Mental Health

A Smartphone-Based Ecological Momentary Intervention for Workplace Mental Health: Randomized Controlled Trial.

TL;DR

A 4-week smartphone-based ecological momentary intervention (Neurum) significantly reduced depression, anxiety, and stress symptoms in working adults, with DASS-21 scores decreasing in the intervention group (MD=-14.518) while increasing in the control group (MD=3.319).

Key Findings

The Neurum smartphone intervention significantly reduced overall DASS-21 scores compared to the control group after 4 weeks.

  • Intervention group showed a mean decrease in DASS-21 scores (MDpost-pre intervention=-14.518), while the control group showed a mean increase (MDpost-pre intervention=3.319).
  • The between-group difference was statistically significant (F1,176=59.358, P<.001).
  • The effect size was large (η²=0.252), indicating that approximately 25% of variance in DASS-21 change was explained by group assignment.
  • The DASS-21 had good internal consistency (Cronbach α=0.87).
  • The trial ran for 4 weeks with 201 initially recruited working adults.

Stress reduction was the primary driver of the overall DASS-21 improvement observed in the intervention group.

  • The stress subscale showed a statistically significant between-group effect (F1,176=64.679, P<.001).
  • The intervention group had a mean stress reduction of -6.692 points, while the control group had a mean increase of 2.000 points.
  • The abstract notes this stress reduction effect 'largely led' the overall DASS-21 improvement.
  • The intervention incorporated cognitive behavioral therapy, mindfulness exercises, and self-regulation exercises.

Differential dropout rates were observed between groups, with significantly more participants leaving the intervention group than the control group.

  • 21 participants dropped out from the intervention group compared to only 2 from the control group.
  • The difference in dropout rates was statistically significant (χ²1=18.259, P<.001).
  • The final analytic sample consisted of 178 participants (85 male, 93 female; mean age 34.65, SD 7.67 years).
  • The intervention group started with 102 participants and the control group with 99 participants.
  • Despite higher dropout in the intervention group, the authors characterized the overall user retention rate as 'satisfactory.'

Participants had low average engagement with the app's exercises and mood journal features during the 4-week intervention.

  • On average, participants completed 6.27 (SD 9.4) exercises over the 4-week period.
  • Participants provided an average of 9.74 (SD 18.2) mood journal logs.
  • Daily engagement averaged 4.95 (SD 6.89) minutes per day.
  • The high standard deviations relative to the means indicate substantial variability in engagement across participants.
  • The associations between changes in DASS-21 scores and the number of exercises completed or mood journal logs provided did not reach statistical significance.

The study used a simple randomization procedure in a randomized controlled trial design with working adults in a nonclinical setting.

  • 201 working adults were recruited for the 4-week trial.
  • A simple randomization procedure was used to assign participants to intervention (n=102) or control (n=99) groups.
  • Participants were noninstitutionalized working adults, representing a nonclinical population.
  • The intervention was delivered via the Neurum smartphone app (Neurum Limited) and featured ecological momentary assessments and interventions.
  • Intervention components included mood journaling, mental health exercises, and user feedback opportunities.

The authors positioned Neurum as an evidence-based digital health alternative to traditional face-to-face mental health services for nonclinical settings.

  • The paper describes the intervention as contributing 'to evidence-based digital health in nonclinical settings for timely needs and general accessibility.'
  • It is framed as 'an alternative to traditional, face-to-face, and high-cost mental health services.'
  • The authors acknowledged 'potential health-related culture differences' as a limitation.
  • Future directions discussed included a personalized approach to online mental health services.
  • The study was conducted in the context of the 'fast-growing mobile health services industry.'

What This Means

This research suggests that a smartphone app called Neurum, used for four weeks, can meaningfully reduce depression, anxiety, and stress in working adults. The study randomly assigned 201 employed adults to either use the app or serve as a control group. The app offered tools rooted in cognitive behavioral therapy and mindfulness, allowing users to log their moods and complete mental health exercises throughout their day. After four weeks, people who used the app saw their combined depression, anxiety, and stress scores drop by about 14.5 points on average, while those in the control group saw scores rise by about 3.3 points — a statistically significant and large difference. Stress reduction appeared to be the biggest contributor to this improvement. However, the study also found some notable challenges. Many more people dropped out of the intervention group (21 people) than the control group (2 people), which raises questions about the app's long-term appeal or ease of use. Among those who continued, average engagement was relatively low — about 5 minutes per day and only about 6 completed exercises over the entire four weeks — and higher engagement did not statistically predict greater improvement in mental health scores. This means it is not yet clear what 'dose' of app use is needed to see benefits, or why some users disengaged. This research matters because workplace stress is a widespread problem, and access to affordable, convenient mental health support remains limited for many people. This study suggests that a smartphone-based tool could serve as a practical, lower-cost supplement to traditional mental health care for working adults who are not in clinical treatment. At the same time, the high dropout rate and variable engagement highlight that designing apps people will actually use consistently remains an important challenge for digital mental health research.

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Citation

Li S, Lo L, Lau C, Lam M, Chan M. (2026). A Smartphone-Based Ecological Momentary Intervention for Workplace Mental Health: Randomized Controlled Trial.. JMIR mHealth and uHealth. https://doi.org/10.2196/72435