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Moeller SB, Kring L. Bridging technology and care: integrating web-based PROMs in mental health services for refugees: a study on clinician training and technology adoption. Front Psychol 2024; 15:1355588. [PMID: 38895500 PMCID: PMC11184662 DOI: 10.3389/fpsyg.2024.1355588] [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: 12/14/2023] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
This study explores the integration of a web-based electronic database technology containing patient-reported outcome measures (PROMs) with electronic health records for refugees with PTSD, emphasizing the systematic inclusion of patient perspectives in clinical decision-making. Our research addresses the notable gap in literature regarding training clinicians for the competent integration of health information technology in healthcare. The training program developed aimed at equipping clinicians, particularly inexperienced with technology, to effectively utilize an electronic PROM system for collecting systematic patient information. Our study is set in the context of the Mental Health Services (MHS) in Denmark, focusing on a specialized clinic for treating trauma-affected refugees. The multidisciplinary team involved in this project reflects a wide range of healthcare professionals. The training program employed a variety of activities over nearly 2 years, adapting to feedback and aiming to engage clinicians in continuous improvement processes. Analyzing qualitative data with thematic analysis we interpreted that the training's extended focus on discussion of the implementation process, with limited hands-on experience, potentially reinforced clinicians' hesitations toward new technology, rather than reducing them. Clinicians prioritized immediate concerns over potential long-term benefits. Despite this, their approach reflects a strong commitment to patient welfare and careful evaluation of new practices. Notably, there were also positive engagements with the technology, highlighting its potential in patient care. This study concludes that the successful integration of technology in clinical settings hinges on its alignment with clinicians' workflows, respect for their professional judgment, and clear benefits to patient care.
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Affiliation(s)
- Stine Bjerrum Moeller
- Mental Health Services, Region of Southern Denmark, Department of Trauma and Torture Survivors, Vejle, Denmark
- Department of Psychology, University of Southern Denmark, Danish Center of Psychotraumatology, Odense, Denmark
| | - Lotte Kring
- Mental Health Services, Region of Southern Denmark, Department of Trauma and Torture Survivors, Vejle, Denmark
- Department of Psychology, University of Southern Denmark, Danish Center of Psychotraumatology, Odense, Denmark
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2
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Ross DC, McCallum N, Truuvert AK, Butt A, Behdinan T, Rojas D, Soklaridis S, Vigod S. The development and evaluation of a virtual, asynchronous, trauma-focused treatment program for adult survivors of childhood interpersonal trauma. J Ment Health 2024:1-10. [PMID: 38572918 DOI: 10.1080/09638237.2024.2332797] [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] [Accepted: 08/05/2023] [Indexed: 04/05/2024]
Abstract
BACKGROUND The long-term mental and physical health implications of childhood interpersonal trauma on adult survivors is immense, however, there is a lack of available trauma-focused treatment services that are widely accessible. This study, utilizing a user-centered design process, sought feedback on the initial design and development of a novel, self-paced psychoeducation and skills-based treatment intervention for this population. AIMS To explore the views and perspectives of adult survivors of childhood interpersonal trauma on the first two modules of an asynchronous trauma-focused treatment program. METHODS Fourteen participants from our outpatient hospital service who completed the modules consented to provide feedback on their user experience. A thematic analysis of the three focus groups was conducted. RESULTS Four major themes emerged from the focus groups: (1) technology utilization, (2) module content, (3) asynchronous delivery, and (4) opportunity for interactivity. Participants noted the convenience of the platform and the use of multimedia content to increase engagement and did not find the modules to be emotionally overwhelming. CONCLUSIONS Our research findings suggest that an asynchronous virtual intervention for childhood interpersonal trauma survivors may be a safe and acceptable way to provide a stabilization-focused intervention on a wider scale.
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Affiliation(s)
- Dana C Ross
- Women's College Hospital and Research Institute, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nancy McCallum
- Women's College Hospital and Research Institute, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Annie K Truuvert
- Women's College Hospital and Research Institute, Toronto, ON, Canada
| | - Aysha Butt
- Women's College Hospital and Research Institute, Toronto, ON, Canada
| | - Tina Behdinan
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - David Rojas
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
| | - Sophie Soklaridis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
- Centre for Addictions and Mental Health, Toronto, ON, Canada
| | - Simone Vigod
- Women's College Hospital and Research Institute, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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3
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Mattison G, Canfell OJ, Forrester D, Dobbins C, Smith D, Reid D, Sullivan C. A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care. Med J Aust 2023; 218:384-388. [PMID: 37182214 DOI: 10.5694/mja2.51920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 05/16/2023]
Affiliation(s)
- Graeme Mattison
- Queensland Digital Health Centre, University of Queensland, Brisbane, QLD
- Digital Health Cooperative Research Centre, Sydney, NSW
| | - Oliver J Canfell
- Queensland Digital Health Centre, University of Queensland, Brisbane, QLD
- Digital Health Cooperative Research Centre, Sydney, NSW
| | - Doug Forrester
- The Prince Charles Hospital, Brisbane, QLD
- Curtin University, Perth, WA
| | | | - Daniel Smith
- The Prince Charles Hospital, Brisbane, QLD
- University of Queensland, Brisbane, QLD
| | - David Reid
- The Prince Charles Hospital, Brisbane, QLD
- QIMR Berghofer Medical Research Institute, Brisbane, QLD
| | - Clair Sullivan
- Queensland Digital Health Centre, University of Queensland, Brisbane, QLD
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4
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Kosasih FR, Yee VTS, Toh SHY, Sündermann O. Efficacy of Intellect's self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up. PLOS DIGITAL HEALTH 2023; 2:e0000095. [PMID: 37224139 DOI: 10.1371/journal.pdig.0000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/24/2023] [Indexed: 05/26/2023]
Abstract
Digital self-guided mobile health [mHealth] applications are cost-effective, accessible, and well-suited to improve mental health at scale. This randomized controlled trial [RCT] evaluated the efficacy of a recently developed mHealth programme based on cognitive-behavioral therapy [CBT] principles in improving worry and anxiety. We also examined psychological mindedness [PM] as a mediator by which app engagement is thought to improve outcomes. The Intervention group completed a 2-week "Anxiety and Worry" programme with daily CBT-informed activities, while the active waitlist-control completed a matched 2-week mHealth programme on procrastination. Participants filled out the Generalized Anxiety Disorder [GAD-7], Patient Health Questionnaire [PHQ-9], and Psychological Mindedness Scale [PMS] at baseline, post-intervention, and 2-week follow-up. App engagement was measured at post-intervention only. Contrary to prediction, the Intervention group did not perform better than the Active Control group; both groups showed significant improvements on anxiety and depressive symptoms from baseline to follow-up. From post-intervention to follow-up, only the Intervention group showed further improvements for anxiety symptoms. Higher engagement with the mHealth app predicted lower anxiety and depressive symptoms at follow-up, and this relationship was fully mediated by psychological mindedness. This study provides evidence that [a] engaging in a CBT mHealth programme can reduce anxiety and worry, and [b] Psychological mindedness is a potential pathway by which engaging with a mHealth app improves anxiety and depressive symptoms. While overall effect sizes were small, at the population level, these can make significant contributions to public mental health.
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Affiliation(s)
| | | | | | - Oliver Sündermann
- Research Department, Intellect Co Pte Ltd, Singapore
- Department of Psychology, National University of Singapore
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5
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Orsolini L, Appignanesi C, Pompili S, Volpe U. The role of digital tools in providing youth mental health: results from an international multi-center study. Int Rev Psychiatry 2022; 34:809-826. [PMID: 36786119 DOI: 10.1080/09540261.2022.2118521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Since the traditional mental health system showed significant limitations in the early identification, diagnosis and treatment of the current new youth psychopathological trajectories, by substantially failing in targeting the needs of the current young generation, there is the demand to redesign and digitally adapt youth mental health care and systems. Indeed, the level of digital literacy and the level of digital competency and knowledge in the field of digital psychiatry is still under-investigated among mental health professionals, particularly in youth mental health. Therefore, we aimed at: (a) carrying out a post-hoc analysis of an international multi-centre study, to investigate the opinions of mental health professionals regarding the feasibility, efficacy and clinical experience in delivering digital mental health interventions (DMHIs) in youths; (b) providing a comprehensive overview on the integrated digitally-based youth mental health care models and innovations. Mental health professionals declared the lack of a formal training in digital psychiatry, particularly in youth mental health. Subjects who received a formal theoretical/practical training on DMHIs displayed a statistical trend towards a positive feasibility of digital psychiatry in youth mental health (p = 0.053) and a perceived increased efficacy of digital psychiatry in youths (p = 0.051). Respondents with higher Digital Psychiatry Opinion (DPO) scores reported a positive perceived feasibility of DMHIs in youths (p < 0.041) and are more prone to deliver DMHIs to young people (p < 0.001). Respondents with higher knowledge scores (KS) declared that DMHIs are more effective in youth mental health (p < 0.001). Overall, the digitalisation indeed allowed young people to keep in touch with a mental health professional, facilitating a more dynamic and fluid mental health care access and monitoring, generally preferred and considered more feasible by post-Millennial youngsters. Accordingly, our findings demonstrated that mental health professionals are more prone to offer DMHIs in youth mental health, particularly whether previously trained and knowledgeable on the topic.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Cristina Appignanesi
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Simone Pompili
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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6
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Topitzer M, Kou Y, Kasumba R, Kreniske P. How Differing Audiences Were Associated with User Emotional Expression on a Well-Being App. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2022; 2022:4453980. [PMID: 38031588 PMCID: PMC10686580 DOI: 10.1155/2022/4453980] [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] [Indexed: 12/01/2023]
Abstract
In the last five years there has been an explosion of mobile apps that aim to impact emotional well-being, yet limited research has examined the ways that users interact, and specifically write to develop a therapeutic alliance within these apps. Writing is a developmental practice in which a narrator transforms amorphous thoughts and emotions into expressions, and according to narrative theory, the linguistic characteristics of writing can be understood as a physical manifestation of a narrator's affect. Informed by literacy theorists who have argued convincingly that narrators address different audiences in different ways, we used IBM Watson's Natural Language Processing software (IBM Watson NLP) to examine how users' expression of emotion on a well-being app differed depending on the audience. Our findings demonstrate that audience was strongly associated with the way users' expressed emotions in writing. When writing to an explicit audience users wrote longer narratives, with less sadness, less anger, less disgust, less fear and more joy. These findings have direct relevance for researchers and well-being app design.
