The below evaluation is an example of the types of information you may find when using our Model to assess specific apps. This sample evaluation is not intended to enable you to make a decision about choosing these specific apps for actual use, as such a decision is a personal one that you will make based on your own unique preferences, needs, and evaluation. We strongly encourage you to download these apps for yourself and use our Model to conduct your own assessment.
This evaluation was completed December 6th and 7th, 2019, and is based on publicly available information found by our Panel at that time. In June 2020, APA's contacted the app developers and offered to them an opportunity to provide feedback on these assessments. Comments from developers who responded are included here. These comments do not necessarily reflect publicy available information at the time of the original assessment or presently.
Access & Background
On which platforms/operating systems does the app work? Does it also work on desktop?
iOS.
Has the app been updated in the last 180 days?
Yes, three weeks ago.
From JOUR: Yes, app updates are released at least once / week, as the team iterates based on user feedback and improves overall app performance.
Does the app identify ownership?
Forward Human, Inc.
Does the app identify funding sources and conflicts of interest?
Per the press kit website: "The firm was awarded 2018 Venture Firm of the Year by the National Venture Capital Association."
Does the app come from a trusted source?
Yes, the U.S. Department of Defense and Stanford University.
Does the app claim to be medical?
No, the app claims to be a "Health and Fitness" app.
Are there additional or hidden costs?
The app is free to download. A premium option is available for $59.99.
Does the app work offline?
Users can write journal entries offline, but are unable to access the "daily jour" and "journeys" features without internet access.
Does the app work with accessibility features of the iPhone/Android? Is it accessible for those with impaired vision or other disabilities?
The reviewer was unable to determine this functionality while using the app.
From JOUR: The only audio content in the app - audio introductions to multi-day guided journals - include a written transcript so that journalers with impaired hearing can follow along.
Privacy & Safety
Is there a transparent privacy policy that is clear and accessible before use?
Yes, found here.
Does the app collect, use, and/or transmit sensitive data? If yes, does it claim to do so securely?
Patient can choose to encrypt data and have protections if they do this. If they do not do this, then vague language describes data use and third party collections. Even if a user encrypts their account, vague language further in the policy contradicts strong language about not sharing personal information, making it seem like third parties may access data and personal information can still be shared under certain circumstances. So, unclear.
From JOUR: While we do share analytic data with third-party providers but have built the app so that we cannot access user Entries in any way. That's because all user entries are automatically encrypted. If a user would like to set their own, individual Encryption Key for extra security, we offer that ability to all users as well.
Does the app declare data use and purpose?
Yes, see privacy policy.
Does the app describe use of PHI?
If the user creates an account, their PHI is encrypted, and the company can't see it.
Can you opt out of data collection or delete data?
Yes.
Is data maintained in the device or on the web?
Data is maintained on the device.
Does the app explain security systems used?
Yes, see the privacy policy.
What third parties does the app share data with?
Third parties have access to numerous types of analytics. See privacy policy.
From JOUR: We share analytic data with third-party providers but have built the app so that we cannot access user Entries in any way.
If appropriate, is the app equipped to respond to potential harms or safety concerns?
Answer is not readily apparent to reviewer within the app or within the privacy policy (e.g., no journaling features appear to detect self-harm, etc.)
From JOUR: We have customer service representatives that can be contacted by shaking your phone while in the app or directly from a journaler's in-app settings. They can answer any questions or concerns a journaler may have, but whenever they receive a message illustrating a more serious or urgent mental health issue, our representatives direct journalers to reach out to a relevant organization or hotline, where specialized experts can help them.
Clinical Foundation
Does the app appear to do what it claims to do?
Yes, the app supports user-journaling.
Is there evidence of specific benefit from academic institutions, publications, end user feedback or research studies?
No evidence found on Google Scholar.
Does the app have a clinical/recovery foundation relevant to your intended use?
App is designed to help users with journalling and mood tracking. It appears to attempt to perform supportive therapy. The company does not claim to provide any therapy and does not site any intended clinical use. It links to a paper that studied the effects of journaling in general but this article did not specifically test this app or other apps for this purpose.
Is the app content correct, well-written, and relevant?
App content is vague and may help with adjustment disorders, but some mental health advice does not appear to coincide with standard of care for patients with other DSM diagnoses.
What are the relevant sources or references supporting the app use cases?
The reviewer was unable to find relevant sources or references supporting app use cases.
Was there an attempt to validate app usability and feasibility?
None found on Google Scholar.
Is there evidence of effectiveness/efficacy?
Usability
Does the app seem easy to use?
Yes, though it is unclear if it's easy to "track mood" over time or if the alerts are helpful on initial download/use. Unclear if the mood feature itself is for long or short term use.
What are the main engagement styles of the app?
Text, video, and notifications.
Do the app and its features align with your needs and priorities?
In the opinion of this reviewer, yes, as the app provides users with a jounaling and mood tracking system.
Is it customizable?
Journaling and mood-tracking features are customizable depending on user needs and preferences for journaling features.
Does the app clearly define its functional scope?
Yes, in the opinion of this reviewer. The app clearly outlines its use cases and target audience (e.g., those seeking to use a journaling app and mood tracking).
Therapeutic Goal
Can data be easily shared and interpreted in a way that's consistent with the stated purpose of the app?
Screenshots and copy/paste, perhaps.
From JOUR: In our newly released Insights feature, we present journalers' private answers in a visual, graphic way so that they can better remember how they've been feeling over time and better understand the factors in their life that are causing them to feel certain ways. We also offer personalized advice, tailored to how they've been feeling.
Do you own your data?
No. Per privacy policy: "We may retain your Personal Information as long as you continue to use our Service. You may close your account by contacting us, but we may retain Personal or Non-Personal Information for an additional period as is permitted or required under applicable laws. Even after we delete your Personal Information, it may persist on backup or archival media for an additional period of time."
Can the app share data with EMR and other data tools (Apple HealthKit, FitBit)?
No.
From JOUR: Time spent in Jour can be recorded as Mindful Minutes in a user's Apple HealthKit (when users activate the functionality).
Is the app for individual use or to be used in collaboration with a provider? If intended to be used with a provider, does the app have the ability to export or transfer data?
The app is intended for personal use.
From JOUR: While intended for individual use, we have received feedback from professional therapists that they recommend Jour for their patients as a way to check-in on their well-being between sessions and have a record of how they were feeling and what happened during the week that they can discuss in their next session.
Does the app lead to any positive behavior change or skill acquisition?
Unclear.
Does the app improve therapeutic alliance between patient and provider?
N/A, it is intended for individual use.