The consequences of mHealth on well-being

Partners: Erasmus University Rotterdam & University of Amsterdam
Type: PhD
Duration: 2023-2027

Mental health disorders are the major health problem of young people. These disorders mostly begin during the adolescent and young adult period of a person’s life making this period crucial for prevention. A subcategory of young adults, university students, have been shown to have significantly higher levels of psychological distress compared to the general population. Smartphone applications can aid in avoiding the barriers to accessing mental health care by providing users accessible and easily available tools for self-management and prevention. Thus, mental wellbeing apps (MWA) have emerged as a useful platform for helping in treatment of psychological issues among younger adults because of their high perceived value and ease of use.

MWAs often provide health suggestions based on user-inputted or collected data, utilizing Automated Decision Systems (ADS) as recommender systems. These systems nudge users in specific directions, personalizing their in-app experience. However, these apps are often commercially driven and mainly focused on optimization and efficiency and can have discriminatory tendencies and biases instilled within them. Currently, there is very little research present that sheds light on how MWAs that contain ADS, directly or indirectly impact university students’ public values such as privacy, security, autonomy, solidarity, transparency, authenticity, and integrity. Some of these values might be perceived by university students as negatively or positively impacted by MWAs, and this perceived impact might influence the way students engage with the MWAs, but this remains understudied.

Therefore, this project will focus on the following research questions:

- Which public values do university students users deem important while using MWAs containing ADS?

- How do users perceive these values being impacted by MWAs containing ADS?

- How do users perceive the different value trade-offs within this context such as the trade-off between autonomy and personalization, privacy and personalization, privacy and wellbeing, privacy and solidarity, etc.?

- What is the relationship between perceived impact MWAs with ADS have on public values, and engagement with those apps?

- To what extent does university students’ perceived impact of mental wellbeing apps on their public values affect their self-reported mental well-being?

This project starts with an exploratory qualitative study which will result in an overview of public values that are deemed most relevant in this context from the university students’ perspectives. This will then instruct the following research within this project in terms of focusing on one or more public values specifically and the potential trade-offs between them. The first study will also produce relevant information about the perceived relationship between public values and engagement. Subsequently, using quantitative methods, the relationship between the perceived realization of public values within MWAs containing ADS and the subsequent engagement with the MWAs as well as the users measured, or self-reported mental wellbeing will be investigated.

Expected outputs of this project include at least three published or submitted articles to relevant journals. Furthermore, the knowledge produced by this project will help the understanding on the role of public values in mHealth (mobile health) specifically for mental wellbeing, and even more specifically for the university student population, and thus, provide information for optimization of such products with a goal of ultimately heightening the benefits, and lowering the risks of using ADS in mental wellbeing apps. Focusing on this population is also relevant as they have been shown to suffer more psychological distress compared to the general population, and at the same time represent the adults of the future. Insights from this research might help in the efforts of addressing the mental health issues students deal with currently, but also give a glimpse into what researchers and app developers should focus on further down the line in order to maximize the effects of these apps, and thus, the health benefits for the users. Finding out the role for public values within this context will be crucial for this project.

As part of the Health sector and Effects stream of the AlgoSoc research program, this research project will aid in helping answer one of the overarching research question of “What are the effects of ADS on the realization of public values for individuals and society?” by investigating this topic within the mHealth field and focusing specifically on mental wellbeing apps containing ADS that are used by the university student population.