Acceptability and satisfaction with emma, a smartphone application dedicated to suicide ecological assessment and prevention

Margot Morgiève; Daniel Yasri; Catherine Genty; Jonathan Dubois; Marion Leboyer; Guillaume Vaiva; Sofian Berrouiguet; Jérôme Azé; Philippe Courtet

doi:10.3389/fpsyt.2022.952865

Acceptability and satisfaction with emma, a smartphone application dedicated to suicide ecological assessment and prevention

Front Psychiatry. 2022 Aug 11:13:952865. doi: 10.3389/fpsyt.2022.952865. eCollection 2022.

Authors

Margot Morgiève^{1

2

3

4}, Daniel Yasri^{1

2}, Catherine Genty^{1

2}, Jonathan Dubois^{1

2}, Marion Leboyer^{5

6

7}, Guillaume Vaiva^{8

9

10}, Sofian Berrouiguet¹¹, Jérôme Azé¹², Philippe Courtet^{1

2

5}

Affiliations

¹ Université Paris Cité, CNRS, Inserm, Cermes3, Paris, France.
² Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.
³ ICM - Paris Brain Institute, Hôpital de la Pitié-Salpêtriére, Paris, France.
⁴ GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France.
⁵ Fondation Fondamental, Hôpital Albert-Chenevier, Créteil, France.
⁶ Faculté de Médicine, Institut National de la Santé et de la Recherche Médicale, Université Paris-Est Créteil, Créteil, France.
⁷ Assistance Publique Hôpitaux de Paris, Pôle de Psychiatrie et Addictologie, Hôpitaux Universitaires Henri Mondor, Créteil, France.
⁸ CHU Lille, Hôpital Fontan, Department of Psychiatry, Lille, France.
⁹ Centre National de Resources and Résilience pour les Psychotraumatisme, Université de Lille, Lille, France.
¹⁰ CNRS UMR-9193, SCALab - Sciences Cognitives et Sciences Affectives, Université de Lille, Lille, France.
¹¹ Laboratoire du Traitement de l'Information Médicale, INSERM UMR1101, CHRU Brest, Brest, France.
¹² LIRMM, CNRS, Univ Montpellier, Montpellier, France.

Abstract

Background: As mHealth may contribute to suicide prevention, we developed emma, an application using Ecological Momentary Assessment and Intervention (EMA/EMI).

Objective: This study evaluated emma usage rate and acceptability during the first month and satisfaction after 1 and 6 months of use.

Methods: Ninety-nine patients at high risk of suicide used emma for 6 months. The acceptability and usage rate of the EMA and EMI modules were monitored during the first month. Satisfaction was assessed by questions in the monthly EMA (Likert scale from 0 to 10) and the Mobile App Rating Scale (MARS; score: 0-5) completed at month 6. After inclusion, three follow-up visits (months 1, 3, and 6) took place.

Results: Seventy-five patients completed at least one of the proposed EMAs. Completion rates were lower for the daily than weekly EMAs (60 and 82%, respectively). The daily completion rates varied according to the question position in the questionnaire (lower for the last questions, LRT = 604.26, df = 1, p-value < 0.0001). Completion rates for the daily EMA were higher in patients with suicidal ideation and/or depression than in those without. The most used EMI was the emergency call module (n = 12). Many users said that they would recommend this application (mean satisfaction score of 6.92 ± 2.78) and the MARS score at month 6 was relatively high (overall rating: 3.3 ± 0.87).

Conclusion: Emma can target and involve patients at high risk of suicide. Given the promising users' satisfaction level, emma could rapidly evolve into a complementary tool for suicide prevention.

Keywords: acceptability; ecological momentary assessment (EMA); ecological momentary intervention (EMI); mHealth; prevention; satisfaction; smartphone application; suicide.