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Affiliation(s)
- Maya Topitzer
- Columbia University Mailman School of Public Health, Department of Biostatistics
| | - Yueming Kou
- Columbia University Mailman School of Public Health, Department of Biostatistics
| | - Robert Kasumba
- Washington University in St. Louis, International Center for Child Health and Development McKelvey School of Engineering
| | - Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University
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7
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Wirsiy FS, Atuhaire C, Ngonzi J, Cumber SN. A randomized controlled trial on mobile phone text messaging to improve sexo-reproductive health among adolescent girls in Cameroon. Contracept Reprod Med 2022; 7:12. [PMID: 35780241 PMCID: PMC9250721 DOI: 10.1186/s40834-022-00180-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background We conducted a single-centered randomized controlled single-blinded trial (i.e. trained interviewers; blinded to group allocation). The target population included adolescent girls in the Kumbo West Health District (KWHD) of Cameroon. This trial tested the efficacy of weekly educational one-way text messages to improve perception of adolescent girls on sexo-reproductive health. Methods Allocation concealment (1:1) was determined by sequentially numbered sealed opaque envelopes. A total of 398 participants either received the mobile phone sexo-reproductive health text messages (199) or not (199). A blinded program secretary send out text messages and recorded delivery. Data was collected and managed at baseline and at 6 month intervals using an interviewer-administered questionnaire before and after intervention, then analysed using the independent T-test (mean differences) and ANOVA on SPSS version 21. Results The mean knowledge, attitude and practice scores respectively increased significantly from 6.03, 4.01 and 3.45 at baseline to 7.99, 5.83 and 4.99 at the end of the study. After performing ANOVA for the overall correct knowledge, positive attitudes and good practices respectively for between and within the intervention groups, we obtained: (F = 15.12, P = 0.023), (F = 60.21, P = 0.001) and (F = 57., P = 0.013) which showed statistical significance thus indicating the overall improvement in adolescents girls perception as a result of the intervention and not by chance. Majority (65.3%) of the participants were satisfied with the Short Message Service (SMS). Conclusion This trial has contributed to the body of knowledge and evidence on the use of mobile phone technology using educative SMS to improve adolescent girl’s perception on sexo-reproductive health in Cameroon. Trial registration Pan African Clinical Trials Registry, PACTR201805003259293. Registered 28 March 2018.
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Affiliation(s)
- Frankline Sevidzem Wirsiy
- United Nations Office for the Coordination of Humanitarian Affairs, Yaoundé, Cameroon.,United Nations Volunteer, Bafoussam, Cameroon.,Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Catherine Atuhaire
- Faculty of Medicine, Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Joseph Ngonzi
- Faculty of Medicine, Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Samuel Nambile Cumber
- Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa.,Office of the Dean, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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8
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McCallum M, Ho AS, Mitchell ES, May CN, Behr H, Ritschel L, Mochrie K, Michaelides A. Feasibility, Acceptability, and Preliminary Outcomes of a Cognitive Behavioral Therapy–Based Mobile Mental Well-being Program (Noom Mood): Single-Arm Prospective Cohort Study. JMIR Form Res 2022; 6:e36794. [PMID: 35436218 PMCID: PMC9055471 DOI: 10.2196/36794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/08/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background The prevalence of anxiety, depression, and general distress has risen in recent years. Mobile mental health programs have been found to provide support to nonclinical populations and may overcome some of the barriers associated with traditional in-person treatment; however, researchers have voiced concerns that many publicly available mobile mental health programs lack evidence-based theoretical foundations, peer-reviewed research, and sufficient engagement from the public. Objective This study aimed to evaluate the feasibility, acceptability, and preliminary outcomes of Noom Mood, a commercial mobile cognitive behavioral therapy– and mindfulness-based program. Methods In this single-arm prospective cohort study, individuals who joined Noom Mood between August and October 2021 completed surveys at baseline and 4-week follow-up. Per-protocol analyses included those who completed both surveys (n=113), and intention-to-treat analyses included all participants (N=185). Results A majority of the sample reported that the program is easy to use, they felt confident recommending the program to a friend, and they perceived the program to be effective at improving stress and anxiety. There were significant improvements in anxiety symptoms, perceived stress, depressive feelings, emotion regulation, and optimism in both the per-protocol and intention-to-treat analyses (all P<.001). Participants reported benefiting most from learning skills (eg, breathing and cognitive reframing techniques), interacting with the program features, and gaining awareness of their emotions and thought patterns. Participants also made a number of suggestions to improve product functionality and usability. Conclusions Results suggest that Noom Mood is feasible and acceptable to participants, with promising preliminary outcomes. Future studies should build on these results to evaluate the effects of Noom Mood using more rigorous designs.
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Affiliation(s)
| | | | | | | | - Heather Behr
- Academic Research, Noom Inc, New York, NY, United States
- Department of Integrative Health, Saybrook University, Pasadena, CA, United States
| | - Lorie Ritschel
- Triangle Area Psychology Clinic, Durham, NC, United States
- School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Kirk Mochrie
- Triangle Area Psychology Clinic, Durham, NC, United States
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9
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Rubeis G. [Digital interventions for refugees. Challenges, opportunities, and perspectives of agency]. Ethik Med 2021; 33:335-352. [PMID: 33785987 PMCID: PMC7994955 DOI: 10.1007/s00481-021-00621-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/08/2021] [Indexed: 02/05/2023]
Abstract
DEFINITION OF THE PROBLEM Refugees show a high prevalence of mental health burden. Catering to the need for mental health services is made difficult by access barriers. These barriers consist of structural factors as well as culturally different attitudes towards mental health, mental illness, and therapeutic interventions. One option to overcome these access barriers and to provide mental healthcare services in an appropriate manner is seen in digital interventions. In the form of interactive websites or smartphone apps, these interventions have proven to be effective in mental healthcare. There are also promising examples of successful use of these technologies with refugees. However, the ethical aspects of digital interventions for refugees have scarcely been studied yet. ARGUMENTS Aim of this paper is to tackle this research desiderate. The instrument of the ethical analysis to be conducted is the concept of agency. According to the concept of agency, persons have to be seen as actors capable of acting based on their own resources and competencies. Agency is the guiding principle here for analyzing the opportunities and risks of digital interventions for refugees. In addition, I will attempt to point out prospects for an agency-based application of digital interventions. CONCLUSION The ethical analysis could be used as the blueprint for developing therapeutic concepts that contribute to the improvement of mental healthcare services for refugees from an ethical perspective.
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Affiliation(s)
- Giovanni Rubeis
- Institut für Geschichte und Ethik der Medizin, Medizinische Fakultät, Ruprecht-Karls-Universität Heidelberg, Im Neuenheimer Feld 327, 69120 Heidelberg, Deutschland
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10
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The emerging clinical role of wearables: factors for successful implementation in healthcare. NPJ Digit Med 2021; 4:45. [PMID: 33692479 PMCID: PMC7946921 DOI: 10.1038/s41746-021-00418-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/16/2021] [Indexed: 01/06/2023] Open
Abstract
Wearable technologies promise to redefine assessment of health behaviors, yet their clinical implementation remains a challenge. To address this gap, two of the NIH’s Big Data to Knowledge Centers of Excellence organized a workshop on potential clinical applications of wearables. A workgroup comprised of 14 stakeholders from diverse backgrounds (hospital administration, clinical medicine, academia, insurance, and the commercial device industry) discussed two successful digital health interventions that involve wearables to identify common features responsible for their success. Seven features were identified including: a clearly defined problem, integration into a system of healthcare delivery, technology support, personalized experience, focus on end-user experience, alignment with reimbursement models, and inclusion of clinician champions. Health providers and systems keen to establish new models of care inclusive of wearables may consider these features during program design. A better understanding of these features is necessary to guide future clinical applications of wearable technology.
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11
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Ganapathy A, Clough BA, Casey LM. Organizational and Policy Barriers to the Use of Digital Mental Health by Mental Health Professionals. Telemed J E Health 2021; 27:1332-1343. [PMID: 33646057 DOI: 10.1089/tmj.2020.0455] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Digital mental health (DMH) provides effective methods of overcoming issues of time constraints, accessibility, and availability of mental health care. They can provide a valuable means to deliver mental health care in the present pandemic. However, adoption of these methods has been slow. Mental health professional (MHP) concerns at the organizational and policy level that influence this slow adoption need to be examined. Materials and Methods: A narrative review was conducted to identify the barriers. Searches using the databases Scopus, Embase, and PubMed were conducted to identify research focused on barriers reported by MHPs to use DMH. Results: The search resulted in 356 unique citations, and 21 papers met the inclusion and exclusion criteria. Forward and backward sampling resulted in identifying an additional 19 relevant papers. Discussion: Unmet needs for information, training, and infrastructure, challenges to the workflow and excessive workloads, and ambiguous policies serve as barriers to DMH use. This article recommends strategies for researchers, organizations, DMH designers, and governmental institutions to ensure efficient utilization of DMH. Conclusion: Concerted efforts at individual, organizational, and governmental levels are essential to ensure efficient utilization of DMH.
