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Scott SE, Thompson MJ. "Notification! You May Have Cancer." Could Smartphones and Wearables Help Detect Cancer Early? JMIR Cancer 2024; 10:e52577. [PMID: 38767941 PMCID: PMC11148520 DOI: 10.2196/52577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/12/2024] [Indexed: 05/22/2024] Open
Abstract
This viewpoint paper considers the authors' perspectives on the potential role of smartphones, wearables, and other technologies in the diagnosis of cancer. We believe that these technologies could be valuable additions in the pursuit of early cancer diagnosis, as they offer solutions to the timely detection of signals or symptoms and monitoring of subtle changes in behavior that may otherwise be missed. In addition to signal detection, technologies could assist symptom interpretation and guide and facilitate access to health care. This paper aims to provide an overview of the scientific rationale as to why these technologies could be valuable for early cancer detection, as well as outline the next steps for research and development to drive investigation into the potential for smartphones and wearables in this context and optimize implementation. We draw attention to potential barriers to successful implementation, including the difficulty of the development of signals and sensors with sufficient utility and accuracy through robust research with the target group. There are regulatory challenges; the potential for innovations to exacerbate inequalities; and questions surrounding acceptability, uptake, and correct use by the intended target group and health care practitioners. Finally, there is potential for unintended consequences on individuals and health care services including unnecessary anxiety, increased symptom burden, overinvestigation, and inappropriate use of health care resources.
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Affiliation(s)
- Suzanne E Scott
- Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
| | - Matthew J Thompson
- Department of Family Medicine, University of Washington, Seattle, WA, United States
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Albrechta H, Goodman GR, Oginni E, Mohamed Y, Venkatasubramanian K, Dumas A, Carreiro S, Lee JS, Glynn TR, O'Cleirigh C, Mayer KH, Fisher CB, Chai PR. Acceptance of digital phenotyping linked to a digital pill system to measure PrEP adherence among men who have sex with men with substance use. PLOS DIGITAL HEALTH 2024; 3:e0000457. [PMID: 38386618 PMCID: PMC10883553 DOI: 10.1371/journal.pdig.0000457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/01/2024] [Indexed: 02/24/2024]
Abstract
Once-daily oral HIV pre-exposure prophylaxis (PrEP) is an effective strategy to prevent HIV, but is highly dependent on adherence. Men who have sex with men (MSM) who use substances face unique challenges maintaining PrEP adherence. Digital pill systems (DPS) allow for real-time adherence measurement through ingestible sensors. Integration of DPS technology with other digital health tools, such as digital phenotyping, may improve understanding of nonadherence triggers and development of personalized adherence interventions based on ingestion behavior. This study explored the willingness of MSM with substance use to share digital phenotypic data and interact with ancillary systems in the context of DPS-measured PrEP adherence. Adult MSM on PrEP with substance use were recruited through a social networking app. Participants were introduced to DPS technology and completed an assessment to measure willingness to participate in DPS-based PrEP adherence research, contribute digital phenotyping data, and interact with ancillary systems in the context of DPS-based research. Medical mistrust, daily worry about PrEP adherence, and substance use were also assessed. Participants who identified as cisgender male and were willing to participate in DPS-based research (N = 131) were included in this subsample analysis. Most were White (76.3%) and non-Hispanic (77.9%). Participants who reported daily PrEP adherence worry had 3.7 times greater odds (95% CI: 1.03, 13.4) of willingness to share biometric data via a wearable device paired to the DPS. Participants with daily PrEP adherence worry were more likely to be willing to share smartphone data (p = 0.006) and receive text messages surrounding their daily activities (p = 0.003), compared to those with less worry. MSM with substance use disorder, who worried about PrEP adherence, were willing to use DPS technology and share data required for digital phenotyping in the context of PrEP adherence measurement. Efforts to address medical mistrust can increase advantages of this technology for HIV prevention.
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Affiliation(s)
- Hannah Albrechta
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
| | - Georgia R Goodman
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Elizabeth Oginni
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
| | - Yassir Mohamed
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
| | - Krishna Venkatasubramanian
- Department of Computer Science and Statistics, The University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Arlen Dumas
- Department of Computer Science and Statistics, The University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Stephanie Carreiro
- Department of Emergency Medicine, University of Massachusetts Chan Medical School
| | - Jasper S Lee
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Tiffany R Glynn
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Conall O'Cleirigh
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Celia B Fisher
- Center for Ethics Education, Fordham University, New York City, New York, United States of America
| | - Peter R Chai
- The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
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Li M, McPhillips MV, Szanton SL, Wenzel J, Li J. Electronic Wearable Device Use for Physical Activity in Older Adults: A Qualitative Study. WORK, AGING AND RETIREMENT 2024; 10:25-37. [PMID: 38196825 PMCID: PMC10772964 DOI: 10.1093/workar/waac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Innovative solutions to help older adults increase physical activity are critically important. In this qualitative study, we explored older adults' acceptance, capability, and experiences of using three different types of electronic wearable devices over a period of 4-24 weeks for self-monitoring and promoting physical activity. We conducted 23 semistructured interviews with older adults who participated in three physical activity intervention studies. Two researchers analyzed the data using NVivo version 12, applying a directed content analysis that was partially guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). Six themes emerged: (1) device learning, (2) hedonic motivation, (3) habit and adherence, (4) facilitating conditions, (5) effort expectancy, and (6) performance expectancy. Although most older adults (95.8%) from this study were first-time users, they reflected positive experiences and generally enjoyed using electronic wearable devices. Participants reported issues related to electronic wearable device functionalities that can be improved to better enhance user experience and motivate increased physical activity. Future research should explore the role of electronic wearable devices in older adults' physical activity with an emphasis on behavioral change over time.
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Affiliation(s)
- Mengchi Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | | | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
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Sawyer C, McKeon G, Hassan L, Onyweaka H, Martinez Agulleiro L, Guinart D, Torous J, Firth J. Digital health behaviour change interventions in severe mental illness: a systematic review. Psychol Med 2023; 53:6965-7005. [PMID: 37759417 PMCID: PMC10719689 DOI: 10.1017/s0033291723002064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 09/29/2023]
Abstract
The use of digital technologies as a method of delivering health behaviour change (HBC) interventions is rapidly increasing across the general population. However, the role in severe mental illness (SMI) remains overlooked. In this study, we aimed to systematically identify and evaluate all of the existing evidence around digital HBC interventions in people with an SMI. A systematic search of online electronic databases was conducted. Data on adherence, feasibility, and outcomes of studies on digital HBC interventions in SMI were extracted. Our combined search identified 2196 titles and abstracts, of which 1934 remained after removing duplicates. Full-text screening was performed for 107 articles, leaving 36 studies to be included. From these, 14 focused on physical activity and/or cardio-metabolic health, 19 focused on smoking cessation, and three concerned other health behaviours. The outcomes measured varied considerably across studies. Although over 90% of studies measuring behavioural changes reported positive changes in behaviour/attitudes, there were too few studies collecting data on mental health to determine effects on psychiatric outcomes. Digital HBC interventions are acceptable to people with an SMI, and could present a promising option for addressing behavioural health in these populations. Feedback indicated that additional human support may be useful for promoting adherence/engagement, and the content of such interventions may benefit from more tailoring to specific needs. While the literature does not yet allow for conclusions regarding efficacy for mental health, the available evidence to date does support their potential to change behaviour across various domains.
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Affiliation(s)
- Chelsea Sawyer
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Grace McKeon
- School of Population Health, University of New South Wales, Randwick, NSW 2052, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW 2052, Australia
| | - Lamiece Hassan
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
| | - Henry Onyweaka
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General/Mclean Hospital, Boston, MA, USA
| | - Luis Martinez Agulleiro
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel Guinart
- Hospital del Mar Research Institute, Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Spain
- Department of Psychiatry, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA
| | - John Torous
- Department of Psychiatry, Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Zucker School of Medicine at Northwell/Hofstra, New York, NY, USA
- Department of Psychiatry, Beth Israel Deaconess Hospital, Boston, MA, USA
| | - Joseph Firth
- Division of Psychology and Mental Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9PL, UK
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Grasa E, Seppälä J, Alonso-Solis A, Haapea M, Isohanni M, Miettunen J, Caro Mendivelso J, Almazan C, Rubinstein K, Caspi A, Unoka Z, Farkas K, Usall J, Ochoa S, van der Graaf S, Jewell C, Triantafillou A, Stevens M, Reixach E, Berdun J, Corripio I. m-RESIST, a Mobile Therapeutic Intervention for Treatment-Resistant Schizophrenia: Feasibility, Acceptability, and Usability Study. JMIR Form Res 2023; 7:e46179. [PMID: 37389933 PMCID: PMC10365616 DOI: 10.2196/46179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND In the European Union, around 5 million people are affected by psychotic disorders, and approximately 30%-50% of people with schizophrenia have treatment-resistant schizophrenia (TRS). Mobile health (mHealth) interventions may be effective in preventing relapses, increasing treatment adherence, and managing some of the symptoms of schizophrenia. People with schizophrenia seem willing and able to use smartphones to monitor their symptoms and engage in therapeutic interventions. mHealth studies have been performed with other clinical populations but not in populations with TRS. OBJECTIVE The purpose of this study was to present the 3-month prospective results of the m-RESIST intervention. This study aims to assess the feasibility, acceptability, and usability of the m-RESIST intervention and the satisfaction among patients with TRS after using this intervention. METHODS A prospective multicenter feasibility study without a control group was undertaken with patients with TRS. This study was performed at 3 sites: Sant Pau Hospital (Barcelona, Spain), Semmelweis University (Budapest, Hungary), and Sheba Medical Center and Gertner Institute of Epidemiology and Health Policy Research (Ramat-Gan, Israel). The m-RESIST intervention consisted of a smartwatch, a mobile app, a web-based platform, and a tailored therapeutic program. The m-RESIST intervention was delivered to patients with TRS and assisted by mental health care providers (psychiatrists and psychologists). Feasibility, usability, acceptability, and user satisfaction were measured. RESULTS This study was performed with 39 patients with TRS. The dropout rate was 18% (7/39), the main reasons being as follows: loss to follow-up, clinical worsening, physical discomfort of the smartwatch, and social stigma. Patients' acceptance of m-RESIST ranged from moderate to high. The m-RESIST intervention could provide better control of the illness and appropriate care, together with offering user-friendly and easy-to-use technology. In terms of user experience, patients indicated that m-RESIST enabled easier and quicker communication with clinicians and made them feel more protected and safer. Patients' satisfaction was generally good: 78% (25/32) considered the quality of service as good or excellent, 84% (27/32) reported that they would use it again, and 94% (30/32) reported that they were mostly satisfied. CONCLUSIONS The m-RESIST project has provided the basis for a new modular program based on novel technology: the m-RESIST intervention. This program was well-accepted by patients in terms of acceptability, usability, and satisfaction. Our results offer an encouraging starting point regarding mHealth technologies for patients with TRS. TRIAL REGISTRATION ClinicalTrials.gov NCT03064776; https://clinicaltrials.gov/ct2/show/record/NCT03064776. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2017-021346.
