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Kepper MM, Fowler LA, Kusters IS, Davis JW, Baqer M, Sagui-Henson S, Xiao Y, Tarfa A, Yi JC, Gibson B, Heron KE, Alberts NM, Burgermaster M, Njie-Carr VP, Klesges LM. Expanding a Behavioral View on Digital Health Access: Drivers and Strategies to Promote Equity. J Med Internet Res 2024; 26:e51355. [PMID: 39088246 PMCID: PMC11327633 DOI: 10.2196/51355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 08/02/2024] Open
Abstract
The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for a unique and comprehensive exploration of current drivers of digital health inequities. This paper aims to present a compilation of strategies that can potentially have an actionable impact on digital health equity. Multilevel factors drive unequal access, so strategies require action from tool developers, individual delivery agents, organizations, and systems to effect change. Strategies were shaped with a behavioral medicine focus as the field has a unique role in improving digital health access; arguably, all digital tools require the user (individual, provider, and health system) to change behavior by engaging with the technology to generate impact. This paper presents a model that emphasizes using multilevel strategies across design, delivery, dissemination, and sustainment stages to advance digital health access and foster health equity.
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Affiliation(s)
- Maura M Kepper
- Prevention Research Center, Washington University in St. Louis, St. Louis, MO, United States
| | - Lauren A Fowler
- Sexuality, Health, and Gender Center, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States
| | - Isabelle S Kusters
- Department of Health, Human, and Biomedical Sciences, University of Houston-Clear Lake, Houston, TX, United States
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Jean W Davis
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Manal Baqer
- Neamah Health Consulting, Boston, MA, United States
| | - Sara Sagui-Henson
- Clinical Strategy and Research Team, Modern Health, San Francisco, CA, United States
| | - Yunyu Xiao
- Department of Population Health Science, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Adati Tarfa
- School of Medicine, Yale University, New Haven, CT, United States
| | - Jean C Yi
- Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Bryan Gibson
- Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Kristin E Heron
- Psychology Department, Old Dominion University, Norfolk, VA, United States
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, United States
| | - Nicole M Alberts
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Marissa Burgermaster
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, United States
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Veronica Ps Njie-Carr
- Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD, United States
| | - Lisa M Klesges
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, United States
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Ahmed M, Marín M, Gangas P, Bentlage E, Louro C, Brach M. Improving the Acceptability and Implementation of Information and Communication Technology-Based Health Care Platforms for Older People With Dementia or Parkinson Disease: Qualitative Study Results of Key Stakeholders. JMIR Form Res 2024; 8:e58501. [PMID: 38935424 PMCID: PMC11240067 DOI: 10.2196/58501] [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: 03/17/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The management of neurodegenerative diseases (NDDs) in older populations is usually demanding and involves care provision by various health care services, resulting in a greater burden on health care systems in terms of costs and resources. The convergence of various health services within integrated health care models, which are enabled and adopted jointly with information and communication technologies (ICTs), has been identified as an effective alternative health care solution. However, its widespread implementation faces formidable challenges. Both the development and implementation of integrated ICTs are linked to the collaboration and acceptance of different groups of stakeholders beyond patients and health care professionals, with reported discrepancies in the needs and preferences among these groups. OBJECTIVE Complementing a previous publication, which reported on the needs and requirements of end users in the development of the European Union-funded project PROCare4Life (Personalized Integrated Care Promoting Quality of Life for Older People), this paper aimed to report on the opinions of other key stakeholders from various fields, including academia, media, market, and decision making, for improving the acceptability and implementation of an integrated ICT-based health care platform supporting the management of NDDs. METHODS The study included 30 individual semistructured interviews that took place between June and August 2020 in 5 European countries (Germany, Italy, Portugal, Romania, and Spain). Interviews were mostly conducted online, except in cases where participants requested to be interviewed in person. In these cases, COVID-19 PROCare4Life safety procedures were applied. RESULTS This study identified 2 themes and 5 subthemes. User engagement, providing training and education, and the role played by the media were identified as strategic measures to ensure the acceptability of ICT-based health care platforms. Sustainable funding and cooperation with authorities were foreseen as additional points to be considered in the implementation process. CONCLUSIONS The importance of the user-centered design approach in ensuring the involvement of users in the development of ICT-based platforms has been highlighted. The most common challenges that hinder the acceptability and implementation of ICT-based health care platforms can be addressed by creating synergies among the efforts of users, academic stakeholders, developers, policy makers, and decision makers. To support future projects in developing ICT-based health care platforms, this study outlined the following recommendations that can be integrated when conducting research on users' needs: (1) properly identify the particular challenges faced by future user groups without neglecting their social and clinical contexts; (2) iteratively assess the digital skills of future users and their acceptance of the proposed platform; (3) align the functionalities of the ICT platform with the real needs of future users; and (4) involve key stakeholders to guide the reflection on how to implement the platform in the future. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/22463.
