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having meaningful interactions with its features. A recent systematic review suggested that while
use and adherence with mental health apps range between 44% and 99% in research settings,
rates in real-world settings may range between 1% and 29% [46]. It appears that Hugr Authentic
Connections app engagement levels in the real world fell within the range purported in this
study. This was consistent with the study's goals to evaluate the app's "real-world" effectiveness.
Ideally, to validate the effectiveness of Hugr Authentic Connections app, we would
require a much higher sample size and more participation. The remedy for this may be a
combination of more structured client education and on-boarding, on-site sponsors and
champions within the organizations promoting the app, and some form of intervention to provide
context. The latter might include a series of webinars on the topics of isolation, loneliness, and
authentic connections to provide Q&A sessions for users.
It is common to lose participants to research over time. However, the ongoing willingness
of 66 participants to complete the study's surveys three times (note: that was done outside the
app, using an online survey) suggested ongoing interest in isolation and loneliness and workplace
mental health (note: only 62 of these 66 also used the app). However, this level of interest did not
transfer into engaging in Hugr Authentic Connections app directly at levels needed to determine
the app's effectiveness to change behaviour or to facilitate resiliency. This study had a much
lower dropout rate with the three surveys than with the Hugr Authentic Connections app. We
have provided some evidence-based suggestions for consideration for future versions of the app
to address these issues (see Appendix A).
Appendix A provides an overview of the research study's data collected on participation
levels and Hugr Authentic Connections app engagement and changes on measures of anxiety,
depression, and loneliness to test the app's impact over time. We used measures of loneliness
