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Cavanagh R, Gerson SM, Gleason A, Mackey R, Ciulla R. Competencies Needed for Behavioral Health Professionals to Integrate Digital Health Technologies into Clinical Care: a Rapid Review. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 8:1-14. [PMID: 35194561 PMCID: PMC8853702 DOI: 10.1007/s41347-022-00242-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/06/2022] [Accepted: 02/02/2022] [Indexed: 11/18/2022]
Abstract
This rapid review examines literature on training and competencies for behavioral health professionals to integrate digital health technologies into clinical practice. While the evidence for digital health is growing, research evidence supports its use in behavioral healthcare. Despite this, behavioral health professionals have been slow to integrate technologies into care for various reasons. The aim of this review is to inform behavioral health professionals on competencies needed to support the adoption of digital health technologies. PubMed and Google Scholar were searched for articles from 2010 through 2020. Search terms associated with digital health technologies, behavioral health professionals, and competencies, skills, training, and best practices yielded 1972 articles. Twenty-three articles met inclusion criteria indicating foundational core competencies and data was extracted and organized based on profession and technology platform in order to detect similarities and differences. The findings were used to generate an interdisciplinary approach for the clinical integration of digital health. Recommendations are presented for foundational digital health competencies applicable across behavioral health disciplines, rather than technology- or discipline-specific training. The universal digital health inter-professional competencies identified include: (a) privacy, security, and patient safety; (b) digital health technical skills; (c) ethical and legal considerations; (d) clinical skills; (e) art of therapy and digital health; and (f) administrative tasks. Research is needed to understand if the development of professional digital health competencies helps to improve patients' behavioral health.
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Affiliation(s)
- Renée Cavanagh
- Connected Health Branch, U.S. Department of Defense, Defense Health Agency, Joint Base Lewis-McChord, 9933 West Hayes Street, Box 339500 MS 34, Tacoma, WA 98433-9500 USA
| | - Sheri Mila Gerson
- Connected Health Branch, U.S. Department of Defense, Defense Health Agency, Joint Base Lewis-McChord, 9933 West Hayes Street, Box 339500 MS 34, Tacoma, WA 98433-9500 USA
| | - Ann Gleason
- Connected Health Branch, U.S. Department of Defense, Defense Health Agency, Joint Base Lewis-McChord, 9933 West Hayes Street, Box 339500 MS 34, Tacoma, WA 98433-9500 USA
| | - Rachel Mackey
- Connected Health Branch, U.S. Department of Defense, Defense Health Agency, Joint Base Lewis-McChord, 9933 West Hayes Street, Box 339500 MS 34, Tacoma, WA 98433-9500 USA
| | - Robert Ciulla
- Connected Health Branch, U.S. Department of Defense, Defense Health Agency, Joint Base Lewis-McChord, 9933 West Hayes Street, Box 339500 MS 34, Tacoma, WA 98433-9500 USA
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Wootton AR, McCuistian C, Legnitto Packard DA, Gruber VA, Saberi P. Overcoming Technological Challenges: Lessons Learned from a Telehealth Counseling Study. Telemed J E Health 2019; 26:1278-1283. [PMID: 31800368 DOI: 10.1089/tmj.2019.0191] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Telehealth methods, including video chat counseling, have been growing in popularity within the behavioral health counseling field for over a decade. While video-based counseling methods have been shown to be effective and convenient, they have unique challenges stemming from the technology they use. Technical challenges can negatively impact appointment flow, intervention effectiveness, and the satisfaction of both patients and clinicians. Methodology: The Y2TEC (Youth to Text or Telehealth for Engagement in HIV Care) study is a pilot randomized control trial examining the feasibility and acceptability of a video counseling series provided to young adults (ages 18-29) living with HIV. The study's clinicians provided about 500 video-based counseling sessions through the Zoom videoconferencing platform. The study team then developed recommendations for overcoming technical challenges through a review of the best practice literature, insights from the clinicians and study coordinator, engaging in consultations during supervision meetings, receiving verbal feedback from participants, and reviewing logs of technical challenges. Results: Through our experience, we have found that quality of video-based counseling services can be greatly improved with minor intentional technological modifications in preparation and provision of services. We provide an overview of common challenges and corresponding recommendations to address them. Conclusion: This article can help clinicians improve their quality of telehealth sessions by identifying several common technological challenges that can occur during video chat sessions, exploring the impact of these challenges on session dynamics and providing concise, best practice-based recommendations to mitigate these issues that clinicians face.