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Affiliation(s)
- Mona Ahmed
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
- Institute of General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus, Bonn, Germany
| | | | - Pilar Gangas
- International Foundation for Integrated Care, Oxford, United Kingdom
| | - Ellen Bentlage
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | | | - Michael Brach
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
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Mumtaz H, Riaz MH, Wajid H, Saqib M, Zeeshan MH, Khan SE, Chauhan YR, Sohail H, Vohra LI. Current challenges and potential solutions to the use of digital health technologies in evidence generation: a narrative review. Front Digit Health 2023; 5:1203945. [PMID: 37840685 PMCID: PMC10568450 DOI: 10.3389/fdgth.2023.1203945] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Digital health is a field that aims to improve patient care through the use of technology, such as telemedicine, mobile health, electronic health records, and artificial intelligence. The aim of this review is to examine the challenges and potential solutions for the implementation and evaluation of digital health technologies. Digital tools are used across the world in different settings. In Australia, the Digital Health Translation and Implementation Program (DHTI) emphasizes the importance of involving stakeholders and addressing infrastructure and training issues for healthcare workers. The WHO's Global Task Force on Digital Health for TB aims to address tuberculosis through digital health innovations. Digital tools are also used in mental health care, but their effectiveness must be evaluated during development. Oncology supportive care uses digital tools for cancer patient intervention and surveillance, but evaluating their effectiveness can be challenging. In the COVID and post-COVID era, digital health solutions must be evaluated based on their technological maturity and size of deployment, as well as the quality of data they provide. To safely and effectively use digital healthcare technology, it is essential to prioritize evaluation using complex systems and evidence-based medical frameworks. To address the challenges of digital health implementation, it is important to prioritize ethical research addressing issues of user consent and addressing socioeconomic disparities in access and effectiveness. It is also important to consider the impact of digital health on health outcomes and the cost-effectiveness of service delivery.
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Affiliation(s)
- Hassan Mumtaz
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Muhammad Hamza Riaz
- Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Hanan Wajid
- Department of Internal Medicine, Shalamar Medical & Dental College, Lahore, Pakistan
| | - Muhammad Saqib
- Department of Internal Medicine, Khyber Medical College, Peshawar, Pakistan
| | | | | | | | - Hassan Sohail
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Cliffe B, Gore-Rodney J, Linton MJ, Biddle L. Developing Suicide Prevention Tools in the Context of Digital Peer Support: Qualitative Analysis of a Workshop With Multidisciplinary Stakeholders. JMIR Form Res 2023; 7:e47178. [PMID: 37728967 PMCID: PMC10551794 DOI: 10.2196/47178] [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: 03/10/2023] [Revised: 07/28/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Suicide is the fourth leading cause of death among young people aged 15-29 years worldwide and suicide rates are increasing. Suicide prevention strategies can be effective but young people face barriers to accessing them. Providing support digitally can facilitate access, but this can also pose risks if there is inappropriate or harmful content. Collaborative approaches are key for developing digital suicide prevention tools to ensure support is appropriate and helpful for young people. Tellmi (previously MeeToo) is a premoderated UK-based peer-support app where people aged 11-25 years can anonymously discuss issues ranging from worries to life challenges. It has procedures to support high-risk users, nevertheless, Tellmi is interested in improving the support they provide to users with more acute mental health needs, such as young people struggling with suicide and self-harm ideation. Further research into the best ways of providing such support for this population is necessary. OBJECTIVE The aim of this study is to explore the key considerations for developing and delivering digital suicide prevention tools for young people aged 18-25 years from a multidisciplinary perspective, including the views of young people, practitioners, and academics. METHODS A full-day, in-person workshop was conducted with mental health academics (n=3) and mental health practitioners (n=2) with expertise in suicide prevention, young people with lived experience of suicidal ideation (n=4), and a computer scientist (n=1) and technical staff from the Tellmi app (n=6). Tellmi technical staff presented 14 possible evidence-based adaptations for the app as a basis for the discussions. A range of methods were used to evaluate them, including questionnaires to rate the ideas, annotating printouts of the ideas with post-it notes, and group discussions. A reflexive thematic analysis was performed on the qualitative data to explore key considerations for designing digital suicide prevention tools in the context of peer support. RESULTS Participants discussed the needs of both those receiving and providing support, noting several key considerations for developing and delivering digital support for high-risk young people. In total, four themes were developed: (1) the aims of the app must be clear and consistent, (2) there are unique considerations for supporting high-risk users: (subtheme) customization helps tailor support to high-risk users, (3) "progress" is a broad and multifaceted concept, and (4) considering the roles of those providing support: (subtheme) expertise required to support app users and (subtheme) mitigating the impact of the role on supporters. CONCLUSIONS This study outlined suggestions that may be beneficial for developing digital suicide prevention tools for young people. Suggestions included apps being customizable, transparent, accessible, visually appealing, and working with users to develop content and language. Future research should further explore this with a diverse group of young people and clinicians.