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Affiliation(s)
- Aarthi Ganapathy
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute, Mount Gravatt, Australia
| | - Bonnie A Clough
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute, Mount Gravatt, Australia
| | - Leanne M Casey
- School of Applied Psychology, Griffith University, Brisbane, Australia.,Menzies Health Institute, Mount Gravatt, Australia
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12
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Jansen R, Reid M. Interest in Communication Technology by Rural Caregivers of Adolescents with Mental Health Issues in South Africa: The Mmogo-Method ®. Issues Ment Health Nurs 2021; 42:24-37. [PMID: 32633169 DOI: 10.1080/01612840.2020.1774017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Caregivers determine the level of care adolescents with mental issues receive; however, caregivers' own needs are often unmet. Communication technology can be tailored to address these challenges, especially in a rural environment. This study aimed to explore caregivers' interest in using communication technology to provide support to address challenges. This study involved a visual-based narrative inquiry that gathered data through the Mmogo-method®. Three (n = 3) groups were held with rural caregivers (n = 17) of adolescents with mental health issues in a rural area in the Free State province of South Africa during 2017. Three themes captured challenges confronting caregivers, namely, psychosocial, social resources, and informational challenges. Interest in communication technology was captured in a fourth theme. The findings indicate that communication technology can address caregivers' challenges by providing support and information to caregivers in rural areas. Communication technology, including mobile phones, electronic devices, and the Internet, has transformed healthcare services and proved to be valuable in resource constraint environments.
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Affiliation(s)
- Ronelle Jansen
- School of Nursing, University of the Free State, Bloemfontein, South Africa
| | - Marianne Reid
- School of Nursing, University of the Free State, Bloemfontein, South Africa
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13
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Buitenweg DC, van de Mheen D, van Oers HAM, van Nieuwenhuizen C. Psychometric Properties of the QoL-ME: A Visual and Personalized Quality of Life Assessment App for People With Severe Mental Health Problems. Front Psychiatry 2021; 12:789704. [PMID: 35069291 PMCID: PMC8767156 DOI: 10.3389/fpsyt.2021.789704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/29/2021] [Indexed: 11/27/2022] Open
Abstract
Background: Quality of Life (QoL) assessment in people with severe mental health problems may benefit from improved personalization and accessibility. Therefore, an innovative, digital, visual, and personalized QoL assessment app for people with severe mental health problems was recently developed: the QoL-ME. The aim of this study was to evaluate the psychometric quality of the QoL-ME by assessing its reliability, validity, and responsiveness. Methods: To examine the reliability of the QoL-ME, the internal consistency of its subscales was assessed using Cronbach's Alpha. Correlations between the QoL-ME and the MANSA were computed to appraise the construct validity of the QoL-ME. Internal responsiveness was evaluated using the standardized response mean and external responsiveness was investigated using hierarchical regression. Results: Cronbach's Alpha's of the subscales of the QoL-ME ranged between 0.5 and 0.84. In accordance with expectations, the language-based core version of the QoL-ME correlated strongly (r = between 0.55 and 0.76) with the MANSA, whilst the picture-based additional modules of the QoL-ME correlated moderately (r = 0.3) with the MANSA. The standardized response mean was 0.23 and the regression model revealed a coefficient β of -0.01. Conclusions: The QoL-ME has adequate psychometric properties. In comparison with similar pictorial instruments, both the QoL-ME's reliability and validity can be considered as sufficient. The results indicate that the responsiveness of the QoL-ME is insufficient. Additional research is needed to evaluate and potentially modify the instrument to improve its responsiveness.
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Affiliation(s)
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Hans A M van Oers
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Chijs van Nieuwenhuizen
- GGzE Institute for Mental Health Care, Eindhoven, Netherlands.,Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
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14
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Hasking P, Lewis SP, Bloom E, Brausch A, Kaess M, Robinson K. Impact of the COVID-19 pandemic on students at elevated risk of self-injury: The importance of virtual and online resources. SCHOOL PSYCHOLOGY INTERNATIONAL 2020. [DOI: 10.1177/0143034320974414] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Non-suicidal self-injury (NSSI), which involves deliberate damage to body tissue without suicidal intent, has long been a concern for schools and school staff. Secondary schools are an ideal setting in which to identify, and appropriately refer, students who self-injure as well as implement evidence-based prevention and early intervention programs. However, in the context of the global COVID-19 pandemic, schools have been closed and students sent home to learn online. This may result in the exacerbation of existing anxieties and pose several new stressors that cumulatively may increase risk of NSSI. In this article, we draw on recent research and our collective experience working with schools, as well as digital mental health, to outline some of these potential stressors and offer resources for school staff to help students who are engaging in or at risk of NSSI.
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Affiliation(s)
| | | | - Elana Bloom
- Student Services Department, Lester B Pearson School Board, Quebec, Canada
| | - Amy Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kealagh Robinson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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15
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Mayer G, Alvarez S, Gronewold N, Schultz JH. Expressions of Individualization on the Internet and Social Media: Multigenerational Focus Group Study. J Med Internet Res 2020; 22:e20528. [PMID: 33146622 PMCID: PMC7673976 DOI: 10.2196/20528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/05/2020] [Accepted: 09/15/2020] [Indexed: 01/26/2023] Open
Abstract
Background Growing individualization within the past decades has been described as a fundamental shift in society. Studies have reported how the digital age promotes new forms of individualism with self-tracking technologies and self-presentation in social networks. Potential harmful effects on the mental health of young adults have already been at the forefront of research. However, 2 questions that remain unanswered are how emotional experiences and expressions of self-relatedness differ among generations in their usage of the internet and social media, and if an increasing individualism can be observed by this. Objective The aim of this study is to examine whether the use of the internet and social media has led people to be more concerned about themselves than former generations. The potential consequences of mental and emotional distress among different age groups are analyzed. Methods A focus-group approach was chosen to study the following age groups: Baby Boomers (those born in 1950-1965), Generation X (those born in 1966-1980), and Digital Natives (those born in 1981-2000). We organized 6 focus groups with 36 participants who discussed their private usage of the internet and social media, different devices, platforms and functions, communication behavior, and self-tracking. We applied inductive category formation and followed the Standards for Reporting Qualitative Research (SRQR) checklist. Results We found differences in the 3 studied generations regarding the reasons for their use of the internet and social media, the effects of this use, personal feelings and experiences, expressions of self-relatedness, and social relationships. The Baby Boomers voiced a wish to stay autonomous while being in contact with their personal network. Generation X included enthusiastic members who appreciate self-tracking for curiosity and fascination, as well as people who felt fears about data surveillance. The Digital Natives reported a wish to optimize their own body by self-tracking while being faced with norms and expectations that were communicated via the internet and social media. Conclusions All generations expressed self-relatedness, yet by different means. The Baby Boomers expressed less individualism than Generation X and the Digital Natives, who felt the highest strain due to social comparisons. However, all generations reported specific, potentially problematic consequences for their mental health. Age-specific coping strategies are necessary to promote a mentally healthy way of using the internet and social media.
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Affiliation(s)
- Gwendolyn Mayer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Simone Alvarez
- Texas A&M University - Central Texas, Killeen Texas, TX, United States
| | - Nadine Gronewold
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
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16
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Parker AM, Nelliot A, Chessare CM, Malik AM, Koneru M, Hosey MM, Ozok AA, Lyons KD, Needham DM. Usability and acceptability of a mobile application prototype for a combined behavioural activation and physical rehabilitation intervention in acute respiratory failure survivors. Aust Crit Care 2020; 33:511-517. [PMID: 32340769 DOI: 10.1016/j.aucc.2020.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Acute respiratory failure survivors experience depression symptoms and new impairments in physical function. Behavioural activation, an evidence-based nonpharmacological treatment for depression, combined with physical rehabilitation, is a promising intervention. Notably, mHealth applications (Apps) are potentially effective methods of delivering home-based interventions. OBJECTIVES The objective of this study was to evaluate the usability and acceptability of a prototype App to deliver a combined, home-based behavioural activation and rehabilitation intervention to acute respiratory failure survivors. METHODS A prospective user-preference study was conducted with acute respiratory failure survivors and self-designated care partners. Survivors were adults with at least mild depression symptoms before hospital discharge who received mechanical ventilation in the intensive care unit for ≥24 h. Survivors and care partners reviewed the App during a single in-person home visit and completed the System Usability Scale (range: 0-100; score >73 considered "good") and a semistructured interview. RESULTS Ten patient/care partner dyads completed study. The median [interquartile range] patient age was 50 [40-64] years, and 50% were female. The median System Usability Scale scores among patients and care partners were 76 [68-83] and 88 [75-94], respectively. Qualitative feedback supported usability and acceptability of the App, with three themes reported: (1) stigma associated with depression, (2) App as a motivator for recovery, and (3) App providing multidisciplinary support for survivor and care partner. CONCLUSIONS A mobile App prototype designed to deliver a combined behavioural activation and rehabilitation intervention was usable and acceptable to survivors of acute respiratory failure and their care partners. Given the reported stigma associated with depression, the self-directed App may be particularly valuable for motivation and multidisciplinary support.
