Use of mobile applications and mental health services among veterans who received internet-connected tablets

Among Veterans Health Administration (VHA) patients receiving internet-connected tablets, we examined (1) app usage, (2) clusters of commonly used apps and patient characteristics across clusters, and (3) the relationship between app clusters and mental health services.

A survey was distributed to a national sample of VHA patients (n = 5449) within 6 months of tablet receipt. Self-reported app use was clustered with agglomerative hierarchical clustering. Survey data were combined with electronic health record data that included sociodemographics and mental health care utilization during the 6 months following survey completion. Differences in patient characteristics by cluster were examined using chi-square tests. A multivariable model assessed prediction of mental health services across app clusters.

Among 1664 patients with complete survey and health care utilization data, the majority (74%) reported using at least 1 app. The most used apps were for video visits (60%) and VA's patient portal (53%). Cluster analysis revealed 5 distinct groups reflecting app usage: Patient Portal (n = 685, 41%), Video Connection (n = 319, 19%), Treatment Companion (n = 166, 10%), Self-Management (n = 85, 5%), and Non-App Group (n = 409, 25%). Cluster characteristics varied, and those in the Patient Portal Group (adjusted odds ratio  = 1.64; 95% CI = 1.15-2.32) and Video Connection Group (adjusted odds ratio = 1.52; 95% CI = 1.02-2.26) were more likely to have a mental health visit in the 6 months after survey completion when compared to the Non-App Group (P < .05).

Tablet provision supports opportunities to use apps for multiple health management tasks, and app use clusters vary across patient characteristics and health care utilization.

Patients most commonly used apps to connect with their care team, and use of some apps and app combinations may improve engagement with mental health services.