(PS10-A13) Adherence and Engagement of Habitworks: An Open Trial of an Interpretation Bias Intervention in Black and Hispanic/latinx Adults

Amidst the current mental health crisis, access to evidenced based interventions are urgently needed. While mobile health (mHealth) interventions, such as smartphone apps, have the potential to increase accessibility, studies have shown that most people stop using mental health apps after two weeks (Baumel, Muench, Edan, & Kane, 2019), and most effectiveness data comes from White women (Bernstein, Weingarden, Wolfe, Hall, Snorrason, & Wilhelm, 2022). HabitWorks is a smartphone app that provides an interpretation bias intervention based on the Word Sentence Association Paradigm (WSAP; Beard & Amir, 2009). HabitWorks also encourages people to engage in other evidence-based practices, such as journaling, symptom tracking, and psychoeducation. Previous pilot studies testing HabitWorks have found that engagement and adherence is higher than most other mental health apps (Ramadurai, Beckham, McHugh, Björgvinsson, & Beard, 2022; Beard, Beckham, Solomon, Fenley, & Pincus, 2022). A limitation of these previous trials is that these samples consisted of predominantly non-Hispanic, white individuals. The current study aimed to address this limitation by conducting an open trial of HabitWorks in a sample of adults who identified as Black and/or Hispanic/Latinx.

We enrolled 42 participants (13 (41.9%) Black, 15 (48.4%) Hispanic/Latinx, 3 (9.7%) Black and Hispanic/Latinx) who endorsed symptoms of anxiety or depression. Of those 42 participants, 31 participants downloaded the HabitWorks app and were included in the analyses. Participants identified as primarily women (71.0%) and ages ranged from 18 to 61 years (M=32.83, SD=11.06). During the four-week intervention period, participants were asked to complete WSAP exercises three times per week and complete mood surveys (PHQ-8 and GAD-7) and diary entries weekly. We monitored the total number of exercises, symptom tracking surveys, and diary entries completed to measure adherence and engagement with HabitWorks.

In preliminary analyses based on 29 participants, 3 (10.34%) participants completed less than 9 exercises in total, 14 (48.28%) participants completed 9-15 exercises in total, and 12 (41.38%) participants completed 16 or more exercises in total. The number of exercises completed decreased over the course of the 4 weeks with 27 (66%) participants meeting the exercise recommendation during Week 1 and 19 (46%) participants during Week 4. Only 2 (6%) participants dropped off during the intervention phase, and both drop off points occurred after Week 2. 26 (63%) participants were still completing some exercises by the end of Week 4. Completion rates for the symptom tracking surveys were similar with 18 (62.07%) participants completing the survey at the end of Week 1 and 17 (58.62%) participants completing the survey at the end of Week 4. 8 (28%) participants did not complete any diary entries, while 9 (31%) completed some, 6 (21%) participants met study suggestion, and 6 (21%) participants went beyond the study suggestion.

HabitWorks demonstrated high engagement and adherence compared to other mHealth apps. This suggests that HabitWorks has the potential to be a helpful and accessible intervention for anxiety and depression, specifically for Black and Hispanic/Latinx individuals.