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Affiliation(s)
- Ann M Parker
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Archana Nelliot
- Department of Pediatrics, Hershey Medical Center, Hershey, PA, USA
| | - Caroline M Chessare
- Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Albahi M Malik
- Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mounica Koneru
- Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Megan M Hosey
- Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Ant Ozok
- Department of Information Systems, University of Maryland Baltimore County, Baltimore, MD, USA
| | - Kathleen D Lyons
- Department of Psychiatry Research, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Dartmouth College, Hanover, NH, USA
| | - Dale M Needham
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Surgery and Critical Illness Research Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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17
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Morgiève M, Genty C, Azé J, Dubois J, Leboyer M, Vaiva G, Berrouiguet S, Courtet P. A Digital Companion, the Emma App, for Ecological Momentary Assessment and Prevention of Suicide: Quantitative Case Series Study. JMIR Mhealth Uhealth 2020; 8:e15741. [PMID: 33034567 PMCID: PMC7584985 DOI: 10.2196/15741] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/08/2020] [Accepted: 06/03/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Many suicide risk factors have been identified, but traditional clinical methods do not allow for the accurate prediction of suicide behaviors. To face this challenge, emma, an app for ecological momentary assessment (EMA), ecological momentary intervention (EMI), and prediction of suicide risk in high-risk patients, was developed. OBJECTIVE The aim of this case report study was to describe how subjects at high risk of suicide use the emma app in real-world conditions. METHODS The Ecological Mental Momentary Assessment (EMMA) study is an ongoing, longitudinal, interventional, multicenter trial in which patients at high risk for suicide are recruited to test emma, an app designed to be used as a self-help tool for suicidal crisis management. Participants undergo clinical assessment at months 0, 1, 3, and 6 after inclusion, mainly to assess and characterize the presence of mental disorders and suicidal thoughts and behaviors. Patient recruitment is still ongoing. Some data from the first 14 participants who already completed the 6-month follow-up were selected for this case report study, which evaluated the following: (1) data collected by emma (ie, responses to EMAs), (2) metadata on emma use, (3) clinical data, and (4) qualitative assessment of the participants' experiences. RESULTS EMA completion rates were extremely heterogeneous with a sharp decrease over time. The completion rates of the weekly EMAs (25%-87%) were higher than those of the daily EMAs (0%-53%). Most patients (10/14, 71%) answered the EMA questionnaires spontaneously. Similarly, the use of the Safety Plan Modules was very heterogeneous (2-75 times). Specifically, 11 patients out of 14 (79%) used the Call Module (1-29 times), which was designed by our team to help them get in touch with health care professionals and/or relatives during a crisis. The diversity of patient profiles and use of the EMA and EMI modules proposed by emma were highlighted by three case reports. CONCLUSIONS These preliminary results indicate that patients have different clinical and digital profiles and needs that require a highly scalable, interactive, and customizable app. They also suggest that it is possible and acceptable to collect longitudinal, fine-grained, contextualized data (ie, EMA) and to offer personalized intervention (ie, EMI) in real time to people at high risk of suicide. To become a complementary tool for suicide prevention, emma should be integrated into existing emergency procedures. TRIAL REGISTRATION ClinicalTrials.gov NCT03410381; https://clinicaltrials.gov/ct2/show/NCT03410381.
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Affiliation(s)
- Margot Morgiève
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,ICM - Brain and Spine Institute, hôpital de la Pitié-Salpêtrière, Paris, France.,GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France
| | - Catherine Genty
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Jérôme Azé
- LIRMM, UMR 5506, Montpellier University/CNRS, Montpellier, France
| | - Jonathan Dubois
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Marion Leboyer
- Fondation Fondamental, hôpital Albert-Chenevier, Créteil, France
| | - Guillaume Vaiva
- GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France.,CHU Lille, Hôpital Fontan, Department of Psychiatry, Lille, France.,Centre National de Ressources & Résilience pour les psychotraumatismes, Lille, France.,Université de Lille, CNRS UMR-9193, SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Sofian Berrouiguet
- GEPS - Groupement d'Étude et de Prévention du Suicide, Paris, France.,EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,IMT Atlantique, Lab-STICC, Brest, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, INSERM, Univ Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.,Fondation Fondamental, hôpital Albert-Chenevier, Créteil, France
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18
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Yang Y, Li S, Zhang K, Xiang X, Li Z, Ahn S, Murphy J. How the Daily Smartphone is Associated With Daily Travel, Physical Activity, and Self-Perceived Health: Evidence From 2017 National Household Travel Survey. J Aging Phys Act 2020; 28:740-748. [PMID: 32434149 DOI: 10.1123/japa.2019-0222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 11/18/2022]
Abstract
Knowledge of how smartphone use in daily life, rather than in the context of intervention, may influence people's behaviors and health is limited and mixed. The 2017 National Household Travel Survey (NHTS) data were used to examine the associations between daily smartphone use and several outcomes, including engaging in vigorous physical activity, self-perceived being healthy, and the adjusted mean differences for total trips and active travels among older adults (≥65 years) as well as among young and middle-aged groups (18-64 years), respectively. The prevalence of daily smartphone use declined with increasing age. Daily smartphone use was associated with increased total trips and active travel, a higher likelihood of engaging in vigorous physical activity, and in self-perceived being healthy status. The associations were stronger among older adults than young and middle-aged adults. More studies are needed to address the complex pathways among daily smartphone use and other outcomes. Daily smartphone use has the potential to address the unmet daily needs of older adults and bridge health disparities for this disadvantaged group.
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19
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Stubbe DE. Enhancing Adherence: Using Mobile Health Technology to Improve Self-Management for Individuals With Schizophrenia. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:424-427. [PMID: 33343253 PMCID: PMC7725159 DOI: 10.1176/appi.focus.20200028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Dorothy E Stubbe
- Child Study Center, Yale University School of Medicine, New Haven, CT
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20
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eHealth Treatments for Compulsive Overeating: a Narrative Review. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00312-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Kamel MM, Westenberg JN, Choi F, Tabi K, Badawy A, Ramy H, Elsawi H, Krausz M. Electronic Mental Health as an Option for Egyptian Psychiatry: Cross-Sectional Study. JMIR Ment Health 2020; 7:e19591. [PMID: 32788155 PMCID: PMC7453323 DOI: 10.2196/19591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/24/2020] [Accepted: 06/12/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Egypt is a country of nearly 100 million citizens, and there are less than 1000 registered psychiatrists. The mental health care system is under resourced and nearly inaccessible for the majority of the population. In addition, youth under the age of 25 years represent 50% of Egyptian citizens; however, there are no specific services addressing their unique needs. How can the needs of the largest population in the Middle East be effectively addressed? Is a web-based framework an option for Egyptian psychiatrists to serve the population? OBJECTIVE The aims of this study were to better understand the opinions of psychiatrists on the current state of mental health care services in Egypt and their current knowledge on electronic mental health (EMH); assess the attitudes of Egyptian psychiatrists toward web-based interventions and telemedicine for mental health; and identify perceived advantages and barriers of EMH development in Egypt. METHODS A cross-sectional survey was conducted online among 640 Egyptian psychiatrists. It included a total of 36 items within a set of 16 questions asking about EMH literacy, integrating EMH into the mental health care system, and the perceived priorities and barriers of EMH. The sampling was supported by Tanta University, a large academic institution close to Cairo. Statistical analysis was performed using SPSS 25 (IBM Corp). Descriptive statistics, the chi-square test, the independent sample t test, and analysis of variance were applied. RESULTS A total of 188 participants responded (response rate of 29.4%), of which 54.2% (102/188) were female and 54.3% (102/188) were between 30 and 45 years old. Less than half of the participants thought that the current health care system was efficient for adults (69/155, 44.4%), and even less thought it was efficient for youth (44/155, 28.3%). Almost all participants agreed that EMH would be beneficial for patient care (147/155, 94.8%) and that integrating EMH into the current health care system would be a good idea (118/155, 76.2%). The highest rated utility of web-based solutions was documentation, followed by psychoeducation and communication with professionals. The main advantages were to improve access to care in rural areas of the country and its convenience. CONCLUSIONS There is scarcity of mental health resources in Egypt. Egyptian psychiatrists are interested in EMH and believe web-based platforms can become part of the solution for the Egyptian mental health care system.
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Affiliation(s)
- Mostafa Mamdouh Kamel
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, Tanta University, Tanta, Egypt
| | | | - Fiona Choi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Katarina Tabi
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Healthy Minds Centre, BC Children's Hospital, Vancouver, BC, Canada
| | - Adel Badawy
- Department of Psychiatry, Tanta University, Tanta, Egypt
| | - Hisham Ramy
- Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Hossam Elsawi
- Department of Psychiatry, Tanta University, Tanta, Egypt
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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22
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Rubeis G, Primc N. Ethische Aspekte internet- und mobilgestützter Interventionen
(IMIs) bei Suchtstörungen. SUCHTTHERAPIE 2020. [DOI: 10.1055/a-1180-5057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Zusammenfassung
Ziel der Studie Internet- und mobilgestützte Interventionen
(IMIs) werden häufig bei Suchtstörungen eingesetzt. Für
die Wirksamkeit von IMIs liegt eine umfangreiche Evidenz vor. Hinsichtlich der
spezifischen ethischen Aspekte, die sich aus dem Einsatz von IMIs bei
Suchtstörungen ergeben, fehlt es bislang an Forschung. Mit unserem
Beitrag leisten wir die erste eingehende ethische Analyse von IMIs in der
Suchttherapie. Dabei orientieren wir uns an normativen Aspekten, die spezifisch
für die Behandlung von Suchtstörungen sind. Dazu gehören
die besondere Stigmatisierung von Suchtkranken, die Zuschreibung von Schuld und
Eigenverantwortung, die mangelnde Akzeptanz des Krankheitskonzepts Sucht sowie
die daraus resultierende Ablehnung und Abwertung von Betroffenen.
Methode Als methodisches Instrument verwenden wir den 3 ACES-Ansatz von
Thornicroft und Tansella. Dieses Instrument erlaubt eine umfassende ethische
Analyse des Einsatzes von IMIs im konkreten Einzelfall sowie der Implementierung
von IMIs im Versorgungssystem.
Ergebnisse Unsere Analyse zeigt, dass IMIs in der Suchttherapie das
Potential haben, ein Empowerment von PatientInnen zu leisten, die
Stigmatisierung zu umgehen und einen niedrigschwelligen Zugang zu
Versorgungsleistungen zu ermöglichen. Kritisch zu sehen sind Aspekte der
Passung von Anwendungen auf die Bedürfnisse einzelner Patientengruppen
und individueller PatientInnen, der therapeutischen Verantwortung, des
Datenschutzes, der Datensicherheit und Privatheit sowie der Vernetzung
unterschiedlicher Anbieter von Versorgungsleistungen.