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Affiliation(s)
- Bethany Cliffe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Myles-Jay Linton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Biddle
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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5
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Bear HA, Ayala Nunes L, DeJesus J, Liverpool S, Moltrecht B, Neelakantan L, Harriss E, Watkins E, Fazel M. Determination of Markers of Successful Implementation of Mental Health Apps for Young People: Systematic Review. J Med Internet Res 2022; 24:e40347. [DOI: 10.2196/40347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/12/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background
Smartphone apps have the potential to address some of the current issues facing service provision for young people’s mental health by improving the scalability of evidence-based mental health interventions. However, very few apps have been successfully implemented, and consensus on implementation measurement is lacking.
Objective
This review aims to determine the proportion of evidence-based mental health and well-being apps that have been successfully adopted and sustained in real-world settings. A secondary aim is to establish if key implementation determinants such as coproduction, acceptability, feasibility, appropriateness, and engagement contribute toward successful implementation and longevity.
Methods
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 5 databases in 2021 yielded 18,660 results. After full-text screening, 34 articles met the full eligibility criteria, providing data on 29 smartphone apps studied with individuals aged 15 to 25 years.
Results
Of 34 studies, only 10 (29%) studies were identified that were evaluating the effectiveness of 8 existing, commercially available mental health apps, and the remaining 24 (71%) studies reported the development and evaluation of 21 newly developed apps, of which 43% (9/21) were available, commercially or otherwise (eg, in mental health services), at the time of enquiry. Most studies addressed some implementation components including adoption, acceptability, appropriateness, feasibility, and engagement. Factors including high cost, funding constraints, and lengthy research processes impeded implementation.
Conclusions
Without addressing common implementation drivers, there is considerable redundancy in the translation of mobile mental health research findings into practice. Studies should embed implementation strategies from the outset of the planned research, build collaborations with partners already working in the field (academic and commercial) to capitalize on existing interventions and platforms, and modify and evaluate them for local contexts or target problems and populations.
Trial Registration
PROSPERO CRD42021224365; https://tinyurl.com/4umpn85f
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Brazeau BW, Hodgins DC. User engagement with technology-mediated self-guided interventions for addictions: scoping review protocol. BMJ Open 2022; 12:e064324. [PMID: 35998968 PMCID: PMC9403117 DOI: 10.1136/bmjopen-2022-064324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Technology-mediated self-guided interventions (TMSGIs) for addictive disorders represent promising adjuncts and alternatives to traditional treatment approaches (eg, face-to-face psychotherapy). However, meaningful evaluation of such interventions remains elusive given the lack of consistent terminology and application. Preliminary findings suggest that TMSGIs are useful but engagement remains modest for various reasons reported by users, including lack of personalisation. The aim of this review is to explore how TMSGIs have been defined and applied in addictions populations with an emphasis on technical and logistical features associated with greater user engagement. METHODS AND ANALYSIS This scoping review protocol was developed in accordance with the Arksey and O'Malley framework. Articles from electronic databases (ie, PsycINFO, Embase, MEDLINE and CINAHL) will be included if they targeted adolescents or adults with one or more substance or behavioural addictions, excessive behaviours or aspects thereof (eg, cravings) using a privately accessible technology-mediated intervention. Two independent reviewers will screen titles and abstracts for relevance before commencing full-text reviews. Extracted data will be presented in descriptive, tabular and graphical summaries as appropriate. ETHICS AND DISSEMINATION Ethics committee approval is not required for this study. Review findings will be used to guide the development of preliminary recommendations for real-time addiction intervention development and provision. Emphasis will be placed on practical considerations of user engagement, accessibility, usability and cost. Knowledge users, including clinicians, researchers and people with lived experience, will be engaged for development of one such intervention following publication of review findings. REGISTRATION This scoping review was registered with the Open Science Framework on 15 April 2022 and can be located at http://www.osf.io/3utp9/.
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Affiliation(s)
- Brad W Brazeau
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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Counson I, Bartholomew A, Crawford J, Petrie K, Basarkod G, Moynihan V, Pires J, Cohen R, Glozier N, Harvey S, Sanatkar S. Development of the Shift Smartphone App to Support the Emotional Well-Being of Junior Physicians: Design of a Prototype and Results of Usability and Acceptability Testing. JMIR Form Res 2021; 5:e26370. [PMID: 34860662 PMCID: PMC8686399 DOI: 10.2196/26370] [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] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/09/2021] [Accepted: 10/21/2021] [Indexed: 01/20/2023] Open
Abstract
Background Junior physicians report higher levels of psychological distress than senior doctors and report several barriers to seeking professional mental health support, including concerns about confidentiality and career progression. Mobile health (mHealth) apps may be utilized to help overcome these barriers to assist the emotional well-being of this population and encourage help-seeking. Objective This study describes the development and pilot trial of the Shift mHealth app to provide an unobtrusive avenue for junior physicians to seek information about, and help for, well-being and mental health concerns, which is sensitive to workplace settings. Methods A 4-phase iterative development process was undertaken to create the content and features of Shift involving junior physicians using the principles of user-centered design. These 4 phases were—needs assessment, on the basis of interviews with 12 junior physicians; prototype development with user experience feedback from 2 junior physicians; evaluation, consisting of a pilot trial with 22 junior physicians to assess the usability and acceptability of the initial prototype; and redesign, including user experience workshops with 51 junior physicians. Results Qualitative results informed the content and design of Shift to ensure that the app was tailored to junior physicians’ needs. The Shift app prototype contained cognitive behavioral, mindfulness, value-based actions, and psychoeducational modules, as well as a tracking function that visualized patterns of daily variations in mood and health behaviors. Pilot-testing revealed possible issues with the organization of the app content, which were addressed through a thorough restructuring and redesign of Shift with the help of junior physicians across 3 user experience workshops. Conclusions This study demonstrates the importance of ongoing end user involvement in the creation of a specialized mHealth app for a unique working population experiencing profession-specific stressors and barriers to help-seeking. The development and pilot trial of this novel Shift mHealth app are the first steps in addressing the mental health and support-seeking needs of junior physicians, although further research is required to validate its effectiveness and appropriateness on a larger scale.