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Affiliation(s)
- Eva Grasa
- Mental Health, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Jussi Seppälä
- Social Insurance Institution of Finland, Kuopio, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Anna Alonso-Solis
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Division, Fundació Althaia, Xarxa Assistencial Universitaria de Manresa, Manresa, Spain
| | - Marianne Haapea
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Matti Isohanni
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Cari Almazan
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain
| | - Katya Rubinstein
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Asaf Caspi
- The Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Kinga Farkas
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | | | | | | | - Matthias Stevens
- EDiT Department, imec, Ghent/Antwerp, Belgium
- Solutions Department, imec, Leuven, Belgium
| | - Elisenda Reixach
- TicSalut Health Department, Generalitat de Catalunya, Barcelona, Spain
| | - Jesus Berdun
- Digital Health Unit, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health and Psychiatry Department, Vic Hospital Consortium, Vic, Spain
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Tang D, Wang H, Gu D, Ye L, Sun S, Li H. The fudan tinnitus relieving system application for tinnitus management. BMC Med Inform Decis Mak 2023; 23:76. [PMID: 37085904 PMCID: PMC10122343 DOI: 10.1186/s12911-023-02164-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/31/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE Tinnitus is a highly prevalent hearing disorder, and the burden of tinnitus diagnosis and treatment is very heavy, especially in China. In order to better benefit the majority of tinnitus patients, we developed a new mobile app based on our patented invention - named the Fudan Tinnitus Relieving System (FTRS) - for tinnitus management. The FTRS app aims to alleviate patients' tinnitus symptoms using customized sound therapy, to evaluate the treatment effect, to provide a doctor-patient communication platform, and to support tinnitus rehabilitation and auditory health. METHODS In this study, we introduced the major functions of the FTRS app, analyzed the geographical distribution of users around China, and performed an analysis on the demographic and clinical characteristics of patients with tinnitus, including age and tinnitus position, duration, frequency, and severity in both men and women based on the user information collected by the FTRS. The data for 22,867 participants (males: 13,715; females: 9,152) were included in the statistical analysis. RESULTS The FTRS app has been popular with tinnitus patients since its launch in May 2018 with its integrated pitch-matching test, individualized sound therapy, follow-up assessment, and provision of easy-to-understand science and education for tinnitus. The users were located throughout Mainland China but primarily concentrated in Shanghai, Jiangsu, Zhejiang, Guangdong, and Shandong provinces. We observed gender differences regarding age and tinnitus frequency, severity, and position among the app's users. The FTRS has not only facilitated patients' access to treatment at times and places that are convenient for them, but also provides a large amount of data based on user feedback in order to support clinical tinnitus research. CONCLUSIONS Compared with traditional face-to-face medical treatment, the FTRS greatly reduced medical costs and enabled patients with tinnitus to arrange their own treatment times. At the same time, the FTRS has provided standardized tinnitus data that have laid a foundation for clinical research on tinnitus. However, because of differences in the popularity and utilization of smart devices, FTRS user data might only reflect the situation of tinnitus patients who can effectively use smart devices. Therefore, the findings of this study need to be interpreted with caution.
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Affiliation(s)
- Dongmei Tang
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China
- Institutes of Biomedical Sciences, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, PR China
- NHC Key Laboratory of Hearing Medicine, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China
- Shanghai ZEHNIT Medical Technology Co., Ltd, 908 Ziping Road, Shanghai, 201203, PR China
| | - Haiyan Wang
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China
| | - Dantong Gu
- Clinical Research Unit of Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China
| | - Lei Ye
- Clinical Research Unit of Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China
| | - Shan Sun
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China.
- Institutes of Biomedical Sciences, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, PR China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China.
| | - Huawei Li
- ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China.
- Institutes of Biomedical Sciences, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, PR China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China.
- Clinical Research Unit of Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, PR China.
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, PR China.
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Rocheteau E. On the role of artificial intelligence in psychiatry. Br J Psychiatry 2023; 222:54-57. [PMID: 36093950 DOI: 10.1192/bjp.2022.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Recently, there has been growing interest in artificial intelligence (AI) to improve efficiency and personalisation of mental health services. So far, the progress has been slow, however, advancements in deep learning may change this. This paper discusses the role for AI in psychiatry, in particular (a) diagnosis tools, (b) monitoring of symptoms, and (c) delivering personalised treatment recommendations. Finally, I discuss ethical concerns and technological limitations.
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Affiliation(s)
- Emma Rocheteau
- School of Clinical Medicine, University of Cambridge, UK; and Department of Computer Science and Technology, University of Cambridge, UK
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Ahmed A, Aziz S, Alzubaidi M, Schneider J, Irshaidat S, Abu Serhan H, Abd-Alrazaq AA, Solaiman B, Househ M. Wearable devices for anxiety & depression: A scoping review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE UPDATE 2023; 3:100095. [PMID: 36743720 PMCID: PMC9884643 DOI: 10.1016/j.cmpbup.2023.100095] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background The rates of mental health disorders such as anxiety and depression are at an all-time high especially since the onset of COVID-19, and the need for readily available digital health care solutions has never been greater. Wearable devices have increasingly incorporated sensors that were previously reserved for hospital settings. The availability of wearable device features that address anxiety and depression is still in its infancy, but consumers will soon have the potential to self-monitor moods and behaviors using everyday commercially-available devices. Objective This study aims to explore the features of wearable devices that can be used for monitoring anxiety and depression. Methods Six bibliographic databases, including MEDLINE, EMBASE, PsycINFO, IEEE Xplore, ACM Digital Library, and Google Scholar were used as search engines for this review. Two independent reviewers performed study selection and data extraction, while two other reviewers justified the cross-checking of extracted data. A narrative approach for synthesizing the data was utilized. Results From 2408 initial results, 58 studies were assessed and highlighted according to our inclusion criteria. Wrist-worn devices were identified in the bulk of our studies (n = 42 or 71%). For the identification of anxiety and depression, we reported 26 methods for assessing mood, with the State-Trait Anxiety Inventory being the joint most common along with the Diagnostic and Statistical Manual of Mental Disorders (n = 8 or 14%). Finally, n = 26 or 46% of studies highlighted the smartphone as a wearable device host device. Conclusion The emergence of affordable, consumer-grade biosensors offers the potential for new approaches to support mental health therapies for illnesses such as anxiety and depression. We believe that purposefully-designed wearable devices that combine the expertise of technologists and clinical experts can play a key role in self-care monitoring and diagnosis.
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Affiliation(s)
- Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mahmood Alzubaidi
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Jens Schneider
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | | | | | - Alaa A Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Barry Solaiman
- College of Law, Hamad Bin Khalifa University, Doha, Qatar
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
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Nicol G, Jansen M, Haddad R, Ricchio A, Yingling MD, Schweiger JA, Keenoy K, Evanoff BA, Newcomer JW. Use of an Interactive Obesity Treatment Approach in Individuals With Severe Mental Illness: Feasibility, Acceptability, and Proposed Engagement Criteria. JMIR Form Res 2022; 6:e38496. [PMID: 36512399 PMCID: PMC9795399 DOI: 10.2196/38496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Digital and mobile health interventions are increasingly being used to support healthy lifestyle change, including in certain high-risk populations such as those with severe mental illnesses (SMIs). Life expectancy in this population lags 15 years behind counterparts in the general population, primarily due to obesity-related health conditions. OBJECTIVE We tested the feasibility and usability of a 12-week interactive obesity treatment approach (iOTA) to adults with chronic SMIs (depression, bipolar disorder and schizophrenia spectrum disorder) receiving treatment in community settings. The iOTA incorporates short message service (SMS) text messages to supplement monthly in-person health coaching. METHODS Factors hypothesized to be associated with weight change were illness severity and treatment engagement. Severe psychiatric symptoms were defined as baseline Clinical Global Impression severity score of >5. Criterion engagement was defined as a text messaging response rate >80% during the first 4 weeks of treatment. Disordered eating, assessed with the Loss of Control Over Eating Scores, was also evaluated. Participants provided qualitative data, further informing assessment of intervention feasibility, usability, and acceptability. RESULTS A total of 26 participants were enrolled. The mean age was 48.5 (SD 15.67) years; 40% (10/26) were Black and 60% (15/26) female. Participants with lower symptom severity and adequate engagement demonstrated significantly decreased weight (F1,16=22.54, P<.001). Conversely, high symptom severity and lower text message response rates were associated with trend-level increases in weight (F1,7=4.33, P=.08). Loss-of-control eating was not observed to impact treatment outcome. Participants voiced preference for combination of live health coaching and text messaging, expressing desire for personalized message content. CONCLUSIONS These results demonstrate the feasibility of delivering an adapted iOTA to SMI patients receiving care in community settings and suggest testable criteria for defining sufficient treatment engagement and psychiatric symptom severity, two factors known to impact weight loss outcomes. These important findings suggest specific adaptations may be needed for optimal treatment outcomes in individuals with SMI.
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Affiliation(s)
- Ginger Nicol
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Madeline Jansen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Los Angeles David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Rita Haddad
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
| | - Amanda Ricchio
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
| | - Michael D Yingling
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
| | - Julia A Schweiger
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
| | - Katie Keenoy
- Washington University School of Medicine, St. Louis, MO, United States
| | - Bradley A Evanoff
- Division of General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - John W Newcomer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
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10
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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11
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Griffiths C, da Silva KM, Leathlean C, Jiang H, Ang CS, Searle R. Investigation of physical activity, sleep, and mental health recovery in treatment resistant depression (TRD) patients receiving repetitive transcranial magnetic stimulation (rTMS) treatment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 8:100337. [PMID: 35619990 PMCID: PMC9025392 DOI: 10.1016/j.jadr.2022.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 02/12/2022] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) is effective in treating depression; however, the effect on physical activity, sleep and recovery is unclear. This study investigated rTMS effect on physical activity and sleep through providing patients with a Fitbit and software apps; and reports the impact of rTMS on depression, anxiety and mental health recovery. Methods Study design was a pre and post data collection without a control, with twenty-four participants with treatment-resistant depression (TRD). Measures used were Fitbit activity and sleep data, and patient-rated Recovering Quality of Life (ReQoL-20), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder (GAD-7). Results Response and remission rates were, respectively: 34.8% and 39% for PHQ-9; 34.8% and 47.8% for GAD-7. ReQoL-20 response and reliable improvement were 29.4% and 53%. PHQ-9, GAD-7 and ReQol-20 scores significantly improved, with large effect sizes. Analysis of Fitbit activity and sleep data yielded non-significant results. The Fitbit data machine learning model classified two levels of depression to 82% accuracy. Limitations rTMS treatment was open-label and adjunct to existing antidepressant medication. No control group. Female patients were overrepresented. Conclusions Improvements on the ReQoL-20 and aspects of sleep and activity indicate the positive impact of rTMS on the individual's real world functioning and quality of life. A wearable activity tracker can provide feedback to patients and clinicians on sleep, physical activity and depression levels. Further research could be undertaken through a sufficiently powered RCT comparing rTMS versus rTMS with use of a Fitbit, its software applications, and sleep and physical activity advice.
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Affiliation(s)
- Chris Griffiths
- Northamptonshire Healthcare NHS Foundation Trust, United Kingdom
| | | | - Chloe Leathlean
- Northamptonshire Healthcare NHS Foundation Trust, United Kingdom
| | - Harmony Jiang
- Northamptonshire Healthcare NHS Foundation Trust, United Kingdom
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12
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Germini F, Noronha N, Borg Debono V, Abraham Philip B, Pete D, Navarro T, Keepanasseril A, Parpia S, de Wit K, Iorio A. Accuracy and Acceptability of Wrist-Wearable Activity-Tracking Devices: Systematic Review of the Literature. J Med Internet Res 2022; 24:e30791. [PMID: 35060915 PMCID: PMC8817215 DOI: 10.2196/30791] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/24/2021] [Accepted: 12/06/2021] [Indexed: 01/19/2023] Open
Abstract
Background Numerous wrist-wearable devices to measure physical activity are currently available, but there is a need to unify the evidence on how they compare in terms of acceptability and accuracy. Objective The aim of this study is to perform a systematic review of the literature to assess the accuracy and acceptability (willingness to use the device for the task it is designed to support) of wrist-wearable activity trackers. Methods We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and SPORTDiscus for studies measuring physical activity in the general population using wrist-wearable activity trackers. We screened articles for inclusion and, for the included studies, reported data on the studies’ setting and population, outcome measured, and risk of bias. Results A total of 65 articles were included in our review. Accuracy was assessed for 14 different outcomes, which can be classified in the following categories: count of specific activities (including step counts), time spent being active, intensity of physical activity (including energy expenditure), heart rate, distance, and speed. Substantial clinical heterogeneity did not allow us to perform a meta-analysis of the results. The outcomes assessed most frequently were step counts, heart rate, and energy expenditure. For step counts, the Fitbit Charge (or the Fitbit Charge HR) had a mean absolute percentage error (MAPE) <25% across 20 studies. For heart rate, the Apple Watch had a MAPE <10% in 2 studies. For energy expenditure, the MAPE was >30% for all the brands, showing poor accuracy across devices. Acceptability was most frequently measured through data availability and wearing time. Data availability was ≥75% for the Fitbit Charge HR, Fitbit Flex 2, and Garmin Vivofit. The wearing time was 89% for both the GENEActiv and Nike FuelBand. Conclusions The Fitbit Charge and Fitbit Charge HR were consistently shown to have a good accuracy for step counts and the Apple Watch for measuring heart rate. None of the tested devices proved to be accurate in measuring energy expenditure. Efforts should be made to reduce the heterogeneity among studies.