Schlussfolgerung Eine weitere Implementierung von IMIs in der
Suchttherapie ist nur dann wünschenswert, wenn verbindliche
Qualitätsstandards geschaffen und die patientenzentrierte Anwendung
unter Berücksichtigung individueller Patientencharakteristika
sichergestellt wird.
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Affiliation(s)
| | - Nadia Primc
- Institut für Geschichte und Ethik der Medizin,
Heidelberg
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23
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Yin H, Wardenaar KJ, Wang Y, Wang N, Chen W, Zhang Y, Xu G, Schoevers RA. Mobile Mental Health Apps in China: Systematic App Store Search. J Med Internet Res 2020; 22:e14915. [PMID: 32716301 PMCID: PMC7418006 DOI: 10.2196/14915] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 03/23/2020] [Accepted: 06/03/2020] [Indexed: 01/16/2023] Open
Abstract
Background Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. Objective The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. Methods A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. Results Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. Conclusions Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.
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Affiliation(s)
- Huifang Yin
- Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Nan Wang
- Tianjin Anding Hospital, Tianjin, China
| | | | - Yan Zhang
- Tianjin Anding Hospital, Tianjin, China
| | | | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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24
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Tan Y, Teng Z, Qiu Y, Tang H, Xiang H, Chen J. Potential of Mobile Technology to Relieve the Urgent Mental Health Needs in China: Web-Based Survey. JMIR Mhealth Uhealth 2020; 8:e16215. [PMID: 32673239 PMCID: PMC7381064 DOI: 10.2196/16215] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/22/2019] [Accepted: 03/28/2020] [Indexed: 02/02/2023] Open
Abstract
Background With the rapid development of information technology and mobile devices, an increasing number of mobile medical services and platforms have emerged. However, China’s current mental health situation necessitates further discussion and research on how to provide more patient-centered services in the face of many challenges and opportunities. Objective This study aims to explore the attitudes and preferences of mental health service stakeholders regarding mobile mental health services and discuss the challenges and opportunities faced by mobile technology developers in China. Methods A web-based survey was conducted by following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) checklist. A total of 586 valid questionnaires were collected. Respondents included 184 patients or their family members, 225 mental health professionals, and 177 people from the general population. Data analysis was completed using SPSS 24.0. Results Among the various problems perceived regarding the current mental health medical environment, difficulty in finding appropriate psychologists and limited visit times ranked highest. Social media (n=380/586, 64.9%) was the most preferred platform among all participants, whereas professionals showed a higher preference for smartphone apps (n=169/225, 75.1%). Professional instruction, psychological consultation, and mental health education (ranked top 3) were the most commonly identified needs. Mental health professionals generally emphasized more on treatment-related mobile mental health service needs, especially medication reminders (χ22=70.7; P<.001), symptom monitoring (χ22=24.0; P<.001), and access to mental health resources (χ22=38.6; P<.001). However, patients and their family members focused more on convenient web-based prescriptions (χ22=7.7; P=.02), with the general population interested in web-based psychological consultation (χ22=23.1; P<.001) and mental health knowledge (χ22=9.1; P=.01). Almost half of the participants regarded mobile mental health services as highly acceptable or supported their use, but less than 30% of participants thought mobile mental health services might be very helpful. Concerns about mobile mental health mainly focused on information security. Service receivers also suspected the quality and professionalism of content, and mental health professionals were worried about time and energy consumption as well as medical safety. Conclusions In terms of service flow, mobile services could be used to expand service time and improve efficiency before and after diagnosis. More individualized mobile mental health service content in more acceptable forms should be developed to meet the various needs of different mental health stakeholders. Multidisciplinary training and communication could be incorporated to facilitate the integration and cooperation of more well-rounded service teams. A standard medical record system and data format would better promote the development of future intelligent medical care. Issues such as ensuring service quality, solving safety risks, and better integrating mobile services with regular medical workflows also need to be addressed.
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Affiliation(s)
- Yuxi Tan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,Institute of Mental Health, Central South University, Changsha, China
| | - Ziwei Teng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,Institute of Mental Health, Central South University, Changsha, China
| | - Yan Qiu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,Institute of Mental Health, Central South University, Changsha, China
| | - Hui Tang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,Institute of Mental Health, Central South University, Changsha, China
| | - Hui Xiang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,Institute of Mental Health, Central South University, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,Institute of Mental Health, Central South University, Changsha, China
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25
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Webelhorst C, Jepsen L, Rummel-Kluge C. Utilization of e-mental-health and online self-management interventions of patients with mental disorders-A cross-sectional analysis. PLoS One 2020; 15:e0231373. [PMID: 32310991 PMCID: PMC7170258 DOI: 10.1371/journal.pone.0231373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 03/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background Web-based treatments and online self-management interventions extend the range of therapeutic supply. Since the number of online self-management interventions is steadily increasing, we aimed to examine, how web-based services currently influence mental health care, asking about previous internet use and future interests of patients with mental disorders. Methods We consulted patients (n = 400) from all services of the Department of Psychiatry and Psychotherapy of the University of Leipzig using a 28-item questionnaire. Overall, 301 questionnaires could be used for analysis. The data were analysed by means of descriptive statistics and group comparisons. Results The majority of patients (98.3%) were using the internet. Data revealed younger patients were searching for information on diseases (p < .001; M = 35.7 ±13.2), psychiatrists (p < .001; M = 34.6 ±11.6) and exchange with other patients (p < .001; M = 32 ±10.6) more often than older patients. We also found the internet was consulted more often regarding the search for information (p = .011; M = 58.3 ±10.9) and psychiatrists (p < .001; M = 35.7 ±13.2) the lower the patients’ level of functioning was. While only a small proportion (10.1%) of the sample had used online self-management interventions before, there is a far greater number (46.1%) who stated an interest to use online self-management interventions in the future. This interest was greater in patients who were younger (p < .001; M = 33.8 ±13.2) had a higher education level (p = .003; university degree = 59.2%, high school degree = 52.3%; mandatory school degree: 34.8%). Conclusions While only a small percentage of patients uses online self-management interventions, there is a far greater interest to include them into the treatment. Further research has to investigate how the integration of web-based services into the whole treatment process can be optimized. In addition, standardized diagnostic methods have to be found to evaluate the needs and experiences of patients.
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Affiliation(s)
- Carolin Webelhorst
- Department of Psychosomatic and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Lene Jepsen
- Department of Psychosomatic and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
- * E-mail:
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Hilty D, Chan S, Torous J, Luo J, Boland R. A Framework for Competencies for the Use of Mobile Technologies in Psychiatry and Medicine: Scoping Review. JMIR Mhealth Uhealth 2020; 8:e12229. [PMID: 32130153 PMCID: PMC7060500 DOI: 10.2196/12229] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 03/26/2019] [Accepted: 05/29/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND To ensure quality care, clinicians need skills, knowledge, and attitudes related to technology that can be measured. OBJECTIVE This paper sought out competencies for mobile technologies and/or an approach to define them. METHODS A scoping review was conducted to answer the following research question, "What skills are needed for clinicians and trainees to provide quality care via mHealth, have they been published, and how can they be made measurable and reproducible to teach and assess them?" The review was conducted in accordance with the 6-stage scoping review process starting with a keyword search in PubMed/Medical Literature Analysis and Retrieval System Online, APA PsycNET, Cochrane, EMBASE, PsycINFO, Web of Science, and Scopus. The literature search focused on keywords in 4 concept areas: (1) competencies, (2) mobile technologies, (3) telemedicine mode, and (4) health. Moreover, 2 authors independently, in parallel, screened the search results for potentially relevant studies based on titles and abstracts. The authors reviewed the full-text articles for final inclusion based on inclusion/exclusion criteria. Inclusion criteria were keywords used from concept area 1 (competencies) and 2 (mobile technologies) and either 3 (telemedicine mode) or 4 (health). Exclusion criteria included, but were not limited to, keywords used from a concept area in isolation, discussion of skills abstractly, outline or listing of what clinicians need without detail, and listing immeasurable behaviors. RESULTS From a total of 1232 results, the authors found 78 papers eligible for a full-text review and found 14 papers directly relevant to the 4 key concepts. Although few studies specifically discussed skills, the majority were clinical studies, and the literature included no lists of measurable behaviors or competency sets for mobile technology. Therefore, a framework for mobile technology competencies was built according to the review, expert consensus, and recommendations of the Institute of Medicine's Health Professions Education Summit and Accreditation Council of Graduate Medical Education framework. This framework borrows from existing competency framework domains in telepsychiatry and social media (patient care, medical knowledge, practice-based learning and improvement, systems-based practice, professionalism, and interpersonal skills and communication) and added domains of mHealth clinical decision support, device/technology assessment/selection, and information flow management across an electronic health record platform. mHealth Asynchronous components require additional traditional learning, teaching, supervisory and evaluation practices. Interactive curricula with case-, problem-, and system-based teaching may help faculty focus on decision making and shape skills and attitudes to complement clinical exposure. CONCLUSIONS Research is needed on how to customize implementation and evaluation of mHealth competencies and to ensure skill development is linked to the quality of care. This will require the management of organizational change with technology and the creation of a positive electronic culture in a complex policy and regulatory environment.