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Affiliation(s)
- Isabelle Counson
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | | | - Joanna Crawford
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Katherine Petrie
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Geetanjali Basarkod
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, Australia
| | | | | | | | - Nicholas Glozier
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Samineh Sanatkar
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
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Gericke F, Ebert DD, Breet E, Auerbach RP, Bantjes J. A qualitative study of university students' experience of Internet‐based CBT for depression. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Franco Gericke
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | - David D. Ebert
- Psychology & Digital Mental Health Care, Department of Sport and Health Sciences Technical University Munich Munich Germany
| | - Elsie Breet
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | | | - Jason Bantjes
- Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
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Ortiz R, Southwick L, Schneider R, Klinger EV, Pelullo A, Guntuku SC, Merchant RM, Agarwal AK. Improving Mood Through Community Connection and Resources Using an Interactive Digital Platform: Development and Usability Study. JMIR Ment Health 2021; 8:e25834. [PMID: 33635280 PMCID: PMC7919843 DOI: 10.2196/25834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/19/2021] [Accepted: 01/28/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND COVID-19 continues to disrupt global health and well-being. In April-May 2020, we generated a digital, remote interactive tool to provide health and well-being resources and foster connectivity among community members through a text messaging platform. OBJECTIVE This study aimed to prospectively investigate the ability of a health system-based digital, remote, interactive tool to provide health and well-being resources to local community participants and to foster connectivity among them during the early phases of COVID-19. METHODS We performed descriptive and nonparametric longitudinal statistical analyses to describe and compare the participants' mood ratings over time and thematic analysis of their responses to text messages to further assess mood. RESULTS From among 393 individuals seeking care in an urban emergency department in an academic setting, engaged in a two-way text messaging platform, we recorded 287 mood ratings and 368 qualitative responses. We observed no difference in the initial mood rating by week of enrollment [Kruskal-Wallis chi-square H(5)=1.34; P=.93], and the average mood rating did not change for participants taken together [Friedman chi-square Q(3)=0.32; P=.96]. However, of participants providing mood ratings at baseline, mood improved significantly among participants who reported a low mood rating at baseline [n=25, 14.97%; Q(3)=20.68; P<.001] but remained stable among those who reported a high mood rating at baseline [n=142, 85.03%; Q(3)=2.84; P=.42]. Positive mood elaborations most frequently included words related to sentiments of thankfulness and gratitude, mostly for a sense of connection and communication; in contrast, negative mood elaborations most frequently included words related to anxiety. CONCLUSIONS Our findings suggest the feasibility of engaging individuals in a digital community with an emergency department facilitation. Specifically, for those who opt to engage in a text messaging platform during COVID-19, it is feasible to assess and respond to mood-related queries with vetted health and well-being resources.
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Affiliation(s)
- Robin Ortiz
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Lauren Southwick
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Rachelle Schneider
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Elissa V Klinger
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Arthur Pelullo
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Sharath Chandra Guntuku
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States.,Penn Medicine Center for Digital Health, Philadelphia, PA, United States
| | - Raina M Merchant
- Penn Medicine Center for Digital Health, Philadelphia, PA, United States
| | - Anish K Agarwal
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, PA, United States
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10
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Pote H, Rees A, Holloway-Biddle C, Griffith E. Workforce challenges in digital health implementation: How are clinical psychology training programmes developing digital competences? Digit Health 2021; 7:2055207620985396. [PMID: 33628457 PMCID: PMC7883155 DOI: 10.1177/2055207620985396] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/13/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives Digital practice in psychological services is a rapidly expanding and innovative area which is supporting continuation of clinical provision during the COVID-19 pandemic. Training the workforce to deliver safe and effective online psychological provision is key to service success and relies on accurate mapping of competences and current training needs. This paper discusses the initial stage for developing the first digital mental health competence framework for applied psychology in the UK. It reports on the digital training currently provided nationally and barriers/facilitators to acquiring these competencies. Methods Eighteen of the thirty UK Clinical Psychology Doctoral training programmes completed a 16-item survey. This mapped current digital health teaching and skills acquisition for trainee Clinical Psychologists throughout their 3-year pre-registration training. Furthermore, potential barriers and facilitators to developing these digital skills for both trainee and qualified Clinical Psychologists were investigated. Results The quantitative analysis highlighted the majority of respondents viewed developing digital mental health competencies with importance, but were not integrating this into teaching or clinical placements activity. The qualitative, inductive content analysis revealed seven key themes influencing the development of digital mental health skills, with the majority of respondents identifying with two themes; the need for practice guidelines (50% of respondents) and opportunities for digital mental health experience. Conclusions The findings suggest the need for a greater focus on developing the digital health knowledge, skills, and confidence across trainee and qualified Clinical Psychologists. Strategic analysis indicated the need to develop a framework for digital mental health competences across the curriculum and placement experience. Easily accessible learning packages may support the implementation of training nationally.
