@Article{info:doi/10.2196/21854,
author="Kruzan, Kaylee Payne
and Whitlock, Janis
and Bazarova, Natalya N",
title="Examining the Relationship Between the Use of a Mobile Peer-Support App and Self-Injury Outcomes: Longitudinal Mixed Methods Study",
journal="JMIR Ment Health",
year="2021",
month="Jan",
day="28",
volume="8",
number="1",
pages="e21854",
keywords="self-injury; mobile apps; peer support; mHealth",
abstract="Background: Many individuals who self-injure seek support and information through online communities and mobile peer-support apps. Although researchers have identified risks and benefits of participation, empirical work linking participation in these web-based spaces to self-injury behaviors and thoughts is limited. Objective: This study aims to investigate the relationship between behavioral and linguistic traces on a mobile peer support app and self-injury outcomes. Methods: Natural use data and web-based surveys (N=697) assessing self-injury outcomes were collected from 268 users (aged 13-38 years; median 19; 149/268, 55.6{\%} female) of a mobile peer-support app for 4 months. Participants were identified as having posted self-injury content using an internal classifier. Natural log data was used to predict self-injury outcomes in a series of multilevel logistic and linear regressions. Results: Greater engagement on a mobile peer-support app was associated with a decreased likelihood of self-injury thoughts (odds ratio [OR] 0.25, 95{\%} CI 0.09-0.73) and fewer intentions to self-injure (b=−0.37, SE 0.09), whereas posting triggering content was associated with an increased likelihood of engaging in behaviors (OR 5.37, 95{\%} CI 1.25-23.05) and having self-injury thoughts (OR 17.87, 95{\%} CI 1.64-194.15). Moreover, viewing triggering content was related to both a greater ability to resist (b=1.39, SE 0.66) and a greater intention to self-injure (b=1.50, SE 0.06). Conclusions: To our knowledge, this is the first study to connect naturally occurring log data to survey data assessing self-injury outcomes over time. This work provides empirical support for the relationship between participation in online forums and self-injury outcomes, and it articulates mechanisms contributing to this relationship. ",
issn="2368-7959",
doi="10.2196/21854",
url="http://mental.jmir.org/2021/1/e21854/",
url="https://doi.org/10.2196/21854",
url="http://www.ncbi.nlm.nih.gov/pubmed/33507154"
}