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Affiliation(s)
- Donald Hilty
- VA Northern California Health Care System, Mental Health & Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Mather, CA, United States
| | - Steven Chan
- Palo Alto VA Health Care System, Palo Alto, CA, United States
| | - John Torous
- Beth Israel Deaconess Medical Center, Psychiatry, Harvard School of Medicine, Boston, MA, United States
| | - John Luo
- Consultation-Liaison & Emergency Psychiatry, UC Irvine Department of Psychiatry, UCI Health, Irvine, CA, United States
| | - Robert Boland
- Harvard Longwood Psychiatry Residency Training Program, Brigham and Women's/Faulkner Hospitals, Harvard Medical School, Boston, MA, United States
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Rubeis G, Ketteler D. [Who Benefits from the App? Internet- and Mobile-Based Interventions (IMIs) and the Tension between Autonomy and Patient Well-Being]. Psychother Psychosom Med Psychol 2020; 70:467-474. [PMID: 32069513 DOI: 10.1055/a-1104-5459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The use of internet- and mobile-based interventions (IMIs) is often considered as empowerment of patients and improvement of accessibility of mental health services. Risks for specific patient groups are seldom discussed. Aim of the study is to identify patient groups that do not benefit from IMIs given the tension between autonomy and patient well-being. METHODS The ethical analysis is based on available empirical evidence (randomized control trials - RCTs, reviews) as well as ethical papers. Methodological background is the tension between patient autonomy and patient well-being, which is crucial to the therapeutic alliance. On this foundation, patient groups are identified that do not benefit from IMIs in terms of empowerment or accessibility. RESULTS The evidence-based ethical analysis shows that patients with certain disorders or high symptom severity, patients with low level of education or a lack of technical skills, and patients with a migrant background do often not benefit from IMIs. Risks of IMIs are a lack of individualization of interventions given individual treatment needs, symptom deterioration, higher dropout-rate, and insufficient identification of emergency situations. DISCUSSION Overemphasizing autonomy may compromize patient well-being in certain patient groups. This may lead to a situation where those patient groups whose inclusion into mental health service should be facilitated by IMIs might not be reached. These access barriers should be considered when designing IMIs, so that multimorbid marginalized groups are not forgotten in the necessary digitalization of the health market. CONCLUSION The application of IMIs depends on the individual resources of the patient. Should IMIs be further implemented within the German mental healthcare system, it is imperative that the patient well-being of those patient groups that do not benefit from IMIs is guaranteed. In addition, an early focus on marginalized groups may and the implementation of low-level access to counselling and treatment may provide chances for said groups.
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Affiliation(s)
- Giovanni Rubeis
- Institut für Geschichte und Ethik der Medizin Ruprecht Karls Universität Heidelberg
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Hilty DM, Unützer J, Ko DG, Luo J, Worley LLM, Yager J. Approaches for Departments, Schools, and Health Systems to Better Implement Technologies Used for Clinical Care and Education. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:611-616. [PMID: 31172384 DOI: 10.1007/s40596-019-01074-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 05/17/2019] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Donald M Hilty
- University of California Davis School of Medicine, Sacramento, CA, USA.
| | - Jürgen Unützer
- University of Washington School of Medicine, Seattle, WA, USA
| | - Dong-Gil Ko
- University of Cincinnati, Carl H. Lindner College of Business, Cincinnati, OH, USA
| | - John Luo
- University of California, Riverside Health, Riverside, CA, USA
| | - Linda L M Worley
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Joel Yager
- University of Colorado at Denver School of Medicine, Denver, CO, USA
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Chan S, Li L, Torous J, Gratzer D, Yellowlees PM. Review and Implementation of Self-Help and Automated Tools in Mental Health Care. Psychiatr Clin North Am 2019; 42:597-609. [PMID: 31672210 DOI: 10.1016/j.psc.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Self-help and automated technologies can be useful for behavioral and mental health education and interventions. These technologies include interactive media, online courses, artificial intelligence-powered chatbots, voice assistants, and video games. Self-help media can include books, videos, audible media like podcasts, blog and print articles, and self-contained Internet sites. Social media, online courses, and mass-market mobile apps also can include such media. These technologies serve to decrease geospatial, temporal, and financial barriers. This article describes different self-help and automated technologies, how to implement such technologies in existing clinical services, and how to implement according to patient needs.
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Affiliation(s)
- Steven Chan
- Palo Alto Veterans Affairs Health System, Palo Alto, CA, USA; Division of Hospital Medicine, Clinical Informatics, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry, University of California, Davis, Davis, CA, USA.
| | - Luming Li
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - John Torous
- Beth Israel Deaconess Medical Center, Boston, MA 02115, USA; Harvard University, Cambridge, MA, USA
| | - David Gratzer
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON M5T 1L8, USA
| | - Peter M Yellowlees
- Department of Psychiatry, University of California, Davis, Sacramento, CA 95817-1353, USA
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Mayer G, Gronewold N, Alvarez S, Bruns B, Hilbel T, Schultz JH. Acceptance and Expectations of Medical Experts, Students, and Patients Toward Electronic Mental Health Apps: Cross-Sectional Quantitative and Qualitative Survey Study. JMIR Ment Health 2019; 6:e14018. [PMID: 31763990 PMCID: PMC6902133 DOI: 10.2196/14018] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/12/2019] [Accepted: 09/02/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The acceptability of electronic mental (e-mental) health apps has already been studied. However, the attitudes of medical experts, students, and patients taking into account their knowledge of and previous experiences with e-mental health apps have not been investigated. OBJECTIVE The aim of this study was to explore the attitudes, expectations, and concerns of medical experts, including physicians, psychotherapists and nursing staff, students of medicine or psychology, and patients toward e-mental health apps when considering their knowledge of and former experiences with e-mental health apps. METHODS This cross-sectional quantitative and qualitative survey was based on a self-developed questionnaire. A total of 269 participants were included (104 experts, 80 students, and 85 patients), and 124 eligible participants answered a paper version and 145 answered an identical online version of the questionnaire. The measures focused on existing knowledge of and experiences with e-mental health apps, followed by a question on whether electronic health development was generally accepted or disliked. Further, we asked about the expectations for an ideal e-mental health app and possible concerns felt by the participants. All items were either presented on a 5-point Likert scale or as multiple-choice questions. Additionally, 4 items were presented as open text fields. RESULTS Although 33.7% (35/104) of the experts, 15.0% (12/80) of the students, and 41.2% (35/85) of the patients knew at least one e-mental health app, few had already tried one (9/104 experts [8.7%], 1/80 students [1.3%], 22/85 patients [25.9%]). There were more advocates than skeptics in each group (advocates: 71/104 experts [68.3%], 50/80 students [62.5%], 46/85 patients [54.1%]; skeptics: 31/104 experts [29.8%], 20/80 students [25.0%], 26/85 patients [30.6%]). The experts, in particular, believed, that e-mental health apps will gain importance in the future (mean 1.08, SD 0.68; 95% CI 0.94-1.21). When asked about potential risks, all groups reported slight concerns regarding data security (mean 0.85, SD 1.09; 95% CI 0.72-0.98). Patient age was associated with several attitudes toward e-mental health apps (future expectations: r=-0.31, P=.005; total risk score: r=0.22, P=.05). Attitudes toward e-mental health apps correlated negatively with the professional experience of the experts (rs(94)=-0.23, P=.03). CONCLUSIONS As opposed to patients, medical experts and students lack knowledge of and experience with e-mental health apps. If present, the experiences were assessed positively. However, experts show a more open-minded attitude with less fear of risks. Although some risks were perceived regarding data security, the attitudes and expectations of all groups were rather positive. Older patients and medical experts with long professional experience tend to express more skepticism. TRIAL REGISTRATION German Clinical Trials Register DRKS00013095; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00013095.
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Affiliation(s)
- Gwendolyn Mayer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Nadine Gronewold
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Simone Alvarez
- Medical Faculty of Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Bastian Bruns
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Hilbel
- Electrical Engineering and Applied Sciences, Westphalian University of Applied Sciences, Gelsenkirchen, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
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Morgiève M, Sebbane D, De Rosario B, Demassiet V, Kabbaj S, Briffault X, Roelandt JL. Analysis of the Recomposition of Norms and Representations in the Field of Psychiatry and Mental Health in the Age of Electronic Mental Health: Qualitative Study. JMIR Ment Health 2019; 6:e11665. [PMID: 31356151 PMCID: PMC6819010 DOI: 10.2196/11665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/15/2018] [Accepted: 01/23/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND For the World Health Organization, electronic health (eHealth) is seen as an effective way to improve therapeutic practices and disease prevention in health. Digital tools lead to major changes in the field of mental medicine, but specific analyses are required to understand and accompany these changes. OBJECTIVE Our objective was to highlight the positions of the different stakeholders of the mental health care system on eHealth services and tools, as well as to establish professional and user group profiles of these positions and the uses of these services. METHODS In order to acquire the opinions and expectations of different categories of people, we carried out a qualitative study based on 10 focus groups (n=70, from 3-12 people per group) composed of: general practitioners, psychiatrists, psychologists, social workers, occupational therapists, nurses, caregivers, mental health services users, user representatives, and the general public. The analyses of focus group discussions were performed independently by four investigators through a common analysis grid. The constant comparative method was adopted within this framework. RESULTS The interviewees expressed different problems that new technologies engender in the field of mental health. What was previously strictly under the jurisdiction of physicians now tends to be fragmented and distributed over different groups and locations. New technologies reposition care in the field of domestic, rather than therapeutic, activities, and thus the conception of care as an autonomous activity in the subject's life is questioned. The ideal of social autonomy through technology is part of the new logic of health democracy and empowerment, which is linked to a strong, contemporary aspiration to perform. Participants emphasized that there was the potential risk of a decrease in autonomy for the digitally engaged patient, while personal empowerment could become a set of obligations. CONCLUSIONS This qualitative research highlights the heterogeneity of opinions among the groups and within each group. It suggests that opinions on electronic mental health devices are still far from being stabilized, and that a change management process should be set up to both regulate the development and facilitate the use of these tools.
