Trial shows Koa Health’s Foundations app can improve measures of mental wellbeing in only four weeks

As the COVID-19 pandemic has led to a rise in common mental health disorders, Koa Health trial saw Koa Foundations improve mental wellbeing by more than a fifth (21%) on average

  • A randomized control trial (RCT)  found Koa Health’s flagship mental wellbeing product, Koa Foundations, can improve mental wellbeing in as little as four weeks

  • The sleep quality of participants using Koa Foundations improved by a third (33%)

  • Participants using Koa Foundations showed a 23% improvement for feelings of anxiety, more than double the statistical improvement over the control group (11%)

Koa Health
Publish Date

Amsterdam, Barcelona and London, 23 February, 2022: Today Koa Health, a leading digital platform for workplace mental health, announces the results from a randomized control trial (RCT) for the efficacy of its evidence-based mental wellbeing app, Koa Foundations, to improve measures of mental wellbeing, anxiety, resilience and sleep during the first wave of the COVID-19 pandemic.

The American Psychological Association estimates between 10,000-20,000 mental health apps are available for download . Yet, according to the Organization for the Review of Health and Care Apps (ORCHA), which evaluates health apps, just under 30% of mental health apps reviewed meet the quality threshold that ORCHA sets .

Against this backdrop the RCT conducted by Koa Health from April 2020 to May 2020, set out to prove how Koa Foundations could help adults better manage mental wellbeing and associated common mental health disorders including stress, sleep, anxiety and resilience. 

Koa Foundations offers users a breadth of evidence-based interventions and activities from Cognitive Behavioral Therapy (CBT) and positive psychology to meditation and mindfulness, to improve user wellbeing including tackling stress, sleeping better, aiding relaxation and positive thinking and boosting self-confidence.

Data published in peer reviewed journal JMIR mHealth and uHealth showed that adults using Koa Foundations improved their mental wellbeing against the WHO-5 scale (1-100) after two weeks and by more than a fifth (21%) on average after four weeks. This was significantly higher than the adults in the control group whose improvement against the same scale was negligible with an average improvement of only 1%. The data revealed the potential of Koa Foundations to significantly improve adult mental wellbeing.

Dr. Oliver Harrison, CEO Koa Health says, “The social impact of the Covid pandemic has been profound and long-lasting. As a result, governments around the world are reporting record levels of depression and anxiety across their populations. In the UK, ONS data shows 35% of adults have clinical symptoms that need treatment. At the same time, an overstretched NHS is reporting 8.4M people are stranded without access to care.  In this context, evidence-based, clinically-validated digital mental health tools present the only scalable way to combat this crisis.”

The RCT also found that on average, after four weeks, Koa Foundations’ users saw:

  • Sleep quality improve by a third (33%) against the Minimal Insomnia Scale (MISS), compared with the control group that improved by only 12% against the same score. This measure of sleep quality was the biggest statistical improvement for Koa Health Foundation users during the study.
  • A 23% improvement in feelings of anxiety, this was more than double the statistical improvement over the control group, with an improvement of only 11%; both measured against the generalized Anxiety Disorder scale (GAD-7).
  • Resilience improvement of 10%, compared to the control group which had a negligible improvement of 1%; both measured against the 10-item Connor-Davidson Resilience scale (CD-RISC-10).
  • A 19% reduction in feelings of stress , compared to the control group which saw a reduction of 14%; both measured against the 10-item Perceived Stress Score (PSS).

The study comes as ONS figures  show almost one in six adults experienced some form of depression in summer 2021, compared with one in ten before the pandemic, with mental health services unable to meet the demand for care . Meanwhile, mental health currently costs UK employers up to £45 billion a year .

Dr. Oliver Harrison adds, These results show that, during a pandemic, Koa Foundations served as an effective treatment for improving the mental health and wellbeing of the adult population, in some cases significantly. With business productivity and economic recovery on the line, we want to give HR leaders and businesses the confidence that they’re investing the right solutions to support their high-performing teams, giving them access to the spectrum of care their employees need. The current state of the nation’s mental health leaves not only the UK’s collective wellbeing at stake, but also business productivity and ultimately the country’s economic recovery.

Koa Foundations is already available to over 3 million people across dozens of companies, including O2 and was ranked a leading app for Stress and Mental Wellbeing with an overall score of 88% by ORCHA.



Koa Health Press Office:

About Koa Health

Koa Health is the leading global provider offering evidence-based, personalized, integrated solutions and services that deliver mental health for everyone. Available to more than 3 million users worldwide, Koa Health addresses a vast spectrum of mental health needs – from improving wellbeing to supporting treatment for the most prolific disorders. Backed by investors such as Telefónica, a consortium advised by Ancora Finance Group, Wellington Partners Life Sciences and MTIP, Koa Health leverages deep clinical expertise, research and technology to deliver effective and accessible care that adapts to users’ unique circumstances, leading to lasting behavior change and positive health outcomes. Koa Health partners with employers, health plans, health systems and providers around the world with its headquarters in the Netherlands and operations in Boston, London and Barcelona.

For more information, please visit

Notes to editor

  1. The RCT conducted from April 2020 to May 2020 involved 136 adults with mild to severe anxiety and moderate to high levels of perceived stress who completed the study. Participants were randomized to either the intervention (n=62) or control arm (n=74). Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalized Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organization-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). Results as published in JMIR Mhealth Uhealth.

  2. NHS England data shows that more than 8 million people with depression and anxiety disorder are unable to get specialist help because they aren’t “sick enough” to meet treatment thresholds that have been increased in light of much higher demand and a shortage of clinicians.

about the author

Koa Health

The Team @ Koa Health

Our diverse team of developers, researchers, psychologists and behavioral health experts work together to create practical, thought-provoking content to accompany our range of digital therapeutics.