The Effects of a Digital Well-Being Intervention on Patients With Chronic Conditions: Observational Study

• Published in: Journal of medical Internet research 2020-01, Vol.22 (1), p.e16211-e16211
• Main Authors: Parks, Acacia C, Williams, Allison L, Kackloudis, Gina M, Stafford, Julia L, Boucher, Eliane M, Honomichl, Ryan D
• Format: Article
• Language: English
• Subjects: Arthritis; Cardiovascular disease; Chronic illnesses; Chronic insomnia; Chronic pain; Clinical outcomes; Cognitive behavioral therapy; Cognitive psychology; Cognitive-behavioral factors; Diabetes; Eczema; Emotionality; Games; Health care expenditures; Health care policy; Health status; Intervention; Life satisfaction; Mental depression; Mental health; Mindfulness; Mobile phones; Multiple sclerosis; Observational studies; Original Paper; Pain; Patients; Positive psychology; Psoriasis; Psychology; Traditions; Well being
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/16211

Chronic conditions account for 75% of health care costs, and the impact of chronic illness is expected to grow over time. Although subjective well-being predicts better health outcomes, people with chronic conditions tend to report lower well-being. Improving well-being might mitigate costs associated with chronic illness; however, existing interventions can be difficult to access and draw from a single theoretical approach. Happify, a digital well-being intervention program drawing from multiple theoretical traditions to target well-being, has already been established as an efficacious means of improving well-being in both distressed and nondistressed users. This study aimed to compare change in well-being over time after using Happify for users with and without a chronic condition. Data were obtained from Happify users, a publicly available digital well-being program accessible via website or mobile phone app. Users work on tracks addressing a specific issue (eg, conquering negative thoughts) composed of games and activities based on positive psychology, cognitive behavioral therapy, and mindfulness principles. The sample included 821 users receiving at least 6 weeks' exposure to Happify (ranging from 42 to 179 days) who met other inclusion criteria. As part of a baseline questionnaire, respondents reported demographic information (age and gender) and whether they had any of the prespecified chronic conditions: arthritis, diabetes, insomnia, multiple sclerosis, chronic pain, psoriasis, eczema, or some other condition (450 reported a chronic condition, whereas 371 did not). Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction. To evaluate changes in well-being over time, a mixed effects linear regression model was fit for subjective well-being, controlling for demographics and platform usage. At baseline, users with a chronic condition had significantly lower subjective well-being (mean 38.34, SD 17.40) than users without a chronic condition (mean 43.65, SD 19.13). However, change trajectories for users with or without a chronic condition were not significantly different; both groups experienced equivalent improvements in well-being. We also found an effect for time from baseline (b=0.071; SE=0.010; P