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Affiliation(s)
- Margot Morgiève
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France
| | - Déborah Sebbane
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France.,Université Lille, Centre Hospitalier Universitaire de Lille, Pôle de psychiatrie, F-59000, Lille, France.,Eceve, Unit 1123, Inserm, Université de Paris, Paris, France
| | - Bianca De Rosario
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France
| | - Vincent Demassiet
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France
| | - Soraya Kabbaj
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France
| | | | - Jean-Luc Roelandt
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France.,Eceve, Unit 1123, Inserm, Université de Paris, Paris, France
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Gulliver A, Banfield M, Morse AR, Reynolds J, Miller S, Galati C. A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial. JMIR Form Res 2019; 3:e12550. [PMID: 31165708 PMCID: PMC6746099 DOI: 10.2196/12550] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 04/01/2019] [Accepted: 04/29/2019] [Indexed: 01/29/2023] Open
Abstract
Background There is an increasing need for peer workers (people with lived experience of mental health problems who support others) to work alongside consumers to improve recovery and outcomes. In addition, new forms of technology (tablet or mobile apps) can deliver services in an engaging and innovative way. However, there is a need to evaluate interventions in real-world settings. Objective This exploratory proof-of-concept study aimed to determine if a peer worker–led electronic mental health (e-mental health) recovery program is a feasible, acceptable, and effective adjunct to usual care for people with moderate-to-severe mental illness. Methods Overall, 6 consumers and 5 health service staff participated in the evaluation of a peer-led recovery app delivered at a community-based public mental health service. The peer worker and other health professional staff invited attendees at the drop-in medication clinics to participate in the trial during June to August 2017. Following the intervention period, participants were also invited by the peer worker to complete the evaluation in a separate room with the researcher. Consumers were explicitly informed that participation in the research evaluation was entirely voluntary. Consumer evaluation measures at postintervention included recovery and views on the acceptability of the program and its delivery. Interviews with staff focused on the acceptability and feasibility of the app itself and integrating a peer worker into the health care service. Results Consumer recruitment in the research component of the study (n=6) fell substantially short of the target number of participants (n=30). However, from those who participated, both staff and consumers were highly satisfied with the peer worker and somewhat satisfied with the app. Health care staff overall believed that the addition of the peer worker was highly beneficial to both the consumers and staff. Conclusions The preliminary findings from this proof-of-concept pilot study suggest that a peer-led program may be a feasible and acceptable method of working on recovery in this population. However, the e-mental health program did not appear feasible in this setting. In addition, recruitment was challenging in this particular group, and it is important to note that these study findings may not be generalizable. Despite this, ensuring familiarity of technology in the target population before implementing e-mental health interventions is likely to be of benefit.
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Affiliation(s)
- Amelia Gulliver
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Julia Reynolds
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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Ben-Zeev D, Buck B, Hallgren K, Drake RE. Effect of Mobile Health on In-person Service Use Among People With Serious Mental Illness. Psychiatr Serv 2019; 70:507-510. [PMID: 30947636 DOI: 10.1176/appi.ps.201800542] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study examined whether mobile health (mHealth) affects the use of in-person services among people with serious mental illness. METHODS This randomized comparative effectiveness trial evaluated minutes of service use among 163 participants for 3 months before, during, and after exposure to mHealth or clinic-based care. RESULTS mHealth and clinic-based care participants used fewer services during the intervention (9% and 14%, respectively) and follow-up (2% and 12%) periods than during the preintervention phase. During treatment, mHealth treatment responders (participants who experienced recovery gains and maintained them at follow-up) reduced service use more than nonresponders (12% vs. 10%). Postintervention, service use by mHealth treatment responders continued to drop (an additional 11%), whereas service use by mHealth nonresponders increased by 8%. CONCLUSIONS mHealth and clinic-based illness management interventions may reduce the need for other in-person services among people with serious mental illness, particularly among mHealth users who experience sustained recovery.
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Affiliation(s)
- Dror Ben-Zeev
- BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Ben-Zeev, Buck, Hallgren); Health Services Research and Development, Puget Sound Veterans Affairs Healthcare System, Seattle (Buck); Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, and Westat Inc., Rockville, Maryland (Drake)
| | - Benjamin Buck
- BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Ben-Zeev, Buck, Hallgren); Health Services Research and Development, Puget Sound Veterans Affairs Healthcare System, Seattle (Buck); Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, and Westat Inc., Rockville, Maryland (Drake)
| | - Kevin Hallgren
- BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Ben-Zeev, Buck, Hallgren); Health Services Research and Development, Puget Sound Veterans Affairs Healthcare System, Seattle (Buck); Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, and Westat Inc., Rockville, Maryland (Drake)
| | - Robert E Drake
- BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Ben-Zeev, Buck, Hallgren); Health Services Research and Development, Puget Sound Veterans Affairs Healthcare System, Seattle (Buck); Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, and Westat Inc., Rockville, Maryland (Drake)
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Torous J, Wisniewski H, Bird B, Carpenter E, David G, Elejalde E, Fulford D, Guimond S, Hays R, Henson P, Hoffman L, Lim C, Menon M, Noel V, Pearson J, Peterson R, Susheela A, Troy H, Vaidyam A, Weizenbaum E, Naslund JA, Keshavan M. Creating a Digital Health Smartphone App and Digital Phenotyping Platform for Mental Health and Diverse Healthcare Needs: an Interdisciplinary and Collaborative Approach. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41347-019-00095-w] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Hilty DM, Chan S, Torous J, Luo J, Boland RJ. A Telehealth Framework for Mobile Health, Smartphones, and Apps: Competencies, Training, and Faculty Development. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41347-019-00091-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ben-Zeev D, Buck B, Chu PV, Razzano L, Pashka N, Hallgren KA. Transdiagnostic Mobile Health: Smartphone Intervention Reduces Depressive Symptoms in People With Mood and Psychotic Disorders. JMIR Ment Health 2019; 6:e13202. [PMID: 30977736 PMCID: PMC6484257 DOI: 10.2196/13202] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/29/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depression is the most prevalent mental health problem. The need for effective treatments for depression far outstrips the availability of trained mental health professionals. Smartphones and other widely available technologies are increasingly being leveraged to deliver treatments for depression. Whether there are patient characteristics that affect the potency of smartphone interventions for depression is not well understood. OBJECTIVE This study aimed to evaluate whether patient characteristics including clinical diagnosis, depression severity, psychosis status, and current use of antidepressant medications impact the effects of an evidence-based smartphone intervention on depressive symptoms. METHODS Data were collected as part of a 2-arm randomized controlled trial comparing a multimodal smartphone intervention called FOCUS with a clinic-based intervention. Here, we report on 82 participants assigned to 12 weeks of FOCUS treatment. We conducted assessments of depressive symptoms using the Beck Depression Inventory-second edition (BDI-II) at baseline, postintervention (3 months), and follow-up (6 months). We tested for differences in the amount of improvement in BDI-II scores from baseline to posttreatment and 6-month follow-up between each of the following patient subgroups using 2 (group) × 2 (time) mixed effects models: diagnosis (ie, schizophrenia spectrum disorder vs bipolar disorder vs major depressive disorder), depression severity (ie, minimal-mild vs moderate-severe depression), psychosis status (ie, presence vs absence of psychotic symptoms), and antidepressant use (ie, taking antidepressants vs not taking antidepressants). RESULTS The majority of participants were male (60%, 49/82), African American (65%, 53/82), and middle-aged (mean age 49 years), with a high school education or lower (62%, 51/82). There were no differences in patient demographics across the variables that were used to stratify the analyses. There was a significant group × time interaction for baseline depression severity (F1,76.8=5.26, P=.02 [posttreatment] and F1,77.4=6.56, P=.01 [6-month follow-up]). Participants with moderate or severe depression had significant improvements (t42=3.20, P=.003 [posttreatment] and t42=4.20, P<.001 [6-month follow-up]), but participants with minimal or mild depression did not (t31=0.20, P=.84 [posttreatment] and t30=0.43, P=.67 [6-month follow-up]). There were no significant group × time interactions for diagnosis, psychosis status, or antidepressant medication use. Participants with minimal or mild depression had negligible nonsignificant improvements (<1 point on the BDI-II). Reduction in depression in all other groups was larger (range 1.7-6.5 points on the BDI-II). CONCLUSIONS Our results suggest that FOCUS can be deployed to treat moderate to severe depressive symptoms among people with schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder, in concert with antidepressant medications or without them, in both people with and without active psychotic symptoms. The study results are consistent with research on transdiagnostic models in psychotherapy and extend our knowledge about the potential of transdiagnostic mobile health. TRIAL REGISTRATION ClinicalTrials.gov NCT02421965; http://clinicaltrials.gov/ct2/show/NCT02421965 (Archived by WebCite at http://www.webcitation.org/76pyDlvAS).
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Affiliation(s)
- Dror Ben-Zeev
- Behavioral Research In Technology and Engineering Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Benjamin Buck
- Behavioral Research In Technology and Engineering Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
- Health Services Research and Development, VA Puget Sound Healthcare System, Seattle, WA, United States
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, United States
| | - Phuonguyen Vu Chu
- Behavioral Research In Technology and Engineering Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Lisa Razzano
- Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
- Thresholds Inc, Chicago, IL, United States
| | | | - Kevin A Hallgren
- Behavioral Research In Technology and Engineering Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Abstract
From artificial intelligence, predictive analytics and biometric sensors, to advanced robotics, virtual reality and mobile applications, rapid advances in technology are transforming the design, delivery and experience of mental healthcare. This paper explores the promise and pitfalls of three technologies (apps, avatars and robots) posed to transform mental health education, practice and research. By highlighting potential practical and ethical implications, this paper argues mental health professionals must actively engage in the co-design and development of new technologies, and reflexively reflect on whether the future will be a techno-utopia or dystopia.
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Affiliation(s)
- Evonne Miller
- a QUT Design Lab Creative Industries , Queensland University of Technology , Brisbane , Australia
| | - Debra Polson
- a QUT Design Lab Creative Industries , Queensland University of Technology , Brisbane , Australia
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Decker V, Valenti M, Montoya V, Sikorskii A, Given CW, Given BA. Maximizing New Technologies to Treat Depression. Issues Ment Health Nurs 2019; 40:200-207. [PMID: 30620622 DOI: 10.1080/01612840.2018.1527422] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In an era of rapid technological evolution, mental healthcare providers are tapping into technology that offers feasible and effective alternatives to reach patients who suffer from depression. This paper provides a brief history and description of current technologies, frequently used taxonomies, and specific applications for the assessment and treatment of depression. These include online healthcare communities and social media, automated screening, wearable technology, and virtual reality therapy. A review of a secondary analysis that incorporated technology used with patients experiencing depressive symptoms is provided and future trends in mHealth or cellular-based technologies to treat depression are explored.
