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Mental health applications (apps) can improve access to evidence-based, mental health strategies. This study evaluated predictors of use for the Virtual Hope Box (VHB), a smartphone app designed to enhance coping among high-risk mental health populations. We also explored the impact of usage on health outcomes. We analyzed data drawn from the treatment arm of a randomized clinical trial of the VHB (n = 58). Veterans at high risk of suicide used the app over 12 weeks and completed psychosocial assessments throughout the study. We received usage data from each participant’s smartphone. We then used negative binomial regression to evaluate demographic and clinical predictors of usage and generalized estimating equations to explore the longitudinal association between usage and psychosocial outcomes. The most commonly used subcomponents were designed to provide distractions and reminders of sources of meaning.Lower levels of usage were associated with younger and having a 2-year college degree or higher. Exploratory findings suggested a possible relationship between usage and protective factors. Certain subgroups had lower VHB usage. The findings suggest usage may be associated with changes in health outcomes. Future studies should recruit larger, more diverse samples to further explore relationships between usage and demographic predictors.
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