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Affiliation(s)
- Helen Pote
- Department of Psychology, Royal Holloway, Egham, Surrey, UK
| | - Annabel Rees
- Department of Psychology, University of Bath, Bath, UK
| | | | - Emma Griffith
- Department of Psychology, University of Bath, Bath, UK.,Avon and Wiltshire Partnership Mental Health NHS Trust, Trowbridge, UK
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11
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Simmonds-Buckley M, Bennion MR, Kellett S, Millings A, Hardy GE, Moore RK. Acceptability and Effectiveness of NHS-Recommended e-Therapies for Depression, Anxiety, and Stress: Meta-Analysis. J Med Internet Res 2020; 22:e17049. [PMID: 33112238 PMCID: PMC7657731 DOI: 10.2196/17049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/18/2020] [Accepted: 07/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background There is a disconnect between the ability to swiftly develop e-therapies for the treatment of depression, anxiety, and stress, and the scrupulous evaluation of their clinical utility. This creates a risk that the e-therapies routinely provided within publicly funded psychological health care have evaded appropriate rigorous evaluation in their development. Objective This study aims to conduct a meta-analytic review of the gold standard evidence of the acceptability and clinical effectiveness of e-therapies recommended for use in the National Health Service (NHS) in the United Kingdom. Methods Systematic searches identified appropriate randomized controlled trials (RCTs). Depression, anxiety, and stress outcomes at the end of treatment and follow-up were synthesized using a random-effects meta-analysis. The grading of recommendations assessment, development, and evaluation approach was used to assess the quality of each meta-analytic comparison. Moderators of treatment effect were examined using subgroup and meta-regression analysis. Dropout rates for e-therapies (as a proxy for acceptability) were compared against controls. Results A total of 24 studies evaluating 7 of 48 NHS-recommended e-therapies were qualitatively and quantitatively synthesized. Depression, anxiety, and stress outcomes for e-therapies were superior to controls (depression: standardized mean difference [SMD] 0.38, 95% CI 0.24 to 0.52, N=7075; anxiety and stress: SMD 0.43, 95% CI 0.24 to 0.63, n=4863), and these small effects were maintained at follow-up. Average dropout rates for e-therapies (31%, SD 17.35) were significantly higher than those of controls (17%, SD 13.31). Limited moderators of the treatment effect were found. Conclusions Many NHS-recommended e-therapies have not been through an RCT-style evaluation. The e-therapies that have been appropriately evaluated generate small but significant, durable, beneficial treatment effects. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) registration CRD42019130184; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130184
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Affiliation(s)
| | - Matthew Russell Bennion
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom.,Department of Computer Science, The University of Sheffield, Sheffield, United Kingdom
| | - Stephen Kellett
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom.,Sheffield Health and Social Care NHS Foundation Trust, Sheffield, United Kingdom
| | - Abigail Millings
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom.,Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, United Kingdom
| | - Gillian E Hardy
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Roger K Moore
- Department of Computer Science, The University of Sheffield, Sheffield, United Kingdom
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12
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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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13
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Păsărelu CR, Andersson G, Dobrean A. Attention-deficit/ hyperactivity disorder mobile apps: A systematic review. Int J Med Inform 2020; 138:104133. [DOI: 10.1016/j.ijmedinf.2020.104133] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 02/23/2020] [Accepted: 03/23/2020] [Indexed: 12/25/2022]
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14
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Murphy C, Thorpe L, Trefusis H, Kousoulis A. Unlocking the potential for digital mental health technologies in the UK: a Delphi exercise. BJPsych Open 2020; 6:e12. [PMID: 31987060 PMCID: PMC7001470 DOI: 10.1192/bjo.2019.95] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Digitally enabled services can contribute to the support, treatment and prevention of mental health difficulties; however, questions remain regarding how we can most usefully harness such technology in primary and secondary mental healthcare settings. AIMS To identify barriers and facilitators to enable the potential of digital mental health in England, Scotland, Wales and Northern Ireland. METHOD A three-round Delphi exercise was carried out online with 16 participants from across the four nations of the UK representing the following stakeholder groups: service providers, health professionals, policymakers, lived experience, small and medium enterprises and academics. Qualitative data were collected in the first round (80 fragments) that were then coded to produce a 26-item round-two questionnaire for participant rating. Participants were given the opportunity to reconsider their scores in light of the group responses in round three. RESULTS Eight statements under the following five themes reached consensus with median scores between 8 and 10 (i.e. important/very important): co-production; the human element; data security; funding; and regulation. CONCLUSIONS The Delphi process allowed consensus to be achieved regarding the factors that experts consider important for harnessing technology in primary and secondary mental healthcare. Knowledge of these factors can help users and providers of mental health services negotiate how best to move forward with digitally enabled systems of care.