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Affiliation(s)
- Federico Germini
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Noella Noronha
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- School of Interdisciplinary Sciences, McMaster University, Hamilton, ON, Canada
| | - Victoria Borg Debono
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Binu Abraham Philip
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Drashti Pete
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Tamara Navarro
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Arun Keepanasseril
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Sameer Parpia
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Kerstin de Wit
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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13
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Na L, Sheu JJ. Health and Information Disparities among Non-Adopters of Smartphones. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Jameel L, Valmaggia L, Barnes G, Cella M. mHealth technology to assess, monitor and treat daily functioning difficulties in people with severe mental illness: A systematic review. J Psychiatr Res 2021; 145:35-49. [PMID: 34856524 DOI: 10.1016/j.jpsychires.2021.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/18/2021] [Accepted: 11/20/2021] [Indexed: 11/21/2022]
Abstract
Severe mental illness (SMI) is associated with poor daily functioning; however available interventions currently under-deliver on their recovery prospect. Mobile digital health (mHealth) interventions are increasingly being developed and evaluated, and have the potential to support recovery. This review evaluates the use of mHealth technology to assess, monitor and reduce functioning difficulties in people with SMI. Studies were systematically searched on multiple databases. Study quality was assessed and double-rated independently. Findings were organised using a narrative synthesis and results were summarised according to the mHealth device purpose, i.e., assessment and monitoring or intervention. Thirty-eight studies comprised of 2262 participants met the inclusion criteria. Smartphones were the most popular mHealth device; personal digital assistants, wearables and tablets were also used. mHealth was widely found to be acceptable and feasible, with preliminary findings suggesting it can support functional recovery by augmenting an intervention, simplifying the assessment, increasing monitoring frequency and/or providing more detailed information. Considerations for overcoming barriers to implementation, recommendations for future research to establish effectiveness, personalisation and specification of mHealth devices and methodologies are discussed. The value of mHealth for remote delivery of recovery based interventions is also considered.
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Affiliation(s)
- Leila Jameel
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Lucia Valmaggia
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Katholieke Leuven Universitet, Belgium
| | - Georgina Barnes
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Matteo Cella
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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15
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Mughal F, Raffe W, Stubbs P, Kneebone I, Garcia J. Fitbits for monitoring depressive symptoms in older aged persons: Qualitative outcomes of a feasibility study (Preprint). JMIR Form Res 2021; 6:e33952. [DOI: 10.2196/33952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 04/06/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
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16
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Onyeaka H, Firth J, Enemuo V, Muoghalu C, Naslund J, Baiden P, Torous J. Exploring the Association Between Electronic Wearable Device Use and Levels of Physical Activity Among Individuals With Depression and Anxiety: A Population Level Study. Front Digit Health 2021; 3:707900. [PMID: 34713178 PMCID: PMC8521960 DOI: 10.3389/fdgth.2021.707900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
Abstract
Aim: The present study aimed to investigate the cross-sectional association between self-reported use of electronic wearable devices (EWDs) and the levels of physical activity among a representative sample of adults with depression and anxiety in the United States. Methods: For this cross-sectional study, data were pooled from the Health Information National Trends Survey 2019. A sample of 1,139 adults with self-reported depression and anxiety (60.9% women; mean age of 52.5 years) was analyzed. The levels of physical activity and prevalence of EWD utilization were self-reported. The chi-square tests were used to compare individual characteristics through the use of EWDs. Multivariable logistic regression was employed to investigate the association between EWDs and physical activity levels while adjusting for sociodemographic and health-related factors. Results: From the 1,139 adults with self-reported depression and anxiety, 261 (weighted percentage 28.1%) endorsed using EWD in the last year. After adjusting for covariates, the use of EWDs was only significantly associated with a higher odds of reporting intention to lose weight (OR 2.12; 95% CI 1.04, 4.35; p = 0.04). We found no association between the use of EWDs and meeting the national weekly recommendation for physical activity or resistance/strength exercise training. Conclusion: About three in 10 adults suffering from depression and anxiety in the United States reported using EWDs in the last year. The current study findings indicate that among people living with mental illness, EWD use is associated with higher odds of weight loss intent suggesting that EWDs may serve as an opening for the clinical interactions around physical health through identifying patients primed for behavior change. Further large-scale studies using randomized trial designs are needed to examine the causal relationships between EWDs and the physical activity of people with mental health conditions.
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Affiliation(s)
- Henry Onyeaka
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Joe Firth
- Division of Psychology and Mental Health, The University of Manchester, Manchester, United Kingdom
| | | | | | - John Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Philip Baiden
- School of Social Work, University of Texas at Arlington, Arlington, TX, United States
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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17
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Ahmed A, Aziz S, Alzubaidi M, Schneider J, Irshaidat S, Abu Serhan H, Abd-alrazaq A, Solaiman B, Househ M. Features of wearable devices used for Anxiety & Depression: A scoping review (Preprint).. [DOI: 10.2196/preprints.33287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
The rates of mental health disorders such as anxiety and depression are at an all time high and the need for readily available digital health care solutions has never been greater. Wearable devices (WD) have seen a steady rise in the usage of sensors previously reserved for hospital settings. The availibity of features that make use of WDs for anxiety and depression is in its infancy, but we are seeing the potential for consumers to self monitor moods and behaviours with everyday commercially available devices and the ability to self-regulate their health needs.
OBJECTIVE
This study aims to explore features of wearable devices (WDs) used for anxiety and depression
METHODS
We have searched the following six bibliographic databases while conducting this review: MEDLINE, EMBASE, PsycINFO, IEEE Xplore, ACM Digital Library, and Google Scholar. Two reviewers independently performed study selection and data extraction; two other individual reviewers justified cross-checking of extracted data. We utilized a narrative approach for synthesizing the data.
RESULTS
From an initial 2,408 studies we assess and report the features in 58 studies that were highlighted according to our inclusion criteria. Wrist worn devices were identified in the bulk of our studies (n=42 or 71%). Depression was assessed in most of the studies (n=27 or 47%), whereas anxiety was assessed in n=15 or 25% of studies. More than a quarter (n=16 or 27%) of the included studies assessed both mental disorders. Finally n=26 or 46% of studies highlighted the wearable device host device as a smartphone.
CONCLUSIONS
The emergence of affordable, consumer-grade biosensors offers the potential for new approaches to support mental health therapies such as anxiety and depression. We see WDs having real potential in aiding with self-care and with purposefully designed WDs that combine the expertise of technologists and clinical experts WDs could play a key role in self-care monitoring and diagnosis.
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18
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Chapman JJ, Hielscher E, Patterson S, Reavley N, Brown WJ, Wyder M, Childs S, Russell A, Suetani S, Scott JG. Preferences of people with mental illness for engaging in exercise programs under COVID-19 restrictions. Australas Psychiatry 2021; 29:175-179. [PMID: 33380159 PMCID: PMC7780068 DOI: 10.1177/1039856220975299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES People with mental illness may be vulnerable to decline in mental health and reduced physical activity because of the COVID-19 pandemic and associated restrictions. The aim of this study was to inform the design of physical activity interventions for implementation under these conditions to improve/maintain well-being and physical activity in this population. METHODS People with mental illness who had participated in a physical activity program prior to the pandemic were invited to complete a survey about the impact of COVID-19 on mental health and physical activity and their preferences for engaging in a physical activity program under pandemic-related restrictions. RESULTS More than half the 59 respondents reported worse mental health and lower physical activity during the pandemic. The preferred format for a physical activity program was one-on-one exercise instruction in-person in a park. Program components endorsed as helpful included incentivization, provision of exercise equipment and fitness devices, and daily exercise programs. About a third of the participants reported limitations in using technology for a physical activity program. CONCLUSIONS In-person exercise support is preferred by people with mental illnesses during pandemic-related restrictions. Enablement strategies such as providing equipment and self-monitoring devices should be utilized; assistance may be needed to incorporate the use of technology in exercise programs.
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Affiliation(s)
- Justin J Chapman
- QIMR Berghofer Medical Research Institute, Australia.,Metro South Addiction and Mental Health Service, Australia.,Queensland Police-Citizens Youth Welfare Association, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | | | | | | | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Marianne Wyder
- Metro South Addiction and Mental Health Service, Australia
| | - Sarah Childs
- Queensland Alliance for Mental Health, Australia
| | | | - Shuichi Suetani
- Metro South Addiction and Mental Health Service, Australia.,School of Medicine, Griffith University, Australia.,School of Medicine, The University of Queensland, Australia
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Australia.,Metro North Mental Health Service, Australia.,School of Medicine, The University of Queensland, Australia
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19
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Integration of a smartwatch within an internet-delivered intervention for depression: Protocol for a feasibility randomized controlled trial on acceptance. Contemp Clin Trials 2021; 103:106323. [PMID: 33621632 DOI: 10.1016/j.cct.2021.106323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/01/2021] [Accepted: 02/12/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Mood tracking is commonly employed within a range of mental health interventions. Physical activity and sleep are also important for contextualizing mood data but can be difficult to track manually and rely on retrospective recall. Smartwatches could enhance self-monitoring by addressing difficulties in recall of sleep and physical activity and reducing the burden on patients in terms of remembering to track and the effort of tracking. This feasibility study will explore the acceptance of a smartwatch app for self-monitoring of mood, sleep, and physical activity, in an internet-based cognitive-behavioral therapy (iCBT) for depression offered in a routine care setting. METHODS Seventy participants will be randomly allocated to (i) iCBT intervention plus smartwatch app or (ii) iCBT intervention alone. Patient acceptance will be measured longitudinally using a theory-based acceptance questionnaire to understand and compare the evolution of acceptance of the technology-delivered self-report in the two groups. A post-treatment interview will explore participants subjective experience of using the smartwatch. Engagement with the intervention, including self-report, and clinical outcomes, will be measured across both groups to assess for any differences. IMPLICATIONS This is the first study investigating the evolution of patient acceptance of smartwatch self-report in an iCBT delivered intervention in a clinical sample. Through an engaging and convenient means of capturing ecologically valid mood data, the study has the potential to show that smartwatches are an acceptable means for patient self-monitoring within iCBT interventions for depression and support potential use-cases for smartwatches in the context of mental health interventions in general. Prospectively registered at ClinicalTrials.gov (NCT04568317).
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20
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Griffiths H. The Acceptability and Feasibility of Using Text Messaging to Support the Delivery of Physical Health Care in those Suffering from a Psychotic Disorder: a Review of the Literature. Psychiatr Q 2020; 91:1305-1316. [PMID: 32970312 PMCID: PMC7593303 DOI: 10.1007/s11126-020-09847-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 12/11/2022]
Abstract
Those suffering with serious mental illness (SMI), such as psychotic disorders, experience life expectancy 15 years shorter than the general population. Cardiovascular disease is the biggest cause of death in those with psychotic disease and many risk factors may be limited by healthy lifestyle choices. Text messaging interventions represent mobile health (mHealth), a nascent way to deliver physical health care to those suffering with a psychotic disorder. This paper aims to review the literature on the feasibility of text messaging to support the delivery of physical health care in those with a psychotic disorder. A thorough electronic database literature review of Medline via Ovid, Embase, APA Psycinfo, Scopus, Cochrane and Web of Science was conducted. Articles were included if text messaging was used as an intervention targeting the physical health of patients with psychotic disorders. A final sample of 11 articles satisfied the eligibility criteria, of which, 3 were ongoing randomised controlled trials. Of the 8 completed trials, all demonstrated the promising feasibility of text messaging, assessed via quotes, conversation samples, response rates, questionnaires or directly based on physical results. 36% of studies analysed those with schizophrenia or schizoaffective disorder, 55% with SMI and 9% with schizophrenia and psychotic disorders, mood disorders or anxiety disorders. Text messaging was used as motivation or reminders (91%), service delivery (27%) or social support (27%) with studies targeting multiple themes simultaneously. This review highlights compelling evidence for the feasibility of text messaging for improvement of physical health in those suffering with psychotic disorders.
