{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:08:24Z","timestamp":1788898104895,"version":"build-2803163510"},"reference-count":78,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Work-related stress has been widely associated with an increased risk of various mental disorders and poor mental well-being. The fast-growing mobile health services industry has provided new opportunities for workplace mental health.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n This randomized controlled trial examined the effectiveness of\n Neurum<\/jats:italic>\n (Neurum Limited), a smartphone-based intervention tool featuring ecological momentary assessments and interventions that aims to reduce workplace stress in real-time and real-world settings.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A total of 201 working adults were recruited for a 4-week smartphone-based intervention that incorporated cognitive behavioral therapy, mindfulness exercises, and self-regulation exercises delivered on\n Neurum<\/jats:italic>\n . A simple randomization procedure was used. Participants in the intervention group were encouraged to log mood journals, complete mental health exercises, and provide user feedback whenever applicable. The key outcome was measured by the Depression, Anxiety, and Stress Scale-21 items (DASS-21; Cronbach \u03b1=0.87).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The intervention group consisted of 102 participants, while the control group consisted of 99 participants. More participants dropped out from the intervention group (n=21) than from the control group (n=2;\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n 1<\/jats:sub>\n =18.259;\n P<\/jats:italic>\n <.001). The final sample consisted of 178 participants (male: 85\/178, 47.8%; female: 93\/178, 52.2%; mean age of 34.65, SD 7.67 y). Analyses revealed that after the 4-week intervention, the DASS-21 scores decreased in the intervention group (mean difference [MD]\n post-pre intervention<\/jats:sub>\n =\n \u2212<\/jats:bold>\n 14.518) but increased in the control group (MD\n post-pre intervention<\/jats:sub>\n =3.319;\n F<\/jats:italic>\n 1,176<\/jats:sub>\n =59.358,\n P<\/jats:italic>\n <.001;\n \n \u03b7\n 2<\/jats:sup>\n <\/jats:italic>\n =0.252). This effect was largely led by stress reduction (\n F<\/jats:italic>\n 1,176<\/jats:sub>\n =64.679,\n P<\/jats:italic>\n <.001; for the intervention group, MD\n post-pre intervention<\/jats:sub>\n =\n \u2212<\/jats:bold>\n 6.692, while for the control group, MD\n post-pre intervention<\/jats:sub>\n =2.000). On average, participants completed 6.27 (SD 9.4) exercises and provided 9.74 (SD 18.2) mood journal logs, with a daily engagement of 4.95 (SD 6.89) minutes. However, the associations between the changes in DASS-21 scores and the numbers of exercises or mood journal logs did not reach statistical significance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This study primarily established the effectiveness of\n Neurum<\/jats:italic>\n in alleviating depression, anxiety, and stress symptoms in noninstitutionalized working adults, with a satisfactory user retention rate. Despite potential health-related culture differences,\n Neurum<\/jats:italic>\n contributed to evidence-based digital health in nonclinical settings for timely needs and general accessibility as an alternative to traditional, face-to-face, and high-cost mental health services. Future directions involving a personalized approach in online mental health services were discussed.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/72435","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:53:13Z","timestamp":1788897193000},"page":"e72435-e72435","source":"Crossref","is-referenced-by-count":0,"title":["A Smartphone-Based Ecological Momentary Intervention for Workplace Mental Health: Randomized Controlled Trial"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4870-3840","authenticated-orcid":false,"given":"Sisi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-5539","authenticated-orcid":false,"given":"Lik Hang Lincoln","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3747-8019","authenticated-orcid":false,"given":"Chiu Yi Charlie","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4110-1671","authenticated-orcid":false,"given":"Megan","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7074-7351","authenticated-orcid":false,"given":"Meanne","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.12927\/hcpap..16820","article-title":"Nature and prevalence of mental illness in the workplace","volume":"5","author":"Dewa","journal-title":"Healthc Pap"},{"issue":"11","key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30432-0","article-title":"Mental health matters","volume":"8","author":"The Lancet Global Health","journal-title":"Lancet Glob Health"},{"issue":"10","key":"R3","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1080\/14656566.2018.1491966","article-title":"Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review","volume":"19","author":"Strawn","journal-title":"Expert Opin Pharmacother"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.12.008","article-title":"The effectiveness of four empirically supported psychotherapies for primary care depression and anxiety: a systematic review and meta-analysis","volume":"245","author":"Zhang","journal-title":"J Affect Disord"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1001\/jamapsychiatry.2020.3650","article-title":"Sequential combination of pharmacotherapy and psychotherapy in major depressive disorder: a systematic review and meta-analysis","volume":"78","author":"Guidi","journal-title":"JAMA Psychiatry"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1192\/bjp.bp.116.189464","article-title":"Association between mental health\u2013related stigma and active help\u2013seeking: systematic review and meta-analysis","volume":"210","author":"Schnyder","journal-title":"Br J Psychiatry"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1080\/13607860600641200","article-title":"Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes","volume":"10","author":"Mackenzie","journal-title":"Aging Ment Health"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1017\/S0033291707000414","article-title":"Work stress precipitates depression and anxiety in young, working women and men","volume":"37","author":"Melchior","journal-title":"Psychol Med"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1037\/1076-8998.10.1.31","article-title":"Working conditions and three types of well-being: a longitudinal study with self-report and rating data","volume":"10","author":"Grebner","journal-title":"J Occup Health Psychol"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1016\/bs.irn.2020.01.001","article-title":"Stress, the cortisol awakening response and cognitive function","volume":"150","author":"Law","journal-title":"Int Rev Neurobiol"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","first-page":"50","DOI":"10.5271\/sjweh.3608","article-title":"Psychosocial job quality and mental health among young workers: a fixed-effects regression analysis using 13 waves of annual data","volume":"43","author":"Milner","journal-title":"Scand J Work Environ Health"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Ogden T Hagen KA . 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