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Affiliation(s)
- Clare Murphy
- Digital Research and Policy Officer, The Mental Health Foundation, UK
| | - Lucy Thorpe
- Head of Policy, The Mental Health Foundation, UK
| | - Harriet Trefusis
- Digital Research and Policy Assistant, The Mental Health Foundation, UK
| | - Antonis Kousoulis
- Director of England and Wales, Development and Delivery, The Mental Health Foundation, UK
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15
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Shang J, Wei S, Jin J, Zhang P. Mental Health Apps in China: Analysis and Quality Assessment. JMIR Mhealth Uhealth 2019; 7:e13236. [PMID: 31697245 PMCID: PMC6873144 DOI: 10.2196/13236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 06/18/2019] [Accepted: 08/31/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Mental disorders have been a great burden on health care systems, affecting the quality of life of millions of people worldwide. Developing countries, including China, suffer from the double burden of both the increasing mental health issues in population and the deficiency in mental health care resources. The use of mobile health technologies, especially for mobile phone apps, can be a possible solution. OBJECTIVE This review aimed to describe the features and assess the quality of mental health apps in major mobile phone app markets in China and further discuss the priorities for mental health app development. METHODS Keywords including psychology, psychological health, psychological hygiene, psychological health service(s), mental, mental health, mental hygiene, mental health service(s), depression, and anxiety were searched in Chinese in 3 Android app markets (Baidu Mobile Assistant, Tencent MyApp, and 360 Mobile Assistant) and iOS App Store independently. Mental health apps were then selected according to established criteria for in-depth analysis and quality assessment by the Mobile App Rating Scale. RESULTS In total, 63 of 997 mental health apps were analyzed in depth, of which 78% (49/63) were developed by commercial entities for general population, 17% (11/63) were for patients or clients of specialized psychiatric hospitals or counseling agencies, 3% (2/63) were by government or local Centers for Disease Control and Prevention for general information, and 2% (1/63) for students of a university. Major built-in features of the apps included counseling services, mental health education, and self-assessment of mental health status by validated self-rating scales. The overall quality score of the MH apps was acceptable. CONCLUSIONS Mental health apps are emerging in the area of mobile health in China. Popular mental health apps usually provide a synthetic platform organizing resources of information, knowledge, counseling services, self-tests, and management for the general population with mental health-related inquiries. The quality of the apps was rated as acceptable on average, suggesting some space for improvement. Official guidelines and regulations are urgently required for the field in the future.
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Affiliation(s)
- Jie Shang
- The George Institute for Global Health, Peking University Health Science Center, Beijing, China
| | - Shaoming Wei
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jianbo Jin
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Puhong Zhang
- The George Institute for Global Health, Peking University Health Science Center, Beijing, China
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16
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Farr M, Pithara C, Sullivan S, Edwards H, Hall W, Gadd C, Walker J, Hebden N, Horwood J. Pilot implementation of co-designed software for co-production in mental health care planning: a qualitative evaluation of staff perspectives. J Ment Health 2019; 28:495-504. [DOI: 10.1080/09638237.2019.1608925] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Michelle Farr
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Christalla Pithara
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Sarah Sullivan
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Centre for Academic Mental Health, Population Health, Sciences, Bristol Medical School University of Bristol, Bristol, UK
| | - Hannah Edwards
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - William Hall
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | | | - Julian Walker
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | | | - Jeremy Horwood
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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17
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Bennion MR, Hardy GE, Moore RK, Kellett S, Millings A. e-Therapies in England for stress, anxiety or depression: how are apps developed? A survey of NHS e-therapy developers. BMJ Health Care Inform 2019; 26:bmjhci-2019-100027. [PMID: 31171556 PMCID: PMC7062334 DOI: 10.1136/bmjhci-2019-100027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2019] [Indexed: 12/01/2022] Open
Abstract
Objective To document the quality of web and smartphone apps used and recommended for stress, anxiety or depression by examining the manner in which they were developed. Design The study was conducted using a survey sent to developers of National Health Service (NHS) e-therapies. Data sources Data were collected via a survey sent out to NHS e-therapy developers during October 2015 and review of development company websites during October 2015. Data collection/extraction methods Data were compiled from responses to the survey and development company websites of the NHS e-therapies developers. Results A total of 36 (76.6%) out of the 48 app developers responded. One app was excluded due to its contact details and developer website being unidentifiable. Data from the missing 10 was determined from the app developer’s website. The results were that 12 out of 13 web apps and 20 out of 34 smartphone apps had clinical involvement in their development. Nine out of 13 web apps and nine out of 34 smartphone apps indicated academic involvement in their development. Twelve out of 13 web apps and nine out of 34 smartphone apps indicated published research evidence relating to their app. Ten out of 13 web apps and 10 out of 34 smartphone apps indicated having other evidence relating to their app. Nine out of 13 web apps and 19 out of 34 smartphone apps indicated having a psychological approach or theory behind their app. Conclusions As an increasing number of developers are looking to produce e-therapies for the NHS it is essential they apply clinical and academic best practices to ensure the creation of safe and effective apps.