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21
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Mehdi M, Dode A, Pryss R, Schlee W, Reichert M, Hauck FJ. Contemporary Review of Smartphone Apps for Tinnitus Management and Treatment. Brain Sci 2020; 10:brainsci10110867. [PMID: 33212928 PMCID: PMC7698350 DOI: 10.3390/brainsci10110867] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/30/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
Tinnitus is a complex and heterogeneous psycho-physiological disorder responsible for causing a phantom ringing or buzzing sound albeit the absence of an external sound source. It has a direct influence on affecting the quality of life of its sufferers. Despite being around for a while, there has not been a cure for tinnitus, and the usual course of action for its treatment involves use of tinnitus retaining and sound therapy, or Cognitive Behavioral Therapy (CBT). One positive aspect about these therapies is that they can be administered face-to-face as well as delivered via internet or smartphone. Smartphones are especially helpful as they are highly personalized devices, and offer a well-established ecosystem of apps, accessible via respective marketplaces of differing mobile platforms. Note that current therapeutic treatments such as CBT have shown to be effective in suppressing the tinnitus symptoms when administered face-to-face, their effectiveness when being delivered using smartphones is not known so far. A quick search on the prominent market places of popular mobile platforms (Android and iOS) yielded roughly 250 smartphone apps offering tinnitus-related therapies and tinnitus management. As this number is expected to steadily increase due to high interest in smartphone app development, a contemporary review of such apps is crucial. In this paper, we aim to review scientific studies validating the smartphone apps, particularly to test their effectiveness in tinnitus management and treatment. We use the PRISMA guidelines for identification of studies on major scientific literature sources and delineate the outcomes of identified studies.
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Affiliation(s)
- Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, 89081 Ulm, Germany
- Correspondence: (M.M.); (F.J.H.)
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.)
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany;
| | - Winfried Schlee
- Clinic and Polyclinic for Psychiatry and Psychotherapy, 93053 Regensburg, Germany;
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.)
| | - Franz J. Hauck
- Institute of Distributed Systems, Ulm University, 89081 Ulm, Germany
- Correspondence: (M.M.); (F.J.H.)
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Bruen AJ, Wall A, Haines-Delmont A, Perkins E. Exploring Suicidal Ideation Using an Innovative Mobile App-Strength Within Me: The Usability and Acceptability of Setting up a Trial Involving Mobile Technology and Mental Health Service Users. JMIR Ment Health 2020; 7:e18407. [PMID: 32985995 PMCID: PMC7551108 DOI: 10.2196/18407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/07/2020] [Accepted: 07/21/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Suicide is a growing global public health problem that has resulted in an increase in the demand for psychological services to address mental health issues. It is expected that 1 in 6 people on a waiting list for mental health services will attempt suicide. Although suicidal ideation has been shown to be linked to a higher risk of death by suicide, not everybody openly discloses their suicidal thoughts or plans to friends and family or seeks professional help before suicide. Therefore, new methods are needed to track suicide risk in real time together with a better understanding of the ways in which people communicate or express their suicidality. Considering the dynamic nature and challenges in understanding suicide ideation and suicide risk, mobile apps could be better suited to prevent suicide as they have the ability to collect real-time data. OBJECTIVE This study aims to report the practicalities and acceptability of setting up and trialing digital technologies within an inpatient mental health setting in the United Kingdom and highlight their implications for future studies. METHODS Service users were recruited from 6 inpatient wards in the north west of England. Service users who were eligible to participate and provided consent were given an iPhone and Fitbit for 7 days and were asked to interact with a novel phone app, Strength Within Me (SWiM). Interaction with the app involved journaling (recording daily activities, how this made them feel, and rating their mood) and the option to create safety plans for emotions causing difficulties (identifying strategies that helped with these emotions). Participants also had the option to allow the study to access their personal Facebook account to monitor their social media use and activity. In addition, clinical data (ie, assessments conducted by trained researchers targeting suicidality, depression, and sleep) were also collected. RESULTS Overall, 43.0% (80/186 response rate) of eligible participants were recruited for the study. Of the total sample, 67 participants engaged in journaling, with the average number of entries per user being 8.2 (SD 8.7). Overall, only 24 participants created safety plans and the most common difficult emotion to be selected was feeling sad (n=21). This study reports on the engagement with the SWiM app, the technical difficulties the research team faced, the importance of building key relationships, and the implications of using Facebook as a source to detect suicidality. CONCLUSIONS To develop interventions that can be delivered in a timely manner, prediction of suicidality must be given priority. This paper has raised important issues and highlighted lessons learned from implementing a novel mobile app to detect the risk of suicidality for service users in an inpatient setting.
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Affiliation(s)
- Ashley Jane Bruen
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Abbie Wall
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Alina Haines-Delmont
- Department of Nursing, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Elizabeth Perkins
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
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23
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Drissi N, Ouhbi S, Janati Idrissi MA, Fernandez-Luque L, Ghogho M. Connected Mental Health: Systematic Mapping Study. J Med Internet Res 2020; 22:e19950. [PMID: 32857055 PMCID: PMC7486675 DOI: 10.2196/19950] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/02/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers. OBJECTIVE The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database. METHODS A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted. RESULTS The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted. CONCLUSIONS CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.
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Affiliation(s)
- Nidal Drissi
- Department of Computer Science and Software Engineering, United Arab Emirates University, Al Ain, United Arab Emirates.,National School For Computer Science, Mohammed V University in Rabat, Rabat, Morocco
| | - Sofia Ouhbi
- Department of Computer Science and Software Engineering, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | - Mounir Ghogho
- TICLab, International University of Rabat, Rabat, Morocco
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24
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Mehdi M, Stach M, Riha C, Neff P, Dode A, Pryss R, Schlee W, Reichert M, Hauck FJ. Smartphone and Mobile Health Apps for Tinnitus: Systematic Identification, Analysis, and Assessment. JMIR Mhealth Uhealth 2020; 8:e21767. [PMID: 32808939 PMCID: PMC7463412 DOI: 10.2196/21767] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023] Open
Abstract
Background Modern smartphones contain sophisticated high-end hardware features, offering high computational capabilities at extremely manageable costs and have undoubtedly become an integral part in users' daily life. Additionally, smartphones offer a well-established ecosystem that is easily discoverable and accessible via the marketplaces of differing mobile platforms, thus encouraging the development of many smartphone apps. Such apps are not exclusively used for entertainment purposes but are also commonplace in health care and medical use. A variety of those health and medical apps exist within the context of tinnitus, a phantom sound perception in the absence of any physical external source. Objective In this paper, we shed light on existing smartphone apps addressing tinnitus by providing an up-to-date overview. Methods Based on PRISMA guidelines, we systematically searched and identified existing smartphone apps on the most prominent app markets, namely Google Play Store and Apple App Store. In addition, we applied the Mobile App Rating Scale (MARS) to evaluate and assess the apps in terms of their general quality and in-depth user experience. Results Our systematic search and screening of smartphone apps yielded a total of 34 apps (34 Android apps, 26 iOS apps). The mean MARS scores (out of 5) ranged between 2.65-4.60. The Tinnitus Peace smartphone app had the lowest score (mean 2.65, SD 0.20), and Sanvello—Stress and Anxiety Help had the highest MARS score (mean 4.60, SD 0.10). The interrater agreement was substantial (Fleiss κ=0.74), the internal consistency was excellent (Cronbach α=.95), and the interrater reliability was found to be both high and excellent—Guttman λ6=0.94 and intraclass correlation, ICC(2,k) 0.94 (95% CI 0.91-0.97), respectively. Conclusions This work demonstrated that there exists a plethora of smartphone apps for tinnitus. All of the apps received MARS scores higher than 2, suggesting that they all have some technical functional value. However, nearly all identified apps were lacking in terms of scientific evidence, suggesting the need for stringent clinical validation of smartphone apps in future. To the best of our knowledge, this work is the first to systematically identify and evaluate smartphone apps within the context of tinnitus.
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Affiliation(s)
- Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Constanze Riha
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Clinic and Policlinic for Psychiatry and Psychotherapy, Regensburg, Germany.,URPP Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Winfried Schlee
- Clinic and Policlinic for Psychiatry and Psychotherapy, Regensburg, Germany
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Franz J Hauck
- Institute of Distributed Systems, Ulm University, Ulm, Germany
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Krzyzanowski MC, Kizakevich PN, Duren-Winfield V, Eckhoff R, Hampton J, Blackman Carr LT, McCauley G, Roberson KB, Onsomu EO, Williams J, Price AA. Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study. JMIR Mhealth Uhealth 2020; 8:e15156. [PMID: 32755883 PMCID: PMC7439144 DOI: 10.2196/15156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND With the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majority of American adults fail to meet daily recommendations for healthy behavior. Testing user engagement with an app in a controlled environment can provide insight into what is effective and not effective in an app focused on improving diet and exercise. OBJECTIVE We developed Rams Have Heart, a mobile app, to support a cardiovascular disease (CVD) intervention course. The app tracks healthy behaviors, including fruit and vegetable consumption and physical activity, throughout the day. This paper aimed to present its functionality and evaluated adherence among the African American college student population. METHODS We developed the app using the Personal Health Informatics and Intervention Toolkit, a software framework. Rams Have Heart integrates self-reported health screening with health education, diary tracking, and user feedback modules to acquire data and assess progress. The parent study, conducted at a historically black college and university-designated institution in southeastern United States, consisted of a semester-long intervention administered as an academic course in the fall, for 3 consecutive years. Changes were made after the cohort 1 pilot study, so results only include cohorts 2 and 3, comprising a total of 115 students (n=55 intervention participants and n=54 control participants) aged from 17 to 24 years. Data collected over the study period were transferred using the secure Hypertext Transfer Protocol Secure protocol and stored in a secure Structured Query Language server database accessible only to authorized persons. SAS software was used to analyze the overall app usage and the specific results collected. RESULTS Of the 55 students in the intervention group, 27 (49%) students in cohort 2 and 25 (45%) in cohort 3 used the Rams Have Heart app at least once. Over the course of the fall semester, app participation dropped off gradually until exam week when most students no longer participated. The average fruit and vegetable intake increased slightly, and activity levels decreased over the study period. CONCLUSIONS Rams Have Heart was developed to allow daily tracking of fruit and vegetable intake and physical activity to support a CVD risk intervention for a student demographic susceptible to obesity, heart disease, and type 2 diabetes. We conducted an analysis of app usage, function, and user results. Although a mobile app provides privacy and flexibility for user participation in a research study, Rams Have Heart did not improve compliance or user outcomes. Health-oriented research studies relying on apps in support of user goals need further evaluation.
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Affiliation(s)
| | | | | | - Randall Eckhoff
- RTI International, Research Triangle Park, NC, United States
| | - Joel Hampton
- RTI International, Research Triangle Park, NC, United States
| | - Loneke T Blackman Carr
- Winston-Salem State University, Winston-Salem, NC, United States
- University of Connecticut, Storrs, CT, United States
| | - Georgia McCauley
- Winston-Salem State University, Winston-Salem, NC, United States
| | | | - Elijah O Onsomu
- Winston-Salem State University, Winston-Salem, NC, United States
| | - John Williams
- Winston-Salem State University, Winston-Salem, NC, United States
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26
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Arnold C, Williams A, Thomas N. Engaging With a Web-Based Psychosocial Intervention for Psychosis: Qualitative Study of User Experiences. JMIR Ment Health 2020; 7:e16730. [PMID: 32558659 PMCID: PMC7334758 DOI: 10.2196/16730] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/31/2020] [Accepted: 04/03/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Web-based interventions are increasingly being used for individuals with serious mental illness, including psychosis, and preliminary evidence suggests clinical benefits. To achieve such benefits, individuals must have some level of engagement with the intervention. Currently, little is known about what influences engagement with web-based interventions for individuals with psychotic disorders. OBJECTIVE This study aimed to explore users' perspectives on what influenced engagement with a web-based intervention for psychosis. METHODS A qualitative design was employed using semistructured telephone interviews. Participants were 17 adults with psychosis who had participated in a trial examining engagement with a self-guided, web-based intervention promoting personal recovery and self-management of mental health. RESULTS We identified 2 overarching themes: challenges to using the website and factors supporting persistence. Both of the main themes included several subthemes related to both user-related factors (eg, mental health, personal circumstances, approach to using the website) and users' experience of the intervention (eg, having experienced similar content previously or finding the material confronting). CONCLUSIONS Individuals with psychosis experienced several challenges to ongoing engagement with a web-based intervention. Adjunctive emails present an important design feature to maintain interest and motivation to engage with the intervention. However, fluctuations in mental health and psychosocial difficulties are a significant challenge. Design and implementation considerations include flexible interventions with tailoring opportunities to accommodate changeable circumstances and individual preferences.
