MeT4VeT: Development and Assessment of a Mental Health Toolkit for Military Veterans

Abstract: A feasibility trial was conducted to assess the acceptability and usability of the MeT4VeT app. Feedback from veterans and app data was collected to provide an initial assessment of the practicality of testing the app, to assess the acceptability and usability of the app and to provide initial feedback on the app. The feasibility trial used randomisation to assign participants to either the full-app group who had access to all features of the MeT4VeT app or a control group, who had an app with only signposting information. Participants who had served for at least two years in the UK Armed Forces and left within the past two years were recruited into the study through discharge medical interviews at several military medical centres, third sector organisations who provide support (e.g. housing) to veterans and social media. To determine the practicality of testing the app, we assessed the technical ability to deliver the app, determined participant recruitment numbers and drop-out and the sample size needed for a randomised controlled trial (RCT). To assess usability, app usage data was collected across the whole study period. App acceptability and usability were also measured after one month using the mHealth App Usability Questionnaire (MAUQ). To assess the app’s acceptability and usability qualitatively and provide feedback on the app, semi-structured interviews were conducted after one month with a sub-sample of the full-app group regarding their app usage. The acceptability and usability of the MeT4VeT app were generally supported. The app was reported to have helped veterans to recognise their own thoughts, feelings, and behaviours; helped 
with the development of concrete goals; aided in relaxation; helped veterans to develop the ability to self-monitor mental health; and provided a source of comfort and guidance when they felt they did not have other sources of mental health support. Feedback from participants did not indicate a need for substantial modifications of the app and suggestions were provided for adding content and improving clarity in some areas. This should be the focus of future development of the app to ensure veterans continue to engage with it. MeT4VeT showed some promise as a useful, accessible way for veterans to monitor and manage their mental health. A robust recruitment and retention strategy should be determined before conducting a RCT to fully understand the effectiveness of the app. Following this, the app can be expanded to other populations such as females and veterans of other age groups.