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Affiliation(s)
| | - Gillian E Hardy
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Roger K Moore
- Department of Computer Science, The University of Sheffield, Sheffield, UK
| | - Stephen Kellett
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Abigail Millings
- Department of Psychology, The University of Sheffield, Sheffield, UK
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18
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Moor S, Williman J, Drummond S, Fulton C, Mayes W, Ward N, Dovenberg E, Whitaker C, Stasiak K. 'E' therapy in the community: Examination of the uptake and effectiveness of BRAVE (a self-help computer programme for anxiety in children and adolescents) in primary care. Internet Interv 2019; 18:100249. [PMID: 31890607 PMCID: PMC6926167 DOI: 10.1016/j.invent.2019.100249] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Recognizing and treating anxiety early is an important public mental health objective. There is clinical trial evidence that 'e' therapies are appealing, engaging and effective and have the potential to improve access to treatment. However, their implementation and effectiveness in real world settings is still emerging. Following a major natural disaster in NZ, an online therapist assisted CBT programme for children with anxiety, (BRAVE_TA) was made available in primary care. METHODS Uptake and feasibility of BRAVE_TA delivery was assessed by examining referral patterns, non-engagement rates and programme progression within a geographic region of NZ (Canterbury population of around 500,000). Effectiveness of BRAVE_TA was measured by the extent of change in the primary outcome measure of anxiety, the CAS8, between baseline and last completed session. RESULTS There were 1361 referrals to BRAVE_TA over 2014-2018, mostly from primary care doctors and nurses in primary schools. After attrition due to triage and family withdrawal, 75% (N = 1026) were enrolled. Around half of children/adolescents completed 4 sessions with moderate effect sizes achieved Children/adolescents who completed more sessions, had lower anxiety after their last session, with most of the improvement occurring within the first three to four sessions. CONCLUSION BRAVE_TA has shown to be an acceptable and effective 'e' therapy tool in a 'real world' primary care setting for children/adolescents with anxiety. This study supports the role of 'e' therapy as part of a stepped-care model within primary care in improving access to treatment and thus improving public mental health in children.Trial registry: ACTRN12612000063819.
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Affiliation(s)
- Stephanie Moor
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand,Corresponding author at: Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand.
| | - Jonathan Williman
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Sarah Drummond
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Caroline Fulton
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Wendy Mayes
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Nicola Ward
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Elizabeth Dovenberg
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Charis Whitaker
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Karolina Stasiak
- Department of Psychological Medicine, University of Auckland, New Zealand
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19
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Watfern C, Heck C, Rule C, Baldwin P, Boydell KM. Feasibility and Acceptability of a Mental Health Website for Adults With an Intellectual Disability: Qualitative Evaluation. JMIR Ment Health 2019; 6:e12958. [PMID: 30920378 PMCID: PMC6458530 DOI: 10.2196/12958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/09/2019] [Accepted: 01/20/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Electronic mental health (e-mental health) programs for people with an intellectual disability are currently underexplored but may provide a way of mitigating some of the barriers that this population faces in accessing appropriate mental health services. OBJECTIVE The aim of this study was to examine the feasibility and acceptability of Healthy Mind, an e-mental health program for adults with an intellectual disability developed by the Black Dog Institute, focusing on the design and implementation of the website. METHODS A qualitative research design was used, which involved semistructured interviews and focus groups with people with an intellectual disability, support workers, and allied health professionals. People with an intellectual disability were also observed while using the website. A thematic analysis was used to interrogate the interview transcripts and observational field notes. RESULTS Participants found the content of the website informative and appreciated the many ways that the website had been made accessible to users. Participants voiced some differing requirements regarding the way information should be presented and accessed on the website. Acknowledging different types of support needs was identified as an important issue for website dissemination. CONCLUSIONS The Healthy Mind website promises to provide an excellent tool for people with ID and their supporters. This research has pragmatic implications for the future development and implementation of the program, while contributing to knowledge in the broader fields of e-mental health and inclusive design for people with an intellectual disability.