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Affiliation(s)
- Angie R Wootton
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA
| | - Caravella McCuistian
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
| | - Dominique A Legnitto Packard
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA
| | - Valerie A Gruber
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
| | - Parya Saberi
- Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA
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García Y, Ferrás C, Rocha Á, Aguilera A. Exploratory Study of Psychosocial Therapies with Text Messages to Mobile Phones in Groups of Vulnerable Immigrant Women. J Med Syst 2019; 43:277. [PMID: 31280404 DOI: 10.1007/s10916-019-1393-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/14/2019] [Indexed: 11/28/2022]
Abstract
Various experimental studies on psychosocial therapy have been carried out through text messages with groups of people suffering from depression, anxiety, alcoholism, addictions, etc., but without distinguishing between men and women or highly vulnerable groups such as immigrants. We present an exploratory study of a mobile communication system which intends to improve the mental, physical and social health of a group of vulnerable immigrant women in Spain (n = 71), distinguishing between an intervention group and a non-equivalent control group. We sent automatic text messages (SMS) to the mobile phones of an intervention group formed by immigrant women who used the social services (n = 44). During a 26-day intervention period, the women received 4 daily automatic text messages on their phones, at a predetermined time. We measured mood and depression symptoms at the beginning and end of the intervention, and analysed the qualitative data to determine the acceptance level of a remote message program. The mood and depression symptoms were measured with the personal health questionnaire-9 (PHQ-9) and were significantly better in the intervention group; they evolved from an initial 9.4 (DS = 6.4, range 1-25) to a 5.0 score at the end of the message period (DS = 4.8); with a significant difference (t (44) = 2.01, p = 7.80). Most women stated that the messages had improved their mood (86.3%), which made them feel more connected to their social environment (65.9%) and that they would like to continue receiving more messages (86.6%).
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Affiliation(s)
- Yolanda García
- Department of Communications Sciences, University of Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain.
| | - Carlos Ferrás
- Department of Geography, University of Santiago de Compostela, Campus Vida s/n, 15782, Santiago de Compostela, Spain
| | - Álvaro Rocha
- Department of Informatics Engineering, University of Coimbra, Coimbra, Portugal
| | - Adrián Aguilera
- School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA
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García Y, Ferrás C, Rocha Á, Aguilera A. Design and acceptability of a psychosocial text messaging intervention for victims of gender-based violence. Health Informatics J 2018; 25:1588-1594. [PMID: 30113247 DOI: 10.1177/1460458218792688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mobile phones can produce detailed and personalized data to help diagnose, treat, prevent or rehabilitate women who are victims of gender violence. We sent automatic text messages, based on cognitive-behavioural therapy, to female victims of gender violence to assess the feasibility of the medium for mental health intervention. During the 28-day intervention period, each woman received four automatic text messages every day on a pre-established schedule. We evaluated symptoms of depression using the Personal Health Questionnaire-9. The Personal Health Questionnaire-9 decreased from an average of 14.8 at the beginning of the intervention, to 6.1 at the end of the text messaging period. All of the women reported that they liked receiving the messages, they found them useful and they felt that the messages had improved their health. Text messages are acceptable to women users who are recipients of public health and social services. Future research should focus more on the evaluation of the results and on how the specific content and aspects of text messaging improve health outcomes.
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Vázquez MYG, Sexto CF, Rocha Á, Aguilera A. Mobile Phones and Psychosocial Therapies with Vulnerable People: a First State of the Art. J Med Syst 2016; 40:157. [PMID: 27194134 DOI: 10.1007/s10916-016-0500-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/15/2016] [Indexed: 11/25/2022]
Abstract
Mobile phones are becoming a communication tool commonly used by people all over the world; and they are started to be adopted in psychosocial therapies involving vulnerable people. We are herein presenting the results of an academic literature review. We identified scientific papers published between 2006 and 2015 resorting to academic databases available on the Internet, applying a systematic selection method based on quality criteria. Secondly, we analysed contents, highlighting the scarcity of research involving vulnerable people. The available literature specialized in psychosocial therapies offers investigation results which involve mobile phones and patients in general, focusing particularly on the clinical psychology field and, to a lesser extent, on the social work field. Particularly significant are the investigation works developed in the United States. In the present paper we introduce a first "state of the art", identifying opportunities and also the limitations surrounding the use of mobile phones in psychosocial therapies targeting the vulnerable. Issues concerning privacy and data confidentiality, and the access of vulnerable people to mobile phones and how they use them, pose significant challenges; but they offer the opportunity to reach isolated or impoverished populations, or even to facilitate access to social and healthcare services. We close this paper formulating possible orientations, hypotheses and goals to design new investigation works involving vulnerable populations.
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Affiliation(s)
- Maria Yolanda García Vázquez
- University of Santiago de Compostela, Idega, University of Santiago de Compostela, Campus Vida s/n, Santiago de Compostela, 15782, Spain.
| | - Carlos Ferrás Sexto
- University of Santiago de Compostela, Idega, Campus Vida s/n, Santiago de Compostela, 15782, Spain
| | - Álvaro Rocha
- University of Coimbra, Informatic Department, Polo II, University of Coimbra, Coimbra, 3004-531, Portugal
| | - Adrián Aguilera
- University of California, School of Social Welfare, UCBerkeley, Haviland Hall, Berkeley, California, 94720, USA
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