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Affiliation(s)
- Chelsea Arnold
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Anne Williams
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.,Department of Psychology and Couselling, La Trobe University, Melbourne, Australia
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia.,The Alfred Hospital, Melbourne, Australia
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Bradway M, Gabarron E, Johansen M, Zanaboni P, Jardim P, Joakimsen R, Pape-Haugaard L, Årsand E. Methods and Measures Used to Evaluate Patient-Operated Mobile Health Interventions: Scoping Literature Review. JMIR Mhealth Uhealth 2020; 8:e16814. [PMID: 32352394 PMCID: PMC7226051 DOI: 10.2196/16814] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/10/2020] [Accepted: 03/25/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Despite the prevalence of mobile health (mHealth) technologies and observations of their impacts on patients' health, there is still no consensus on how best to evaluate these tools for patient self-management of chronic conditions. Researchers currently do not have guidelines on which qualitative or quantitative factors to measure or how to gather these reliable data. OBJECTIVE This study aimed to document the methods and both qualitative and quantitative measures used to assess mHealth apps and systems intended for use by patients for the self-management of chronic noncommunicable diseases. METHODS A scoping review was performed, and PubMed, MEDLINE, Google Scholar, and ProQuest Research Library were searched for literature published in English between January 1, 2015, and January 18, 2019. Search terms included combinations of the description of the intention of the intervention (eg, self-efficacy and self-management) and description of the intervention platform (eg, mobile app and sensor). Article selection was based on whether the intervention described a patient with a chronic noncommunicable disease as the primary user of a tool or system that would always be available for self-management. The extracted data included study design, health conditions, participants, intervention type (app or system), methods used, and measured qualitative and quantitative data. RESULTS A total of 31 studies met the eligibility criteria. Studies were classified as either those that evaluated mHealth apps (ie, single devices; n=15) or mHealth systems (ie, more than one tool; n=17), and one study evaluated both apps and systems. App interventions mainly targeted mental health conditions (including Post-Traumatic Stress Disorder), followed by diabetes and cardiovascular and heart diseases; among the 17 studies that described mHealth systems, most involved patients diagnosed with cardiovascular and heart disease, followed by diabetes, respiratory disease, mental health conditions, cancer, and multiple illnesses. The most common evaluation method was collection of usage logs (n=21), followed by standardized questionnaires (n=18) and ad-hoc questionnaires (n=13). The most common measure was app interaction (n=19), followed by usability/feasibility (n=17) and patient-reported health data via the app (n=15). CONCLUSIONS This review demonstrates that health intervention studies are taking advantage of the additional resources that mHealth technologies provide. As mHealth technologies become more prevalent, the call for evidence includes the impacts on patients' self-efficacy and engagement, in addition to traditional measures. However, considering the unstructured data forms, diverse use, and various platforms of mHealth, it can be challenging to select the right methods and measures to evaluate mHealth technologies. The inclusion of app usage logs, patient-involved methods, and other approaches to determine the impact of mHealth is an important step forward in health intervention research. We hope that this overview will become a catalogue of the possible ways in which mHealth has been and can be integrated into research practice.
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Affiliation(s)
- Meghan Bradway
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Science, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | - Elia Gabarron
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Monika Johansen
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Telemedicine and eHealth Research Group, Department of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | - Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Telemedicine and eHealth Research Group, Department of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
| | | | - Ragnar Joakimsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Louise Pape-Haugaard
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Eirik Årsand
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Science, University of Tromsø The Arctic University of Norway, Tromsø, Norway
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28
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Mehdi M, Riha C, Neff P, Dode A, Pryss R, Schlee W, Reichert M, Hauck FJ. Smartphone Apps in the Context of Tinnitus: Systematic Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E1725. [PMID: 32204540 PMCID: PMC7146490 DOI: 10.3390/s20061725] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/16/2022]
Abstract
Smartphones containing sophisticated high-end hardware and offering high computational capabilities at extremely manageable costs have become mainstream and an integral part of users' lives. Widespread adoption of smartphone devices has encouraged the development of many smartphone applications, resulting in a well-established ecosystem, which is easily discoverable and accessible via respective marketplaces of differing mobile platforms. These smartphone applications are no longer exclusively limited to entertainment purposes but are increasingly established in the scientific and medical field. In the context of tinnitus, the ringing in the ear, these smartphone apps range from relief, management, self-help, all the way to interfacing external sensors to better understand the phenomenon. In this paper, we aim to bring forth the smartphone applications in and around tinnitus. Based on the PRISMA guidelines, we systematically analyze and investigate the current state of smartphone apps, that are directly applied in the context of tinnitus. In particular, we explore Google Scholar, CiteSeerX, Microsoft Academics, Semantic Scholar for the identification of scientific contributions. Additionally, we search and explore Google's Play and Apple's App Stores to identify relevant smartphone apps and their respective properties. This review work gives (1) an up-to-date overview of existing apps, and (2) lists and discusses scientific literature pertaining to the smartphone apps used within the context of tinnitus.
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Affiliation(s)
- Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, 89081 Ulm, Germany
| | - Constanze Riha
- Department of Psychology, University of Zürich, Box 1, CH-8050 Zürich, Switzerland;
| | - Patrick Neff
- Clinic and Polyclinic for Psychiatry and Psychotherapy, 93053 Regensburg, Germany; (P.N.); (W.S.)
- URPP Dynamics of Healthy Aging, University of Zürich, Box 2, CH-8050 Zürich, Switzerland
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.); (R.P.)
| | - Rüdiger Pryss
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.); (R.P.)
| | - Winfried Schlee
- Clinic and Polyclinic for Psychiatry and Psychotherapy, 93053 Regensburg, Germany; (P.N.); (W.S.)
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, 89081 Ulm, Germany; (A.D.); (M.R.); (R.P.)
| | - Franz J. Hauck
- Institute of Distributed Systems, Ulm University, 89081 Ulm, Germany
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29
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Mobile Apps for the Management of Comorbid Overweight/Obesity and Depression/Anxiety: A Systematic Review. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:9317179. [PMID: 32047587 PMCID: PMC7003257 DOI: 10.1155/2020/9317179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/18/2019] [Accepted: 01/06/2020] [Indexed: 11/18/2022]
Abstract
Objective This review aimed at searching for scientific literature on mobile apps for the management of comorbid overweight/obesity and depression/anxiety and providing a brief and comprehensive summary of their main features, targeted groups, and relevant results. Methods A bibliographical search was performed in Pubmed, PsycNet, Web of Science, ResearchGate, and Lilacs databases. The terms “obesity” and “overweight” were introduced in combination with “anxiety” and “depression” and “mobile app (application),” “smartphone app (application),” “android app (applicattion),” “iOS app (application),” “mobile health app (application),” and “mHealth app (application).” Results The initial search eliciting 204 citations was reduced to 7 relevant papers (4 original articles, 1 brief communication, and 2 study protocols). All publications were from the last five years, most were produced by research teams from the United States. All had adult samples, and interventions mostly followed a cognitive behavioral framework. Regarding mobile apps, five studies only used one to monitor weight and physical activity, one study to provide therapy to improve psychological wellness, and one study to monitor cognitions and emotions. No mobile app was found for the simultaneous management of overweight/obesity and depression/anxiety. Conclusions The prevalence and costs related to overweight/obesity and depression/anxiety are significant and likely to increase. Very often these conditions overlap; thus, it would be recommendable to treat their comorbidity simultaneously. Nevertheless, no mobile app has been designed for this purpose, which would help to reduce service provision costs and make treatment more easily accessible for patients.
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A Narrative Review of Methods for Applying User Experience in the Design and Assessment of Mental Health Smartphone Interventions. Int J Technol Assess Health Care 2020; 36:64-70. [DOI: 10.1017/s0266462319003507] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractObjectivesUser experience (UX) plays a key role in uptake and usage of mental health smartphone interventions, yet remains underinvestigated. This review aimed to characterize and compare UX evaluation approaches that have been applied in this specific context, and to identify implications for research and practice.MethodsA narrative review was conducted of UX-themed studies published in PubMed, PsycINFO, and Scopus up to February 2019. Eligible studies reported on data reflecting users' interactions with a smartphone intervention for any mental health condition. Studies were categorized into “situated” versus “construct-based” methods according to whether or not an established UX construct was used to acquire and analyze data.ResultsSituated approaches used bespoke UX metrics, including quantitative measures of usage and performance, as well as grounded interview data. Construct-based approaches such as assessments of usability and acceptability were based on conceptual frameworks, with methodologically stronger versions featuring construct definitions, validated measurement tools, and an ability to compare data across studies. Constructs and measures were sometimes combined to form bespoke construct-based approaches.ConclusionsBoth situated and construct-based UX data may provide benefits during design and implementation of a mental health smartphone intervention by helping to clarify the needs of users and the impact of new features. Notable however was the omission of UX methods, such as split testing. Future research should consider these unaddressed methods, aim to improve the rigor of UX assessment, integrate their use alongside clinical outcomes, and explore UX assessment of more complex, adaptive interventions.
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31
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López S, Cervantes JA, Cervantes S, Molina J, Cervantes F. The plausibility of using unmanned aerial vehicles as a serious game for dealing with attention deficit-hyperactivity disorder. COGN SYST RES 2020. [DOI: 10.1016/j.cogsys.2019.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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32
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O'Brien T, Meyer T. A Feasibility Study for Teaching Older Kidney Transplant Recipients How to Wear and Use an Activity Tracker to Promote Daily Physical Activity. Nephrol Nurs J 2020; 47:47-51. [PMID: 32083436 PMCID: PMC7286068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Activity trackers have demonstrated promise in promoting physical activity in chronic disease populations, but few studies describe how participants were educated to use the activity tracker. The purpose of this study was to describe the teach-back method used to instruct older kidney transplant recipients to use an activity tracker/app and to describe the facilitators/challenges of wearing the activity tracker. A feasibility design was used for implementing the use of the tracker. A four-week follow-up questionnaire was administered to obtain participants' opinions on wear ing the tracker. The leading facilitator was the desire to track daily steps. The main challenge was securing the band. Reports of challenges were minimal, suggesting the teach-back method is feasible for teaching this population how to use an activity tracker.
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Affiliation(s)
- Tara O'Brien
- Assistant Professor, The Ohio State University College of Nursing, Columbus, OH
| | - Tess Meyer
- Registered Nurse, Nationwide Chidren's Hospital, Columbus, OH
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33
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Buchan K, Morgan HM. Using the Onitor ® Track for weight loss: A mixed methods study among overweight and obese women. Health Informatics J 2019; 26:1841-1865. [PMID: 31845831 DOI: 10.1177/1460458219890790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Non-communicable disease rates associated with being overweight or obese are rising. Technologies warrant consideration as weight loss interventions. Cloudtag's® Onitor® Track, a dual-position wearable plus smartphone application, monitors energy expenditure and provides tailored exercise programmes. This research aimed to undertake an experimental study of 20 overweight and obese women using the technology; explore its feasibility and acceptability through interviews; and investigate its behaviour change techniques. The primary outcome was decreased body weight (kg) at 4 weeks. Secondary outcomes were body mass index (kg/m2) and waist circumference (cm) changes. 15 overweight and obese women took part. Results indicated weight loss (median 2.7 kg, p < 0.05) and waist circumference decrease (median 4 cm, p < 0.05), but attrition was high (60%). Users reported dietary changes but few activity adjustments. They valued feedback. 27 behaviour change techniques were identified. The Onitor® Track shows potential for weight loss in overweight and obese women, but further work is needed.
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Looijmans A, Jörg F, Bruggeman R, Schoevers RA, Corpeleijn E. Multimodal lifestyle intervention using a web-based tool to improve cardiometabolic health in patients with serious mental illness: results of a cluster randomized controlled trial (LION). BMC Psychiatry 2019; 19:339. [PMID: 31690281 PMCID: PMC6833253 DOI: 10.1186/s12888-019-2310-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/09/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Unhealthy lifestyle behaviours contribute to alarming cardiometabolic risk in patients with serious mental illness (SMI). Evidence-based practical lifestyle tools supporting patients and staff in improving patient lifestyle are lacking. METHODS This multi-site randomized controlled pragmatic trial determined the effectiveness of a twelve-month multimodal lifestyle approach, including a web-based tool to improve patients' cardiometabolic health, versus care-as-usual. Using the web tool, nurses (trained in motivational interviewing) assisted patients in assessing their lifestyle behaviours, creating a risk profile and constructing lifestyle goals, which were discussed during fortnightly regular care visits. Twenty-seven community-care and sheltered-living teams were randomized into intervention (N = 17) or control (N = 10) groups, including 244 patients (140 intervention/104 control, 49.2% male, 46.1 ± 10.8 years) with increased waist circumference (WC), BMI or fasting glucose. The primary outcomes concerned differences in WC after six and twelve months intervention, while BMI and metabolic syndrome Z-score were secondary outcome measures. RESULTS General multilevel linear mixed models adjusted for antipsychotic medication showed that differences in WC change between intervention and control were - 0.15 cm (95%CI: - 2.49; 2.19) after six and - 1.03 cm (95%CI: - 3.42; 1.35) after twelve months intervention; however, the differences were not statistically significant. No intervention effects were found for secondary outcome measures. The intervention increased patients' readiness to change dietary behaviour. CONCLUSION A multimodal web-based intervention facilitating nurses to address lifestyle changes in SMI patients did not improve patient cardiometabolic health. Web-tool use was lower than expected and nurses need more lifestyle coaching knowledge and skills. The type of intervention and delivery mode need optimization to realize effective lifestyle care for SMI patients. TRIAL REGISTRATION Dutch Trial Registry, www.trialregister.nl , NTR3765, 21 December 2012.
