An Alternative to the ‘Light Touch’ Digital Health Remote Study: The Stress and Recovery in Frontline COVID-19 Healthcare Workers Study


Goodday M.S, Karlin E, Alfarano A, Brooks A, Chapman C, Desille R, Karlin D.R, Emami H, Woods N, Boch A, Foschini L, Wildman M, Cormack F, Taptiklis N, Pratap A, Ghassemi M, Goldenberg A, Nagaraj S, Walsh E, and Friend S

BACKGROUND: Several app-based studies share similar characteristics of a ‘light touch’ approach that recruit, enroll, and onboard via a smartphone app and attempt to minimize burden through low-friction active study tasks, while emphasizing the collection of passive data with minimal human contact. However, engagement is a common challenge across these studies reporting low retention and adherence.

OBJECTIVE: To describe an alternative to a ‘light touch’ digital health study that involved a participant centric design including high friction app-based assessments, semi-continuous passive data from wearable sensors and a digital engagement strategy centered on providing knowledge and support to participants.

METHODS: The Stress and Recovery in Frontline COVID-19 Healthcare Workers Study included US frontline healthcare workers followed between May-November 2020. The study comprised 3 main components: 1) active and passive assessments of stress and symptoms from a smartphone app; 2) objective measured assessments of acute stress from wearable sensors; and 3) a participant co-driven engagement strategy that centered on providing knowledge and support to participants. The daily participant time commitment was an average of 10-15 minutes. Retention and adherence are described both quantitatively and qualitatively.

RESULTS: 365 participants enrolled and started the study and 81.0% (297/365) of them completed the study for a total study duration of 4 months. Average wearable sensor usage was 90.6% days of total study duration. App-based daily, weekly, and every other week surveys were completed on average 69.18%, 68.37%, 72.86% of the time, respectively.

CONCLUSIONS: This study found evidence for feasibility and acceptability of a participant centric digital health study approach that involved building trust with participants and providing support through regular phone check-ins. In addition to high retention and adherence, the collection of large volumes of objective measured data alongside contextual self-reported subjective data was able to be collected that is often missing from ‘light touch’ digital health studies.