Move Mood powered by stem4 provides ways for young people to manage the behaviours associated with low mood or depression. Developed by Dr Nihara Krause, a consultant clinical psychologist, together with ideas and input from young people, Move Mood uses a Behavioural Activation Framework* to help increase motivation to change.
It is not a substitute for the assessment and individualised treatment of a health/mental health
The Move Mood app has been developed for young people and is suitable for mild/moderate depression. If severely depressed it should only be used alongside treatment.
“Low mood and depression weigh you down. Instead, engage, initiate and activate. Build your power to lift this weight”.
Move Mood aims to help young people manage the behaviours associated with low mood or depression. It follows a type of treatment called Behavioural Activation Therapy (BAT) which encourages people with depression to approach activities they may be avoiding. This is done by defining goals and setting activity schedules since when a person is depressed they tend to avoid particular situations or activities. Unfortunately, avoidance leads to more depression trapping people in further depression. The app encourages the user, with the help of a ‘companion’ to carry out tasks they make a commitment to complete and to work towards ‘awards’ for completing them.
There is opportunity for monitoring progress and a section for resources.
For those individuals with severe symptoms of depression, Move Mood needs to be used together with individual support from a mental health professional.
It is password protected and confidential.
– To develop an evidence-based, widely accessible digital tool to help young people (age 12-25) manage the behaviours associated with low mood or depression symptoms.
– To devise an anonymised analytical model to evidence effectiveness and inform future development.
– To comply with NHS information governance requirements to facilitate publication on the NHS Apps Library.
– To raise the profile of stem4 and its work to support teenage mental health.
A small pilot study is currently underway but interim measures are as follows. Six young people and two parents all experiencing low mood/depression, seeing a psychologist were given Move Mood to use alongside Cognitive Treatment for depression.
All participants were assessed at baseline using the Moods and Feelings Questionnaire Angold and Costello, 1987. This measure has been noted to be a reliable measure of depression in children and young people in both clinical and non-clinical samples (Burleson et al, 2006).
The child report version was given to the six young people (aged 14-17) and the adult version to the two parents. Due to the pandemic, all consultations, including questionnaire feedback was carried out remotely with the participant feeding back verbally. None of the young people had self-harm behaviours or reported high risk.
The app was used to reinforce homework assignments of behavioural goals. In addition, there was an attitude to the app questionnaire. The app was used alongside treatment for four weeks and will continue for a further four weeks.
At mid-point in treatment, the following are noted. Acceptability (wanting to use the app) is 98% (one adult slightly unsure of their technology skills in setting up). Reported engagement with reminders of the app 95%. Number completing their targets 90%. Weekly measures on the Moods and Feelings Questionnaire show reduction in symptoms although the sample size is too small for statistical analysis. Reminders were 100% appreciated, engagement with companions 80%. Liked categories were ‘view my tracker’ (77%) and ‘view my awards’ (75%).
stem4 will be seeking funding to carry out a large scale, quantitative and qualitative study on the app effectiveness later this year.
In order to evidence the effectiveness of the app, the following anonymised data is collected:
– Number of downloads and Number of users (on both iOS and Android)
– Data submitted on installation of the app (optional) including:
– Gender, Age Range, Location, whether they have sought professional treatment
– Aggregated data on user activity and its effectiveness
– Analytics on user journeys
In the first month of release Move Mood has had 1,480 downloads. Feedback comments include:
“This has helped me a lot. It’s just nice being organized about tasks and then getting an award, I really like it.”
We worked co-collaboratively with young people to develop Move Mood. The co-collaborative workshops with young people explored desired outputs, user journeys, visual concepts, security/privacy, user experience, and tone of voice.
The clinical and professional groups provided input on safety, user characteristics, strengths, potential barriers, referrer experience and tone of voice.
The clinical content of Mood Move was created by a Clinical Psychologist and the app underwent a clinical safety assessment with a range of clinicians including a GP, Adolescent Psychiatrist, family therapist and Clinical Psychologists.
stem4 consistently monitors user feedback via emails, social media and reviews on the App Store/Google Play.
Mood disorders have been impacted significantly as a result of the pandemic. This is partly because of the stressful nature of the pandemic itself and limited access to treatments and also because mood enhancement strategies such as exercise and meeting friends are restricted. In order to support children and young people affected, stem4 has created an animated video and user booklet on how to use Move Mood over this time. This includes specific mood issues that may have increased during the pandemic, also outlining pandemic safe tasks which abide by safety guidelines such as social distancing.
Downloads of the stem4 digital portfolio of apps has increased by 40% subsequent to the pandemic and we will endeavour to use the feedback we receive from our users and our focus groups to update the app. Given the disruption to goals and daily structure, stem4 believes Move Mood has an important place in helping build resilience in recovery.
We do not collect any personally identifiable data, the app can be used independent of WIFI, there is a clinical safety report and hazard log. The app will be updated regularly based on user feedback and relevance.
Move Mood is reviewed and updated every three months to ensure the app is clinically valid.
The clinical risk is monitored and laid out in the hazard log and map to the DCB 0129 guidelines. A flow chart of hazard mitigation and response is available. This outlines how issues will be addressed together with target response times.
Our target response time for urgent issues is 24 hours, for high priority issues 72 hours, medium priority 7 working days and low priority 14 working days.
Move Mood does not collect any personally identifiable information. Anonymised data is collected to ensure the effectiveness of the app can be monitored.
Move Mood is an app which can be used on IOS, Android or tablets/laptop devices. The content is downloaded the first time the user opens the app and then cached. It can still be viewed and used offline.
All data collected via the app is aggregated and cannot be tracked to each user/device. However, the security of this data is still important to us and as such, we will take all steps reasonably necessary to ensure that the data is treated securely. The transfer of data is encrypted over a secure connection
App data is stored using Amazon Web Services (AWS) which has certification for compliance with ISO 27001:2013 – https://d1.awsstatic.com/certifications/iso_27001_global_certification.pdf.
Clinical risk is managed by having a contractual agreement with the developer that data security and technical risks will be addressed at every update or when concerns are raised via the clinical safety system which indicates clear timeframes and the flow of what action will be taken.
The app is stand-alone and does not interact with existing enterprise systems.
It has been designed with young people to ensure data and device memory/data use in their preferred device (smartphone) is not compromised.
Activity is logged to present the user with the following information:
● Activities chosen
● How hard it is to carry out the activities
● Pre-activity mood rating and post completion mood measure
● Activity log
● Most used activities
In order to evidence the effectiveness of the app, the following data will be made available:
● Number of downloads and number of users (both iOS and Android)
● Data submitted on installation of the app (optional) including:
● Gender, Age Range, Location,
● Whether they have sought professional treatment
● Aggregated data on user activity and its effectiveness
● Analytics on user journeys
To report an issue with Move Mood please email email@example.com.
stem4 endeavours to respond to the enquirer according to our target response times. Risk will be amended with immediate effect. Amendments to the workings of the app will be made at every update.
NHS Digital DCB0129 standards.
Also our app developers:
● Design with Users Needs – our workshop helped us to identify these
● Design with Data – we used the existing stem4 app data, (e.g passcode consideration) as well as
ongoing updates based on the Move Mood analytics.
● Iteration – New updates depending on things that have (or haven’t) worked or new functionality.
We also do strive to be as broadly accessible as possible through the use of industry best practices. For example, contrast colours for those with sight issues, using a font that’s clear to read etc.