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Affiliation(s)
- Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700, RB, Groningen, The Netherlands.
| | - Frederike Jörg
- Rob Giel Research Centre, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands ,Research Department, Friesland Mental Health Services, Leeuwarden, The Netherlands
| | - Richard Bruggeman
- Rob Giel Research Centre, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands ,0000 0000 9558 4598grid.4494.dDepartment of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert A. Schoevers
- 0000 0000 9558 4598grid.4494.dDepartment of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Eva Corpeleijn
- 0000 0000 9558 4598grid.4494.dDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Fortuna KL, Torous J, Depp CA, Jimenez DE, Areán PA, Walker R, Ajilore O, Goldstein CM, Cosco TD, Brooks JM, Vahia IV, Bartels SJ. A Future Research Agenda for Digital Geriatric Mental Healthcare. Am J Geriatr Psychiatry 2019; 27:1277-1285. [PMID: 31196619 PMCID: PMC7059198 DOI: 10.1016/j.jagp.2019.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/17/2019] [Accepted: 05/20/2019] [Indexed: 12/23/2022]
Abstract
The proliferation of mobile, online, and remote monitoring technologies in digital geriatric mental health has the potential to lead to the next major breakthrough in mental health treatments. Unlike traditional mental health services, digital geriatric mental health has the benefit of serving a large number of older adults, and in many instances, does not rely on mental health clinics to offer real-time interventions. As technology increasingly becomes essential in the everyday lives of older adults with mental health conditions, these technologies will provide a fundamental service delivery strategy to support older adults' mental health recovery. Although ample research on digital geriatric mental health is available, fundamental gaps in the scientific literature still exist. To begin to address these gaps, we propose the following recommendations for a future research agenda: 1) additional proof-of-concept studies are needed; 2) integrating engineering principles in methodologically rigorous research may help science keep pace with technology; 3) studies are needed that identify implementation issues; 4) inclusivity of people with a lived experience of a mental health condition can offer valuable perspectives and new insights; and 5) formation of a workgroup specific for digital geriatric mental health to set standards and principles for research and practice. We propose prioritizing the advancement of digital geriatric mental health research in several areas that are of great public health significance, including 1) simultaneous and integrated treatment of physical health and mental health conditions; 2) effectiveness studies that explore diagnostics and treatment of social determinants of health such as "social isolation" and "loneliness;" and 3) tailoring the development and testing of innovative strategies to minority older adult populations.
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Affiliation(s)
- Karen L Fortuna
- Geisel School of Medicine, Department of Psychiatry, Dartmouth College, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH.
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Colin A Depp
- Stein Institute for Research on Aging, Department of Psychiatry, University of California, San Diego, CA
| | - Daniel E Jimenez
- University of Miami Miller School of Medicine, Center for Cognitive Neuroscience and Aging, Miami, FL
| | - Patricia A Areán
- University of Washington, Department of Psychiatry & Behavioral Sciences, Seattle, WA
| | - Robert Walker
- Office of Recovery and Empowerment, Massachusetts Department of Mental Health, Boston, MA
| | - Olu Ajilore
- Mood and Anxiety Disorders Program, Department of Mental Health, University of Illinois, Chicago, IL
| | - Carly M Goldstein
- The Miriam Hospital, The Weight Control and Diabetes Research Center, Providence, RI; Alpert Medical School of Brown University, Department of Mental Health & Human Behavior, Providence, RI
| | - Theodore D Cosco
- Gerontology Research Center, Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Jessica M Brooks
- James J. Peters VA Medical Center, Geriatric Research, Education and Clinical Center, The Bronx, NY
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Rieger A, Gaines A, Barnett I, Baldassano CF, Connolly Gibbons MB, Crits-Christoph P. Psychiatry Outpatients' Willingness to Share Social Media Posts and Smartphone Data for Research and Clinical Purposes: Survey Study. JMIR Form Res 2019; 3:e14329. [PMID: 31493326 PMCID: PMC6754680 DOI: 10.2196/14329] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/13/2019] [Accepted: 06/09/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Psychiatry research has begun to leverage data collected from patients' social media and smartphone use. However, information regarding the feasibility of utilizing such data in an outpatient setting and the acceptability of such data in research and practice is limited. OBJECTIVE This study aimed at understanding the outpatients' willingness to have information from their social media posts and their smartphones used for clinical or research purposes. METHODS In this survey study, we surveyed patients (N=238) in an outpatient clinic waiting room. Willingness to share social media and passive smartphone data was summarized for the sample as a whole and broken down by sex, age, and race. RESULTS Most patients who had a social media account and who were receiving talk therapy treatment (74.4%, 99/133) indicated that they would be willing to share their social media posts with their therapists. The percentage of patients willing to share passive smartphone data with researchers varied from 40.8% (82/201) to 60.7% (122/201) depending on the parameter, with sleep duration being the parameter with the highest percentage of patients willing to share. A total of 30.4% of patients indicated that media stories of social media privacy breaches made them more hesitant about sharing passive smartphone data with researchers. Sex and race were associated with willingness to share smartphone data, with men and whites being the most willing to share. CONCLUSIONS Our results indicate that most patients in a psychiatric outpatient setting would share social media and passive smartphone data and that further research elucidating patterns of willingness to share passive data is needed.
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Affiliation(s)
- Agnes Rieger
- University of Pennsylvania, Philadelphia, PA, United States
| | - Averi Gaines
- University of Pennsylvania, Philadelphia, PA, United States
| | - Ian Barnett
- University of Pennsylvania, Philadelphia, PA, United States
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Noel VA, Carpenter-Song E, Acquilano SC, Torous J, Drake RE. The technology specialist: a 21st century support role in clinical care. NPJ Digit Med 2019; 2:61. [PMID: 31388565 PMCID: PMC6594932 DOI: 10.1038/s41746-019-0137-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 06/05/2019] [Indexed: 11/17/2022] Open
Abstract
Mental health clinicians, clients, and researchers have shown keen interest in using technology to support mental health recovery. However, technology has not been routinely integrated into clinical care. Clients use a wide range of digital tools and apps to help manage their mental health, but clinicians rarely discuss this form of self-management in clinical interactions. This absence of communication is concerning because the safety and quality of the digital tools and apps people use may negatively affect their mental health outcomes. Mental health systems could benefit from someone to help identify technology-based supports that reflect current evidence and minimize privacy and security concerns. This technology specialist may also enhance the therapeutic bond between the client and the clinician. In working with a technology specialist, clients may begin to gain a sense of control over their mental health, and perhaps use fewer mental health services.
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Affiliation(s)
| | | | - Stephanie C Acquilano
- 3The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH USA
| | - John Torous
- 4Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - Robert E Drake
- 1Westat, Inc., Lebanon, NH USA.,3The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH USA
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Shin G, Jarrahi MH, Fei Y, Karami A, Gafinowitz N, Byun A, Lu X. Wearable activity trackers, accuracy, adoption, acceptance and health impact: A systematic literature review. J Biomed Inform 2019; 93:103153. [DOI: 10.1016/j.jbi.2019.103153] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 03/17/2019] [Accepted: 03/18/2019] [Indexed: 11/24/2022]
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Fortuna KL, Naslund JA, Aschbrenner KA, Lohman MC, Storm M, Batsis JA, Bartels SJ. Text message exchanges between older adults with serious mental illness and older certified peer specialists in a smartphone-supported self-management intervention. Psychiatr Rehabil J 2019; 42:57-63. [PMID: 30010355 PMCID: PMC6335192 DOI: 10.1037/prj0000305] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To identify the strategies peer specialists use to provide illness self-management support for older adults with serious mental illness (SMI) through text messaging. METHOD Transcripts of text message exchanges between 8 older adult participants with SMI who completed the PeerTECH intervention and 3 older adult certified peer specialists who delivered the 12-week program were analyzed. Text message analyses explored themes relevant to peer support and health behavior change. Quantitative data comprised frequency of text messages by either the peer or consumer. RESULTS Consumers (N = 8) had a mean age of 68.8 years (SD = 4.9) and were mainly women (88%), White (100%), and married (75%). Certified peer specialists (N = 3) were all 55 or older; 100% were female, 66% identified as White, and 33% identified as African American. Overall, peers sent 215 text messages whereas consumers sent 141 text messages. In the peer specialist-consumer text message exchanges, we identified 4 themes on different aspects of illness self-management, including health behavior change, self-management therapeutic techniques, engagement in health technology, and peer support. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This exploratory qualitative study offers preliminary support that peers are able to use text messages to support the delivery of a peer-delivered home-based medical and psychiatric self-management intervention. Certified peer specialists can potentially provide a range of illness self-management support to older adults with SMI via text messaging. These findings will inform the development of standardized peer text-messaging services to augment evidence-based illness self-management interventions for older adults with SMI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Karen L. Fortuna
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
| | - John A. Naslund
- Harvard Medical School, Department of Global Health and Social Medicine, 641 Huntington Avenue Boston, MA 02115
| | - Kelly A. Aschbrenner
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
| | | | - Marianne Storm
- The Dartmouth Institute, 1 Medical Center Drive, Lebanon, NH 03766
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | | | - Stephen J. Bartels
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
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Seppälä J, De Vita I, Jämsä T, Miettunen J, Isohanni M, Rubinstein K, Feldman Y, Grasa E, Corripio I, Berdun J, D'Amico E, Bulgheroni M. Mobile Phone and Wearable Sensor-Based mHealth Approaches for Psychiatric Disorders and Symptoms: Systematic Review. JMIR Ment Health 2019; 6:e9819. [PMID: 30785404 PMCID: PMC6401668 DOI: 10.2196/mental.9819] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/30/2018] [Accepted: 12/15/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mobile Therapeutic Attention for Patients with Treatment-Resistant Schizophrenia (m-RESIST) is an EU Horizon 2020-funded project aimed at designing and validating an innovative therapeutic program for treatment-resistant schizophrenia. The program exploits information from mobile phones and wearable sensors for behavioral tracking to support intervention administration. OBJECTIVE To systematically review original studies on sensor-based mHealth apps aimed at uncovering associations between sensor data and symptoms of psychiatric disorders in order to support the m-RESIST approach to assess effectiveness of behavioral monitoring in therapy. METHODS A systematic review of the English-language literature, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed through Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials databases. Studies published between September 1, 2009, and September 30, 2018, were selected. Boolean search operators with an iterative combination of search terms were applied. RESULTS Studies reporting quantitative information on data collected from mobile use and/or wearable sensors, and where that information was associated with clinical outcomes, were included. A total of 35 studies were identified; most of them investigated bipolar disorders, depression, depression symptoms, stress, and symptoms of stress, while only a few studies addressed persons with schizophrenia. The data from sensors were associated with symptoms of schizophrenia, bipolar disorders, and depression. CONCLUSIONS Although the data from sensors demonstrated an association with the symptoms of schizophrenia, bipolar disorders, and depression, their usability in clinical settings to support therapeutic intervention is not yet fully assessed and needs to be scrutinized more thoroughly.
