Evidence map›Paper›PMID 42536970›Full record

ArticleJMIR formative research2026

Development of the Rational Thinking, Emotion Regulation, and Problem-Solving Mental Fitness Mobile App for US Navy Sailors: Qualitative and Quantitative Usability Evaluation.

David P Cenkner, Jennifer June, Stephen M Schueller, Alyson K Zalta, Joseph Grammer, Eric Ekman, Kailee Baldini, Jessica M LaCroix, Marjan Ghahramanlou-Holloway

Abstract read
In one paragraph

Article in JMIR formative research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

David P CenknerDepartment of Psychology, School of Social Ecology, University of California, 214 Pereira Dr, Irvine, CA, 92617, United States, 1 724-787-0991.ORCID 0000-0002-1318-4043
Jennifer JuneThe Informatics Applications Group, Reston, VA, United States.ORCID 0009-0009-2228-0131
Stephen M SchuellerDepartment of Psychology, School of Social Ecology, University of California, 214 Pereira Dr, Irvine, CA, 92617, United States, 1 724-787-0991.ORCID 0000-0002-1003-0399
Alyson K ZaltaDepartment of Psychology, School of Social Ecology, University of California, 214 Pereira Dr, Irvine, CA, 92617, United States, 1 724-787-0991.ORCID 0000-0002-5159-8431
Joseph GrammerDepartment of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.ORCID 0009-0006-4280-0200
Eric EkmanDepartment of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.ORCID 0000-0002-9534-4038
Kailee BaldiniThe Informatics Applications Group, Reston, VA, United States.ORCID 0009-0004-8823-1846
Jessica M LaCroixDepartment of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.ORCID 0000-0002-4040-4275
Marjan Ghahramanlou-HollowayDepartment of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.ORCID 0000-0001-8377-3698

Funding

US Department of Defense HU00012320011
6 · The paper itself

Abstract

Background: US Navy sailors experience a range of personal and interpersonal stressors due to challenging operational tempos that can contribute to psychological distress and increased suicide risk. Digital mental fitness tools offer scalable, stigma-reducing solutions to support psychological readiness. However, many existing digital mental health interventions use top-down designs that lack input from the target population and focus on treating psychological symptoms rather than improving overall mental fitness. Objective: This study aimed to design a mobile app version of the Rational Thinking, Emotion Regulation, and Problem Solving (REPS) program and evaluate usability and user experience. REPS is grounded in cognitive-behavioral and rational emotive behavior therapy principles. We examined sailor feedback across two evaluation phases to make iterative improvements to the app. Methods: Two rounds of usability testing were conducted with 13 first-term Navy sailors over a 2-month period in spring of 2024. Sailors on duty at a naval ship were recruited by their commanding officer. Evaluation phase 1 (n=8) included exploratory interviews and concept testing using an initial prototype that covered a learning objective of the first module. Sailor feedback from phase 1 informed iterative refinements, including a gamified badge feature and dedicated skill practice session. Evaluation phase 2 (n=5) included a think-aloud protocol using an updated, fully functioning prototype of the first module, with three structured learning objectives. Both phases assessed sailor feedback through qualitative interviews and the System Usability Scale (SUS). Thematic analysis identified core themes related to user needs and app characteristics, and SUS scores were summarized to describe usability. Results: Sailors found the REPS app prototype to be culturally relevant and relatable to their daily life within the Navy. Sailors also commented that the app had an intuitive, user-friendly design and praised the modern and visually appealing interface. Sailors reported liking the scenario-based situations and clear explanation of how thoughts, feelings, and actions are intertwined. Sailors also identified ways to enhance user engagement, including clearly defining psychological terminology, introducing gamified rewards, outlining learning objectives, and incorporating more prominent visual cues to enhance the discoverability of interactive content. Quantitatively, SUS scores for both evaluation phases were in the excellent range (phase 1: median 92.50, range 72.5-95.0; phase 2: median 85.00, range 80.0-92.5). Conclusions: The REPS mobile app was rated as highly relevant and usable by newly enlisted Navy sailors. Scenario-based activities, intuitive design, and relatability with lived military experiences were identified as core strengths. Iterative feedback emphasized the importance of human-centered design in refining app functionality, esthetics, and information. These findings support REPS as a promising, scalable digital tool to enhance mental fitness and contribute to universal suicide prevention in the Navy.

Indexed as

Emotional RegulationMilitary PersonnelMobile ApplicationsProblem SolvingThinkingAdultFemaleHumansMaleQualitative ResearchUnited Statesdigital mental healthearly careerhuman-centered designmental fitnessmHealthmilitarymilitary mental healthmobile healthmobile interventionservice memberssuicide preventionusability testing

Identifiers

PMID42536970
PMCPMC13427060

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.