Reducing concussion symptoms among teenage youth: Evaluation of a mobile health app

Objective: To evaluate whether a mobile health application that employs elements of social game design could compliment medical care for unresolved concussion symptoms.Design: Phase I and Phase II (open-label, non-randomized, ecological momentary assessment methodology).Setting: Outpatient concussion clinic.Participants: Youth, aged 13-18 years, with concussion symptoms 3+ weeks after injury; Phase I: n = 20; Phase II: n = 19.Interventions: Participants received standard of care for concussion. The experimental group also used a mobile health application as a gamified symptoms journal.Outcome measures: Phase I: feasibility and satisfaction with intervention (7-point Likert scale, 1 high). Phase II: change in SCAT-3 concussion symptoms (primary), depression and optimism.Results: Phase 1: A plurality of participants completed the intervention (14 of 20) with high use (110 +/- 18% play) and satisfaction (median +/- interquartile range (IQR) = 2.0+/- 0.0). Phase II: Groups were equivalent on baseline symptoms, intervention duration, gender distribution, days since injury and medication prescription. Symptoms and optimism improved more for the experimental than for the active control cohort (U = 18.5, p = 0.028, effect size r = 0.50 and U = 18.5, p = 0.028, effect size r = 0.51, respectively).Conclusions: Mobile apps incorporating social game mechanics and a heroic narrative may promote health management among teenagers with unresolved concussion symptoms.