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Affiliation(s)
- Veronica Decker
- a College of Nursing, University of Central Florida , Orlando, FL, USA
| | - Michael Valenti
- a College of Nursing, University of Central Florida , Orlando, FL, USA
| | - Vicki Montoya
- a College of Nursing, University of Central Florida , Orlando, FL, USA
| | - Alla Sikorskii
- b College of Nursing, Michigan State University, East Lansing, MI , USA
| | - Charles W Given
- b College of Nursing, Michigan State University, East Lansing, MI , USA
| | - Barbara A Given
- b College of Nursing, Michigan State University, East Lansing, MI , USA
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Internet- und mobilgestützte Interventionen bei psychischen Störungen. DER NERVENARZT 2019; 90:497-502. [DOI: 10.1007/s00115-018-0663-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hilty DM, DeJong S. Putting Technologies Used for Clinical Care and Education in Context. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:753-758. [PMID: 30350270 DOI: 10.1007/s40596-018-0996-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Donald M Hilty
- Northern California Veterans Administration Health Care System, Sacramento, CA, USA.
| | - Sandra DeJong
- Harvard University School of Medicine, Cambridge, MA, USA
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41
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Torous J, Bauer A, Chan S, Boland R, Ramo D. Smart Steps for Psychiatric Education: Approaching Smartphone Apps for Learning and Care. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:791-795. [PMID: 29637514 PMCID: PMC6179955 DOI: 10.1007/s40596-018-0901-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/27/2018] [Indexed: 06/08/2023]
Affiliation(s)
| | - Amy Bauer
- University of Washington School of Medicine, Seattle, WA, USA
| | - Steven Chan
- University of California San Francisco Medical Center, San Francisco, CA, USA
| | | | - Danielle Ramo
- University of California San Francisco Medical Center, San Francisco, CA, USA
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42
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Telemental Health in Low- and Middle-Income Countries: A Systematic Review. Int J Telemed Appl 2018; 2018:9602821. [PMID: 30519259 PMCID: PMC6241375 DOI: 10.1155/2018/9602821] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/03/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction The rising incidence of mental illness and its impact on individuals, families, and societies is becoming a major public health concern, especially in resource-constrained countries. Consequently, there is an increasing demand for mental health services in many middle- and low-income countries (LMIC). Challenges such as inequality in access, lack of staff and hospital beds, and underfunding, often present in the LMIC, might in part be addressed by telemental health services. However, little is known about telemental health in the LMIC. Methods A systematic review was performed, drawing on several electronic databases, including PubMed, PsycINFO, Web of Science, Springer Link, and Google Scholar. Original English language studies on the practice of telemental health in LMIC, involving patients and published between 1 January 2000 and 16 February 2017, were included. Results Nineteen studies met the inclusion criteria. Most of the articles were recent, which may reflect an increasing focus on telemental health in the LMIC. Eight of these studies were from Asia. Eight of the studies were interventional/randomized controlled trials, and 11 examined general mental health issues. Videoconferencing was the most frequently (6) studied telemental modality. Other modalities studied were online decision support systems (3), text messaging and bibliotherapy (1), e-chatting combined with videoconferencing (1), online therapy (2), e-counseling (1), store-and-forward technology (1), telephone follow-up (1), online discussion groups (1), audiovisual therapy and bibliotherapy (1), and computerized occupational therapy (1). Although many of the studies showed that telemental services had positive outcomes, some studies reported no postintervention improvements. Conclusion The review shows a rising trend in telemental activity in the LMIC. There is a greater need for telemental health in the LMIC, but more research is needed on empirical and theoretical aspects of telemental activity in the LMIC and on direct comparisons between telemental activity in the LMIC and the non-LMIC.
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Abstract
PURPOSE OF REVIEW This article systematically reviews studies examining remote measurement-based care (RMBC), defined as using technology to measure patients' psychiatric symptoms outside the context of a clinical encounter. RECENT FINDINGS Thirty-six studies were identified that measured patients' psychiatric symptoms remotely and provided feedback to treatment providers. The majority were single group designs. There was evidence supporting the short-term feasibility and acceptability of RMBC, although long-term sustainability was less clear. Thirteen randomized controlled trials were identified. RMBC was typically implemented as part of a multicomponent intervention (e.g., internet-based cognitive behavioral therapy with feedback to provider). Three studies experimentally isolated the clinical effects of RMBC, with two reporting no statistically significant differences between the RMBC and control conditions and one reporting greater symptom improvement associated with RMBC. RMBC appears feasible and acceptable and may be a promising intervention for improving mental health care, but additional experimental studies are needed.
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Abstract
Telepsychiatric care in the emergency setting is a viable and accessible modality that helps address the needs of patients, families, and communities. An expanding literature base for telepsychiatry in multiple clinical settings has shown benefits, including increased access to care, equal efficacy to face-to-face encounters, cost efficiency, decreased wait-times, decreased unnecessary psychiatric hospitalizations, and high levels of patient satisfaction. The evidence base for emergency telepsychiatry is growing for pediatric populations. Increased use of the modality is part of the solution to address high demand for pediatric psychiatric expertise in emergency rooms and to help bridge service gaps in parts of the country.
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Cardinale AM. The Opportunity for Telehealth to Support Neurological Healthcare. Telemed J E Health 2018; 24:969-978. [PMID: 29652625 DOI: 10.1089/tmj.2017.0290] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Neurological conditions affect one-third of Americans and are some of the most prevalent health issues in the country. Many sufferers have difficulty accessing treatment, however, advances in technology may be able to support availability, affordability, and convenience of care through telehealth services. This review outlines the current state of telemedicine in neurological healthcare, highlighting evidence-based research and use cases for digital services. Details on expenses associated with managing certain well-known conditions are included to shed light on the financial burden of disease and how telehealth can contribute to cost savings for patients and providers. Finally, a discussion of current telehealth legislature gives additional perspective on regulatory dynamics experienced by different stakeholders in the field. Research supports telemedicine as a solution to enhance current care models given its many benefits, including efficient and clinically useful service delivery. This movement has the opportunity to help billions of individuals globally by acting as a mechanism to provide impactful and scalable neurological healthcare.
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Affiliation(s)
- Amanda M Cardinale
- Teachers College Columbia University , Department of Biobehavioral Sciences, Neuroscience and Education, New York, New York
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46
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Atallah N, Khalifa M, El Metwally A, Househ M. The prevalence and usage of mobile health applications among mental health patients in Saudi Arabia. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 156:163-168. [PMID: 29428068 DOI: 10.1016/j.cmpb.2017.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 11/13/2017] [Accepted: 12/05/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Mobile health (mHealth) applications provide new methods of engagement with patients and can help patients manage their mental health condition. OBJECTIVE The main objective of this study is to explore the prevalence of the use of mobile health applications for mental health patients in Saudi Arabia. METHODS A total of 376 participants with depression and/or anxiety completed an online survey distributed by social networks which asked questions relating to mobile phone ownership, uses of health applications, and utilization patterns to track mental health related issues. RESULTS Approximately, 46% of the participants reported running one or two healthcare related applications on their mobile phones. In all age groups, 64% of the participants used their mobile phones to access information related to their own health. Also, 64% of the participants expressed interest in using their own mobile phones to track and follow the progression of their depression and/or anxiety. CONCLUSIONS Developing mobile health applications for Saudi mental health patients is needed since it can offer opportunities for patients, researchers, caregivers, and legislators to work together to improve the state of mental health care in Saudi Arabia.
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Affiliation(s)
- Nora Atallah
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Khalifa
- Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Ashraf El Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia
| | - Mowafa Househ
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia.
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Implementing Video to Home to Increase Access to Evidence-Based Psychotherapy for Rural Veterans. ACTA ACUST UNITED AC 2017; 2:140-148. [PMID: 32346604 DOI: 10.1007/s41347-017-0032-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This clinical demonstration project used facilitation to implement VA Video to Home (VTH) to deliver evidence-based psychotherapies to underserved rural Veterans, to increase access to mental health care. Participants were Veterans seeking mental health treatment at "Sonny" Montgomery Veterans Affairs Medical Center in Jackson, MS, and/or its six community-based outpatient clinics. Measures included patient encounter and demographic data, patient and provider interviews, reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) factors, measures of fidelity to manualized evidence-based psychotherapies (EBPs), and qualitative interviews. The project was deemed feasible; 93 (67 men, 26 women, including 77 rural, 16 urban) patients received weekly EBPs via VTH. Nearly half were Black (n = 46), 36 of whom (78.3%) were also rural. Fifty-three (48.4%) were Operation Enduring Freedom/Operation Iraqi Freedom Veterans. Ages varied widely, from 20 to 79 years. Primary diagnoses included posttraumatic stress disorder (41), depressive disorders (22), anxiety disorders (nine), insomnia (eight), chronic pain (eight), and substance use disorder (five). Fifteen clinicians were trained to deliver eight EBPs via VTH. Growth in number of Veterans treated by telehealth was 10.12 times and mental health visits were 7.34 times greater than the national annual average of growth for telehealth at VHA facilities. Illustrative examples and qualitative data from both patients and providers suggested overall satisfaction with VTH. This demonstrates the benefits of VTH for increasing access to mental health treatment for rural patients and advantages of an implementation facilitation strategy using an external facilitator. Continuing research should clarify whether certain patients are more likely to participate than others and whether certain EBPs are more easily delivered with VTH than others.
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Mermelstein H, Guzman E, Rabinowitz T, Krupinski E, Hilty D. The Application of Technology to Health: The Evolution of Telephone to Telemedicine and Telepsychiatry: A Historical Review and Look at Human Factors. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s41347-017-0010-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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