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Affiliation(s)
- Jussi Seppälä
- Center for Life Course of Health Research, University of Oulu, Oulu, Finland.,Department of Mental and Substance Use Services, Eksote, Lappeenranta, Finland
| | | | - Timo Jämsä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course of Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Matti Isohanni
- Center for Life Course of Health Research, University of Oulu, Oulu, Finland
| | - Katya Rubinstein
- The Gertner Institute for Epidemiology and Health Policy Research, Tel Aviv, Israel
| | - Yoram Feldman
- The Gertner Institute for Epidemiology and Health Policy Research, Tel Aviv, Israel
| | - Eva Grasa
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Sant Pau, Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,CIBERSAM, Madrid, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Sant Pau, Barcelona, Spain.,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,CIBERSAM, Madrid, Spain
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- m-RESIST, Barcelona, Spain
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Krzystanek M, Borkowski M, Skałacka K, Krysta K. A telemedicine platform to improve clinical parameters in paranoid schizophrenia patients: Results of a one-year randomized study. Schizophr Res 2019; 204:389-396. [PMID: 30154027 DOI: 10.1016/j.schres.2018.08.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/16/2018] [Accepted: 08/12/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The study objective was to test a smartphone-based MONEO platform designed to improve the clinical condition of paranoid schizophrenia patients. Telemedicine treatment is considered to be as effective as traditional treatment in outpatient clinics. METHOD A total of 290 patients with paranoid schizophrenia in the symptomatic remission state were recruited to this 12-month multicenter, open-label randomized trial. A study group (n = 191) received a smartphone with the MONEO platform installed. Patients conducted cognitive training twice a week. Patients' mental state was assessed every month via teleconference. A placebo group (n = 99) received a platform with functionality limited to monthly teleconsultation and performing cognitive training every 6 months. The clinical status was measured using the Positive and Negative Syndrome Scale (PANSS), Calgary, and Clinical Global Impression-Severity (CGI-S) clinical scales. RESULTS After 12 months, a significant reduction of symptoms was observed in the study group, as assessed using the Calgary (36%, P < 0.01) and PANSS (8.6%, P < 0.05) scales. Symptom reduction of 23.6% was also observed in the placebo group (P < 0.05, Calgary scale). In the study group, depression, positive symptoms, excitement, general psychopathology and disorganization subscales decreased significantly, while in the placebo group, only the depression subscale decreased. The greatest improvement of 11.2% (study group, P < 0.05), vs 16.2% (placebo group, P < 0.05), was observed for the depression subscale. CONCLUSION The MONEO platform was demonstrated to positively influence the clinical condition of individuals with paranoid schizophrenia. A lack of negative consequences associated with usage of the device was also reported.
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Affiliation(s)
- Marek Krzystanek
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Medical School of Silesia, Ziolowa 45/47 Street, 40-635 Katowice, Poland..
| | - Mariusz Borkowski
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Medical School of Silesia, Ziolowa 45/47 Street, 40-635 Katowice, Poland
| | - Katarzyna Skałacka
- Institute of Psychology, University of Opole, Kopernika 11A Street, 45-040 Opole, Poland
| | - Krzysztof Krysta
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Medical School of Silesia, Ziolowa 45/47 Street, 40-635 Katowice, Poland
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Simblett S, Matcham F, Siddi S, Bulgari V, Barattieri di San Pietro C, Hortas López J, Ferrão J, Polhemus A, Haro JM, de Girolamo G, Gamble P, Eriksson H, Hotopf M, Wykes T. Barriers to and Facilitators of Engagement With mHealth Technology for Remote Measurement and Management of Depression: Qualitative Analysis. JMIR Mhealth Uhealth 2019; 7:e11325. [PMID: 30698535 PMCID: PMC6372936 DOI: 10.2196/11325] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mobile technology has the potential to provide accurate, impactful data on the symptoms of depression, which could improve health management or assist in early detection of relapse. However, for this potential to be achieved, it is essential that patients engage with the technology. Although many barriers to and facilitators of the use of this technology are common across therapeutic areas and technology types, many may be specific to cultural and health contexts. OBJECTIVE This study aimed to determine the potential barriers to and facilitators of engagement with mobile health (mHealth) technology for remote measurement and management of depression across three Western European countries. METHODS Participants (N=25; 4:1 ratio of women to men; age range, 25-73 years) who experienced depression participated in five focus groups held in three countries (two in the United Kingdom, two in Spain, and one in Italy). The focus groups investigated the potential barriers to and facilitators of the use of mHealth technology. A systematic thematic analysis was used to extract themes and subthemes. RESULTS Facilitators and barriers were categorized as health-related factors, user-related factors, and technology-related factors. A total of 58 subthemes of specific barriers and facilitators or moderators emerged. A core group of themes including motivation, potential impact on mood and anxiety, aspects of inconvenience, and ease of use was noted across all countries. CONCLUSIONS Similarities in the barriers to and facilitators of the use of mHealth technology have been observed across Spain, Italy, and the United Kingdom. These themes provide guidance on ways to promote the design of feasible and acceptable cross-cultural mHealth tools.
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Affiliation(s)
- Sara Simblett
- Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
| | - Faith Matcham
- Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Biomedical Research Centre for Mental Health, South London and Maudsley National Health Service Foundation Trust, King's College London, London, United Kingdom
| | - Sara Siddi
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Centro de Investigacion Biomedica en Red CIBERSAM, Madrid, Spain.,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Viola Bulgari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Chiara Barattieri di San Pietro
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Jorge Hortas López
- Research Department, QITERIA Investigación Social Aplicada, Madrid, Spain
| | - José Ferrão
- Information Technology Department, MSD Czech Republic, Prague, Czech Republic
| | - Ashley Polhemus
- Information Technology Department, MSD Czech Republic, Prague, Czech Republic
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Centro de Investigacion Biomedica en Red CIBERSAM, Madrid, Spain.,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | | | - Peter Gamble
- Information Technology Department, MSD Czech Republic, Prague, Czech Republic
| | - Hans Eriksson
- Clinical Development, Depression and Paediatrics, H Lundbeck A/S, Copenhagen, Denmark
| | - Matthew Hotopf
- Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Biomedical Research Centre for Mental Health, South London and Maudsley National Health Service Foundation Trust, King's College London, London, United Kingdom
| | - Til Wykes
- Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Biomedical Research Centre for Mental Health, South London and Maudsley National Health Service Foundation Trust, King's College London, London, United Kingdom
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Rönkkö K. An Activity Tracker and Its Accompanying App as a Motivator for Increased Exercise and Better Sleeping Habits for Youths in Need of Social Care: Field Study. JMIR Mhealth Uhealth 2018; 6:e193. [PMID: 30578186 PMCID: PMC6320395 DOI: 10.2196/mhealth.9286] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 08/03/2018] [Accepted: 08/16/2018] [Indexed: 12/13/2022] Open
Abstract
Background The number of mobile self-tracking devices connected to the Web has exploded in today’s society. With these wearable activity trackers related to Web 2.0 apps and social media have come new ways of monitoring, measuring, representing, and sharing experiences of the human body. New opportunities related to health and new areas of implementation for professionals have appeared, and one identified area that can benefit from mobile health technologies is social work. Objective There are still only a small number of papers reporting the results from studying wearable activity trackers and accompanying apps in the context of agency-based social work. This study aimed to contribute to the identified shortage by presenting results from a research project framed by the following overarching question: What effects will the studied youths in need of social care experience in relation to exercise and sleep as the result of using a wearable activity tracker and its accompanying app? Methods A field study framed by action research was performed. The study concerned vulnerable youths living in a Swedish municipality’s care and accommodation home that tried out an activity tracker and its accompanying app. Results The results from the study confirm previously published research results reporting that instant graphical feedback, sharing information, and being part of a social community can have a positive impact on lifestyle changes. In addition, this study’s main results are that (1) the most important factor for positive health-related lifestyle changes was the establishment of personal long-term goals and (2) professional social workers found the studied technology to function as a valuable counseling tool, opening up avenues for lifestyle talks that otherwise were hard to undertake. Conclusions This study demonstrates how an activity tracker and its accompanying app can open up a topic for discussion regarding how vulnerable youths can achieve digital support for changing unhealthy lifestyle patterns, and it shows that the technology might be a valuable counseling tool for professionals in social work.
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Affiliation(s)
- Kari Rönkkö
- Department of Design, Faculty of Business, Kristianstad University, Kristianstad, Sweden
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Fortuna KL, Storm M, Naslund JA, Aschbrenner KA, Lohman MC, Chow PI, DiMilia PR, Bartels SJ. Certified Peer Specialists and Older Adults With Serious Mental Illness' Perspectives of the Impact of a Peer-Delivered and Technology-Supported Self-Management Intervention. J Nerv Ment Dis 2018; 206:875-881. [PMID: 30371642 PMCID: PMC6209327 DOI: 10.1097/nmd.0000000000000896] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We explored the perspectives of certified peer specialists and older adults with serious mental illness on the impact of a peer-delivered medical and psychiatric self-management intervention, "PeerTECH." Transcripts from interviews with consumers with serious mental illness and a focus group with certified peer specialists who were engaged in PeerTECH were analyzed. Consumer participants (n = 8) had a mean age of 68.8 years (SD = 4.9) and included individuals diagnosed with major depressive disorder (five people), schizophrenia spectrum disorders (two people), and bipolar disorder (one person). Certified peer specialists (n = 3) were aged 55 years or more. Themes included internal and external forces of accountability, confidence, internal and external locus of hope, human bonding, and peer support. This exploratory qualitative study found that human support from peers can potentially influence health behavioral change in a combined peer and technology-based medical and psychiatric illness self-management intervention.
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Affiliation(s)
- Karen L. Fortuna
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
| | - Marianne Storm
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Dartmouth Institute, 1 Medical Center Drive, Lebanon, NH 03766
| | - John A. Naslund
- Harvard Medical School, Department of Global Health and Social Medicine, 641 Huntington Avenue Boston, MA 02115
| | - Kelly A. Aschbrenner
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
| | - Matthew C. Lohman
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 921 Assembly St, Columbia, SC 29208
| | - Philip I. Chow
- Center for Behavioral Health and Technology, Dept. of Psychiatry and Neurobehavioral Sciences, University of Virginia, 1300 Jefferson Park Ave, Charlottesville, VA 22903
| | - Peter R. DiMilia
- The Dartmouth Institute, 1 Medical Center Drive, Lebanon, NH 03766
| | - Stephen J. Bartels
- Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Suite 200 Lebanon, NH 03766
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, United States
- The Dartmouth Institute, 1 Medical Center Drive, Lebanon, NH 03766
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Aschbrenner KA, Naslund JA, Gorin AA, Mueser KT, Scherer EA, Viron M, Kinney A, Bartels SJ. Peer support and mobile health technology targeting obesity-related cardiovascular risk in young adults with serious mental illness: Protocol for a randomized controlled trial. Contemp Clin Trials 2018; 74:97-106. [PMID: 30316998 PMCID: PMC6217796 DOI: 10.1016/j.cct.2018.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/29/2018] [Accepted: 10/10/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Individuals with serious mental illness (SMI) such as schizophrenia and bipolar disorder face a higher risk of early death due to cardiovascular disease and other preventable chronic illnesses. Young adulthood is a critical window of development for lifestyle interventions to improve the long-term health and quality of life in this population. Fit Forward is an NIH-funded randomized clinical trial examining the effectiveness of a group lifestyle intervention (PeerFIT) enhanced with mobile health technology compared to one-on-one mobile lifestyle coaching with Basic Education in fitness and nutrition supported by a wearable Activity Tracking device (BEAT) in achieving clinically significant weight loss and improved cardiorespiratory fitness in young adults with SMI. METHODS Fit Forward targets 144 young adults (18 to 35 years) with SMI and a body mass index (BMI) of ≥25 receiving public mental health services. In a two-arm randomized clinical trial, participants will be randomly assigned with equal probability to PeerFIT or BEAT, stratified by birth sex and psychiatric diagnosis. Participants will be assessed at baseline, 6, and 12 months. The primary outcome is cardiovascular risk reduction indicated by either clinically significant weight loss (5% or greater) or increased fitness (>50 m on the 6-Minute Walk Test). Secondary outcomes include change in BMI, lipids, and hemoglobin A1c. Perceived self-efficacy for exercise and peer support will be evaluated as mechanisms underlying intervention effects. CONCLUSION If effective, PeerFIT will provide a potentially scalable approach to addressing health risks among young adults with SMI in mental health settings. TRIALS REGISTRATION ClinicalTrials.gov, NCT02815813.
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Affiliation(s)
- Kelly A Aschbrenner
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States.
