An app’s mental health focus was determined in the following manner: first, the app’s description had to explicitly state that it targeted people with [mental health focus] and, second, most of the techniques used within the app had to have been built to help users cope with or manage their symptoms directly related to the mental health focus. We grouped apps based on several mental health foci. Under “mental health problems,” we included apps that were focused on supporting people coping with depression, anxiety-related disorders, and emotional difficulties. We also subcoded the app with the terms (a) anxiety-related disorders or (b) depression if the app specifically targeted only one of these aims. (During our coding process, we did not identify another theme for the remaining apps.) Under “happiness,” we included apps that focused on nurturing happiness or general positivity (eg, exercising gratitude, happiness assessment, suggestions for activities nurturing positive feelings), rather than the management of mental health states or problems.
During our coding process, we found a greater ambiguity around the description of apps with a primary incorporated technique of mindfulness/meditation, which leaned more toward enhancing emotional well-being (ie, helping users achieve a positive sense of experience and good mental health), but also aimed at stress reduction. Therefore, we grouped mindfulness and meditation apps separately and did not attribute either of the two mental health foci to them. For this reason, and to enable a proper comparison between categories, we present the mindfulness/meditation category in both the mental health focus and technique outcomes, despite being the same results.
A Cohen kappa interrater agreement of .92 was obtained for coding the variables of interest (incorporated technique, primary technique, and mental health focus). All disagreements were discussed with a third author with reference to the apps until consensus was reached.