A Pilot Randomized Controlled Trial of Renew: An Exposure-Based Mobile App for Symptoms of Posttraumatic Stress Disorder in Veterans (Preprint)

BACKGROUND Posttraumatic stress disorder is an impairing mental health condition that disproportionately affects veterans. Although PTSD is treatable, there are many barriers to accessing traditional in-person care. Mobile applications may help to address unmet need for services by offering tools for users to self-manage PTSD symptoms. OBJECTIVE Renew is a mobile mental health application that focuses on exposure therapy and incorporates a social support function designed to promote user engagement. METHODS In this pilot randomized controlled trial, we compared the effects of Renew with support and without support from a research staff member (No Support) to Delayed Use among ninety-three veterans with clinically significant PTSD symptoms. Participants were recruited through online advertisements. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) was used to measure PTSD symptoms at pre-, post (6-weeks later), and 6-week follow up. Usage data were collected to assess engagement with Renew. RESULTS Results indicated a small effect size (d = -0.39) favoring those in the two active use conditions (n = 31; n =31) relative to the Delayed Use condition (n = 31), but the between group difference did not reach statistical significance. There were no differences between those in the Support and the No Support condition on indices of app engagement or PTSD symptom reduction. Contact with support persons is a core feature of Renew, and exploratory analyses suggest that the number of support persons users added to the app, but not the number of support messages received, was positively correlated with app engagement. CONCLUSIONS Findings suggest Renew may hold promise as a self-management tool to reduce PTSD symptoms in veterans and that involving friends and family in mobile mental health applications may help bolster engagement. CLINICALTRIAL NCT04155736