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, United States
| | - Amy A Gorin
- Department of Psychology, University of Connecticut, Storrs, CT, United States
| | - Kim T Mueser
- Department of Occupational Therapy, Boston University, Boston, MA, United States
| | - Emily A Scherer
- Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Mark Viron
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Allison Kinney
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, United States
| | - Stephen J Bartels
- The Mongan Institute, Massachusetts General Hospital, Cambridge, MA, United States
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Terp M, Jørgensen R, Laursen BS, Mainz J, Bjørnes CD. A Smartphone App to Foster Power in the Everyday Management of Living With Schizophrenia: Qualitative Analysis of Young Adults' Perspectives. JMIR Ment Health 2018; 5:e10157. [PMID: 30274966 PMCID: PMC6231723 DOI: 10.2196/10157] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 08/08/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Literature indicates that using smartphone technology is a feasible way of empowering young adults recently diagnosed with schizophrenia to manage everyday living with their illness. The perspective of young adults on this matter, however, is unexplored. OBJECTIVE This study aimed at exploring how young adults recently diagnosed with schizophrenia used and perceived a smartphone app (MindFrame) as a tool to foster power in the everyday management of living with their illness. METHODS Using participatory design thinking and methods, MindFrame was iteratively developed. MindFrame consists of a smartphone app that allows young adults to access resources to aid their self-management. The app is affiliated with a website to support collaboration with their health care providers (HCPs). From January to December 2016, community-dwelling young adults with a recent diagnosis of schizophrenia were invited to use MindFrame as part of their care. They customized the resources while assessing their health on a daily basis. Then, they were invited to evaluate the use and provide their perspective on the app. The evaluation was qualitative, and data were generated from in-depth interviews. Data were analyzed using a hermeneutical approach. RESULTS A total of 98 individuals were eligible for the study (mean age 24.8, range 18-36). Of these, 27 used MindFrame and 13 participated in the evaluation. The analysis showed that to the young adults, MindFrame served to foster power in their everyday management of living with schizophrenia. When MindFrame was used with the HCPs consistently for more than a month, it could provide them with the power to keep up their medication, to keep a step ahead of their illness, and to get appropriate help based on their needs. This empowered them to stay on track with their illness, thus in control of it. It was also reported that MindFrame could fuel the fear of restraint and illness exacerbation, thereby disempowering some from feeling certain and secure. CONCLUSIONS The findings demonstrate that young adults diagnosed with schizophrenia are amenable to use a smartphone app to monitor their health, manage their medication, and stay alert of the early signs of illness exacerbation. This may empower them to stay on track with their illness, thus in control of it. This indicates the potential of smartphone-based care being capable of aiding this specific population to more confidently manage their new life situation. The potentially disempowering aspect of MindFrame accentuates a need for further research to understand the best uptake and the limitations of smartphone-based schizophrenia care of young adults.
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Affiliation(s)
- Malene Terp
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rikke Jørgensen
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | - Birgitte Schantz Laursen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Jan Mainz
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Community Mental Health, Haifa University, Haifa, Israel
| | - Charlotte D Bjørnes
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
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Mueller NE, Panch T, Macias C, Cohen BM, Ongur D, Baker JT. Using Smartphone Apps to Promote Psychiatric Rehabilitation in a Peer-Led Community Support Program: Pilot Study. JMIR Ment Health 2018; 5:e10092. [PMID: 30111526 PMCID: PMC6115596 DOI: 10.2196/10092] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/18/2018] [Accepted: 05/29/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, treaters, and the health care system at large. Community-based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness but has only been implemented in specialty centers. It remains unclear how the peer-based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain. OBJECTIVE Here, we describe the results from a study of one such program implemented within Waverley Place, a community support program at McLean Hospital, emphasizing psychiatric rehabilitation for individuals with severe and persistent mental illness, as well as describing the challenges encountered during the implementation of the program. Key questions were whether the patients could, and would, successfully use the app. METHODS The smartphone app offered multiple features relevant to psychiatric rehabilitation, including daily task lists, activity tracking, and text messaging with peer specialists. A 90-day program of activities, goals, and content specific to the community support program was created on the basis of a prior pilot, in collaboration between members of the app development team (WellFrame), and peers, clinical, and research staff associated with the program. Hospital research staff recruited patients into the study, monitored peer and patient engagement, and handled all raw data acquired from the study. RESULTS Of 100 people approached for the study, a total of 13 provided consent, of which 10 downloaded and used the app. Two patients were unable to complete the app installation. Five used the app regularly as part of their daily lives for at least 20 days of the 90-day program. We were unable to identify any specific factors (eg, clinical or demographic) that affected willingness to consent or engage with the app platform in the very limited sample, although the individuals with significant app use were generally satisfied with the experience. CONCLUSIONS Smartphone apps may become a useful tool for psychiatric rehabilitation, addressing both psychiatric and co-occurring medical problems. Individualizing functions to each patient and facilitating connection with a certified peer specialist may be an important feature of useful apps. Unlike prior reports emphasizing that patients with schizophrenia will adopt smartphone platforms, we found that implementation of digital tools into existing community support programs for severe and persistent mental illness has many challenges yet to be fully overcome to realize the potential benefits such apps could have to promote systematization and cost reduction for psychiatric rehabilitation.
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Affiliation(s)
- Nora E Mueller
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
| | | | - Cathaleene Macias
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Bruce M Cohen
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Dost Ongur
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Justin T Baker
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Mitchell L, Hussain Z. Predictors of Problematic Smartphone Use: An Examination of the Integrative Pathways Model and the Role of Age, Gender, Impulsiveness, Excessive Reassurance Seeking, Extraversion, and Depression. Behav Sci (Basel) 2018; 8:bs8080074. [PMID: 30110898 PMCID: PMC6115828 DOI: 10.3390/bs8080074] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/30/2018] [Accepted: 08/11/2018] [Indexed: 11/30/2022] Open
Abstract
Background: The progression of mobile phone technology has led to the development of multi-functional smartphones providing access to features such as social media, e-mail, and videos alongside the basic functions of a mobile phone. Increasing amounts of research has explored the potential addictive nature of smartphones to develop a theoretical framework that describes personality factors related to problematic use. The present study examined the Integrative Pathways Model and the effect of age, gender, impulsiveness, excessive reassurance seeking, extraversion, and depression on problematic smartphone use. Method: A total of 147 smartphone users (mean age = 30.96, SD = 12.97, 69.4% female) completed an online survey comprising of measures of problematic smartphone use, excessive reassurance seeking, extraversion, depression, and impulsiveness. Results: Age, impulsiveness, excessive reassurance seeking, and depression were all significantly related to problematic smartphone use, however extraversion was not significantly related. Furthermore, age and impulsiveness were significant independent predictors of problematic smartphone use. No gender differences were found. Conclusions: The findings presented several factors that predict problematic smartphone use, implications and suggestions for future research are discussed.
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Affiliation(s)
- Lewis Mitchell
- College of Life and Natural Sciences, School of Human Sciences, University of Derby, Derby DE22 1GB, UK.
| | - Zaheer Hussain
- College of Life and Natural Sciences, School of Human Sciences, University of Derby, Derby DE22 1GB, UK.
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Simblett S, Greer B, Matcham F, Curtis H, Polhemus A, Ferrão J, Gamble P, Wykes T. Barriers to and Facilitators of Engagement With Remote Measurement Technology for Managing Health: Systematic Review and Content Analysis of Findings. J Med Internet Res 2018; 20:e10480. [PMID: 30001997 PMCID: PMC6062692 DOI: 10.2196/10480] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Remote measurement technology refers to the use of mobile health technology to track and measure change in health status in real time as part of a person's everyday life. With accurate measurement, remote measurement technology offers the opportunity to augment health care by providing personalized, precise, and preemptive interventions that support insight into patterns of health-related behavior and self-management. However, for successful implementation, users need to be engaged in its use. OBJECTIVE Our objective was to systematically review the literature to update and extend the understanding of the key barriers to and facilitators of engagement with and use of remote measurement technology, to guide the development of future remote measurement technology resources. METHODS We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines involving original studies dating back to the last systematic review published in 2014. We included studies if they met the following entry criteria: population (people using remote measurement technology approaches to aid management of health), intervention (remote measurement technology system), comparison group (no comparison group specified), outcomes (qualitative or quantitative evaluation of the barriers to and facilitators of engagement with this system), and study design (randomized controlled trials, feasibility studies, and observational studies). We searched 5 databases (MEDLINE, IEEE Xplore, EMBASE, Web of Science, and the Cochrane Library) for articles published from January 2014 to May 2017. Articles were independently screened by 2 researchers. We extracted study characteristics and conducted a content analysis to define emerging themes to synthesize findings. Formal quality assessments were performed to address risk of bias. RESULTS A total of 33 studies met inclusion criteria, employing quantitative, qualitative, or mixed-methods designs. Studies were conducted in 10 countries, included male and female participants, with ages ranging from 8 to 95 years, and included both active and passive remote monitoring systems for a diverse range of physical and mental health conditions. However, they were relatively short and had small sample sizes, and reporting of usage statistics was inconsistent. Acceptability of remote measurement technology according to the average percentage of time used (64%-86.5%) and dropout rates (0%-44%) was variable. The barriers and facilitators from the content analysis related to health status, perceived utility and value, motivation, convenience and accessibility, and usability. CONCLUSIONS The results of this review highlight gaps in the design of studies trialing remote measurement technology, including the use of quantitative assessment of usage and acceptability. Several processes that could facilitate engagement with this technology have been identified and may drive the development of more person-focused remote measurement technology. However, these factors need further testing through carefully designed experimental studies. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO) CRD42017060644; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=60644 (Archived by WebCite at http://www.webcitation.org/70K4mThTr).
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Affiliation(s)
- Sara Simblett
- Institute of Psychiatry, Psychology and Neuroscience, Psychology, King's College London, London, United Kingdom
| | - Ben Greer
- Institute of Psychiatry, Psychology and Neuroscience, Psychology, King's College London, London, United Kingdom
| | - Faith Matcham
- Institute of Psychiatry, Psychology and Neuroscience, Psychology, King's College London, London, United Kingdom
| | - Hannah Curtis
- Institute of Psychiatry, Psychology and Neuroscience, Psychology, King's College London, London, United Kingdom
| | | | - José Ferrão
- MSD IT Global Innovation Center, Prague, Czech Republic
| | - Peter Gamble
- MSD IT Global Innovation Center, Prague, Czech Republic
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, Psychology, King's College London, London, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Ng A, Reddy M, Zalta AK, Schueller SM. Veterans' Perspectives on Fitbit Use in Treatment for Post-Traumatic Stress Disorder: An Interview Study. JMIR Ment Health 2018; 5:e10415. [PMID: 29907556 PMCID: PMC6026306 DOI: 10.2196/10415] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/19/2018] [Accepted: 04/26/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The increase in availability of patient data through consumer health wearable devices and mobile phone sensors provides opportunities for mental health treatment beyond traditional self-report measurements. Previous studies have suggested that wearables can be effectively used to benefit the physical health of people with mental health issues, but little research has explored the integration of wearable devices into mental health care. As such, early research is still necessary to address factors that might impact integration including patients' motivations to use wearables and their subsequent data. OBJECTIVE The aim of this study was to gain an understanding of patients' motivations to use or not to use wearables devices during an intensive treatment program for post-traumatic stress disorder (PTSD). During this treatment, they received a complementary Fitbit. We investigated the following research questions: How did the veterans in the intensive treatment program use their Fitbit? What are contributing motivators for the use and nonuse of the Fitbit? METHODS We conducted semistructured interviews with 13 veterans who completed an intensive treatment program for PTSD. We transcribed and analyzed interviews using thematic analysis. RESULTS We identified three major motivations for veterans to use the Fitbit during their time in the program: increase self-awareness, support social interactions, and give back to other veterans. We also identified three major reasons certain features of the Fitbit were not used: lack of clarity around the purpose of the Fitbit, lack of meaning in the Fitbit data, and challenges in the veteran-provider relationship. CONCLUSIONS To integrate wearable data into mental health treatment programs, it is important to understand the patient's perspectives and motivations in using wearables. We also discuss how the military culture and PTSD may have contributed to our participants' behaviors and attitudes toward Fitbit usage. We conclude with possible approaches for integrating patient-generated data into mental health treatment settings that may address the challenges we identified.
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Affiliation(s)
- Ada Ng
- People, Information, and Technology Changing Health Lab, Technology and Social Behavior Program, Northwestern University, Evanston, IL, United States
| | - Madhu Reddy
- People, Information, and Technology Changing Health Lab, School of Communication, Northwestern University, Evanston, IL, United States
| | - Alyson K Zalta
- Departments of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Stephen M Schueller
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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