Publications and Research
Our Science team is led by Professor Joseph Hayes and Dr Aaron Kandola.
Below we highlight some of the key publications that have used juli data. Each shows a key facet of juli’s approach to research.
Randomized controlled trials
Key components: remote recruitment, Institutional Review Board/Independent Ethics Committee standards for Patient Information Sheets, in-platform consent, in-platform randomisation, ability to switch elements on/off to test interventions, in-platform outcome measures, range of standardised Patient Reported Outcome Measures (PROMs), in-platform participant compensation system.
We have completed two all remote randomised controlled trials as juli as an intervention:
Digitally managing depression
We recruited 456 people with depression from all over the world. Participants were identified as suitable, consented, and randomsied to a full version of juli or a placebo control arm through the platform. All outcome measures were collected through juli and participants were compensated for their time through juli.
We found that participants in the full juli arm had a significant reduction in depression symptoms at week 8, compared to those in the control arm, as measured by the Patient Health Questionnaire (PH-8) .
This was published in Digital Health.
Kandola A, Edwards K, Muller MA, Dührkoop B, Hein B, Straatman J, Hayes JF. Digitally managing depression: A fully remote randomised attention-placebo controlled trial. Digital Health. 2024 Jun;10:20552076241260409. health trials that have a control arm have also struggled to achieve statistical significance, in part due to challenges keeping people engaged.
Self management of asthma
We took the same approach to testing juli’s efficacy for self-management of asthma.
In 156 patients with asthma we found a significant improvement in asthma symptoms, measured by the Asthma Control Test, in the juli arm.
This was published in the Journal of Medical Internet Research (JMIR).
Kandola A, Edwards K, Straatman J, Dührkoop B, Hein B, Hayes J. Digital self-management platform for adult asthma: randomized attention-placebo controlled trial. Journal of medical Internet research. 2024 Apr 29;26:e50855.
Observational studies
Key components: geographically diverse remote recruitment, iOS and Android versions, flexible ecological momentary assessment (EMA), validation of EMA with regular PROMs, small area weather and air pollution data, links to period tracking apps and wearables, anonymisation of data for researchers, provision of data to independent researchers in ready-to-use formats.
We have delivered research-ready datasets for novel environmental and EMA studies of diverse populations:
Premenstrual exacerbation of depression symptoms
In this cohort study of 352 women, we observed a gradual decline in daily mood ratings, beginning at 14 days before menstruation and continuing until 3 days before the next menstruation. During the remainder of the cycle, participants experienced a gradual improvement in mood Mood ra ting was associated with heart rate variability on the same day and 3 days before. Energy was not associated with menstrual cycle.
This was published in BMJ Mental Health.
Delray K, Lewis G, Hayes JF. Tracking mood symptoms across the menstrual cycle in women with depression using ecological momentary assessment and heart rate variability. BMJ Mental Health. 2025 Jun 24;28(1).
Effects of air pollution on bipolar disorder
In a sample of 1423 patients with bipolar disorder, we found that as air quality worsened, symptoms of depression increased. We found no association between air quality and mania symptoms.
This was published in the British Journal of Psychiatry Open.
Kandola A, Hayes JF. Real-time air pollution and bipolar disorder symptoms: remote-monitored cross-sectional study. BJPsych open. 2023 Jul;9(4):e107.
Ambient temperature and depression and mania
We used ecological momentary assessment data from juli to investigate the association between real-time mean and maximum ambient temperature collected from smartphone geolocation (5km2), and depressive (PHQ-8) and manic (Altman Self-Rating Mania Scale) symptom scales, every two weeks, in 4000 adults with depression and bipolar disorder.
This was published in the Journal of Affective Disorders.
Clery P, Hayes JF, Launders N, Thompson R, Kandola A, Osborn DP, Lawrance EL, Jeffery A, Dykxhoorn J. The association between outdoor ambient temperature and depression and mania: An ecological momentary assessment study. Journal of Affective Disorders. 2025 Jun 15;379:457-66.
White Papers
Why does engagement matter in health apps? (White Paper)
Good apps support healthcare effectively, but only if they are used regularly by patients. We analyze the topic:
Retention and engagement drive clinical outcomes
Most health apps struggle to retain patients
juli has proven to drive very high retention well above industry norms
Personalization, gamification, reminders and a highly personable UI help drive continued utilization
Do you want to know more about the science behind juli?
Get in contact with us: info@juli.co.