER -