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Affiliation(s)
- Chloe Watfern
- Black Dog Institute, Sydney, Australia.,University of New South Wales Art & Design, Sydney, Australia
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20
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Walsh S, Szymczynska P, Taylor SJ, Priebe S. The acceptability of an online intervention using positive psychology for depression: A qualitative study. Internet Interv 2018; 13:60-66. [PMID: 30206520 PMCID: PMC6112095 DOI: 10.1016/j.invent.2018.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/25/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Positive psychology interventions may usefully treat depression and can be delivered online to reduce the treatment gap. However, little is known about how acceptable patients find this approach. To address this, the present study interviewed recent users of a positive psychology self-help website. METHODS In-depth semi-structured interviews explored the experiences of twenty-three participants from a larger feasibility study. A stratified purposive sampling strategy selected participants with varying intervention experience according to their intervention logins, as well as varying age, gender and depressive symptoms. Framework analysis was used to explore patterns and linkages within and between participants' accounts. RESULTS Acceptability varied between participants. Those who found it more acceptable felt it was relevant to their depression and reported feeling empowered by a self-help approach. Conversely, participants for whom it was less acceptable perceived the positive focus irrelevant to their depression and found the emphasis on self-action unsupportive. CONCLUSIONS The acceptability of an online positive psychology intervention may be facilitated by a patients' preference for a psychological focus on the positive. However, patients may also have distinct preferences for online self-help. Future research should investigate the importance of the therapeutic orientation of online self-help interventions and whether patients' preferences for these can be reliably identified. This could help to target online self-help in clinical practice.
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Affiliation(s)
- Sophie Walsh
- Queen Mary University of London, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Glen Road, London, Newham E13 8SP, UK
| | - Paulina Szymczynska
- Queen Mary University of London, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Glen Road, London, Newham E13 8SP, UK
| | - Stephanie J.C. Taylor
- Centre for Primary Care and Public Health, Blizard Institute Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Stefan Priebe
- Queen Mary University of London, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Glen Road, London, Newham E13 8SP, UK
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21
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Hill C, Creswell C, Vigerland S, Nauta MH, March S, Donovan C, Wolters L, Spence SH, Martin JL, Wozney L, McLellan L, Kreuze L, Gould K, Jolstedt M, Nord M, Hudson JL, Utens E, Ruwaard J, Albers C, Khanna M, Albano AM, Serlachius E, Hrastinski S, Kendall PC. Navigating the development and dissemination of internet cognitive behavioral therapy (iCBT) for anxiety disorders in children and young people: A consensus statement with recommendations from the #iCBTLorentz Workshop Group. Internet Interv 2018; 12:1-10. [PMID: 30135763 PMCID: PMC6096322 DOI: 10.1016/j.invent.2018.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/13/2018] [Accepted: 02/14/2018] [Indexed: 12/21/2022] Open
Abstract
Initial internet-based cognitive behavioral therapy (iCBT) programs for anxiety disorders in children and young people (CYP) have been developed and evaluated, however these have not yet been widely adopted in routine practice. The lack of guidance and formalized approaches to the development and dissemination of iCBT has arguably contributed to the difficulty in developing iCBT that is scalable and sustainable beyond academic evaluation and that can ultimately be adopted by healthcare providers. This paper presents a consensus statement and recommendations from a workshop of international experts in CYP anxiety and iCBT (#iCBTLorentz Workshop Group) on the development, evaluation, engagement and dissemination of iCBT for anxiety in CYP.
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Affiliation(s)
- Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, UK
| | - Cathy Creswell
- School of Psychology & Clinical Language Sciences, University of Reading, UK
| | - Sarah Vigerland
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Maaike H. Nauta
- Clinical Psychology and Experimental Psychopathology, University of Groningen, The Netherlands
| | - Sonja March
- School of Psychology and Counselling & Institute for Resilient Regions, University of Southern Queensland, Australia
| | | | - Lidewij Wolters
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Trondheim, Norway
- Academic Center for Child and Adolescent Psychiatry, de Bascule, Amsterdam, The Netherlands
| | - Susan H. Spence
- Australian Institute of Suicide Research and Prevention and School of Applied Psychology, Griffith University, Australia
| | - Jennifer L. Martin
- NIHR MindTech Cooperative, Faculty of Medicine & Health Sciences, University of Nottingham, UK
| | - Lori Wozney
- Centre for Research in Family Health, IWK Health Centre, Halifax, Canada
| | - Lauren McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - Leonie Kreuze
- Clinical Psychology and Experimental Psychopathology, University of Groningen, The Netherlands
| | - Karen Gould
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - Maral Jolstedt
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Martina Nord
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Jennifer L. Hudson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - Elisabeth Utens
- Academic Center for Child and Adolescent Psychiatry, de Bascule, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, The Netherlands
| | - Jeroen Ruwaard
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| | - Casper Albers
- Department of Psychometrics & Statistics, University of Groningen, The Netherlands
| | - Muniya Khanna
- OCD & Anxiety Institute, Plymouth Meeting, PA, USA
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Eva Serlachius
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Stockholm Health Care Services, Stockholm County Council, Sweden
| | | | - Philip C. Kendall
- Child & Adolescent Anxiety Disorders Clinic, Temple University, Philadelphia, PA, USA
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22
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Digital Ecologies of Youth Mental Health: Apps, Therapeutic Publics and Pedagogy as Affective Arrangements. SOCIAL SCIENCES 2017. [DOI: 10.3390/socsci6040135] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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