Preliminary investigation of Shift, a novel smartphone application to support junior doctors’ mental health and wellbeing: Examination of symptom progression, usability, and acceptability after one month of use (Preprint)

Abstract

Shift is a novel smartphone application (app) to provide a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioural modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues.

To conduct a preliminary investigation of the usage and potential effectiveness of Shift on depressive and anxiety symptoms (primary outcomes), and work and social functioning, coronavirus safety concerns, and help-seeking (secondary outcomes). This study also sought feedback on whether Shift was seen as an acceptable tool.

Junior doctors in New South Wales, Australia were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided online baseline data, used the Shift app for 30 days, and were asked to complete a post-study online questionnaire. Outcomes were analysed under the ITT principle.

A total of 222 (156/222 female, 70%; mean age = 29.2 years) junior doctors provided full baseline data. Of those, 198/222 (89%) downloaded the app, logged into the app about 6 times (M = 5.68, SD = 7.51), completed 4 in-app activities (M = 3.77, SD = 4.36), and spent a total of one hour on in-app activities (M = 52:23, SD = 6:00:18) over 30 days. Post-intervention data were provided by 54/222 (24%) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and post-assessment points as expected, however, doctors’ coronavirus safety concerns significantly increased. Work and social functioning, coronavirus concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app usage (number of logins, days between first and last login, and total activity time). Most post-study completers (31/54, 57%) rated Shift highly or very highly.

Despite high levels of non-response to the post-study assessment and increases in coronavirus safety concerns, junior doctors who used the app reported some improvements in depression and anxiety that warrant further exploration in a robust manner.

The study was prospectively registered with the Australian New Zealand Clinical Trials Registry under the trial number ACTRN12620000571976.