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CBT-i Coach

"CBT-i Coach is for people who are engaged in Cognitive Behavioral Therapy for Insomnia with a health provider, or who have experienced symptoms of insomnia and would like to improve their sleep habits." Evaluated: December 2019

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 and Android.

Has the app been updated in the last 180 days?

No, last updated nine months ago.

Does the app identify ownership?

Yes, the U.S. Veteran's Administration.

Does the app identify funding sources and conflicts of interest?

Yes, the app is funded by the U.S. VA, and has no apparent conflicts of interest.

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.

Are there additional or hidden costs?

No.

Does the app work offline?

Yes.

Does the app work with accessibility features of the iPhone/Android? Is it accessible for those with impaired vision or other disabilities?

Unclear.

 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?

Does not collect or transmit data (data are anonymously sent).

Does the app declare data use and purpose?

Yes, license agreement on App Store (for statistical purposes, deidentified data is sent to "a data provider."

Does the app describe use of PHI?

The app does not collect or share PHI.

Can you opt out of data collection or delete data?

Cannot opt out. Unknown if data can be deleted.

Is data maintained in the device or on the web?

Both.

Does the app explain security systems used?

The reviewer was unable to find information on security systems used.

What third parties does the app share data with?

None listed and no addresses for third parties are provided other than that of the VA.

If appropriate, is the app equipped to respond to potential harms or safety concerns?

In the opinion of this reviewer, it does not appear that the app is so equipped.

 Clinical Foundation

Does the app appear to do what it claims to do?

Yes, it supports provider-driven CBT-i.

Is there evidence of specific benefit from academic institutions, publications, end user feedback or research studies?

Yes, through the DoD and academic partners found here.

Does the app have a clinical/recovery foundation relevant to your intended use?

Yes, the app uses manualized therapy and CBT-i.

Is the app content correct, well-written, and relevant?

The content appears to be correct; user reviews report "clunkiness."

What are the relevant sources or references supporting the app use cases?

The app relies on CBT-i manual and i-CBT empircal background.

Was there an attempt to validate app usability and feasibility?

Yes.

Is there evidence of effectiveness/efficacy?

Yes.

 Usability

Does the app seem easy to use?

Yes.

What are the main engagement styles of the app?

Audio/Visual, journaling; graphs; reminders; scheduling; patient education.

Do the app and its features align with your needs and priorities?

Yes, this app aligns with the needs and priorities of the reviewer (e.g., aligning with CBTi as a therapeutic modality).

Is it customizable?

No.

Does the app clearly define its functional scope?

Yes, the app defines its functional scope as augmenting CBTi processes.

 Therapeutic Goal

Can data be easily shared and interpreted in a way that's consistent with the stated purpose of the app?

Unclear.

Do you own your data?

Yes.

Can the app share data with EMR and other data tools (Apple HealthKit, FitBit)?

Unclear.

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?

App is intended to be used in collaboration with a provider. Unknown if data can be exported.

Does the app lead to any positive behavior change or skill acquisition?

App purports so with use. Also, CBT-I is research-based and supports behavior change/skill acquisition.

Does the app improve therapeutic alliance between patient and provider?

App is meant to be used in conjunction with provider, so it is assumed so.

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