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Medich M, Cannedy SL, Hoffmann LC, Chinchilla MY, Pila JM, Chassman SA, Calderon RA, Young AS. Clinician and Patient Perspectives on the Use of Passive Mobile Monitoring and Self-Tracking for Patients With Serious Mental Illness: User-Centered Approach. JMIR Hum Factors 2023; 10:e46909. [PMID: 37874639 PMCID: PMC10630855 DOI: 10.2196/46909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Early intervention in mental health crises can prevent negative outcomes. A promising new direction is remote mental health monitoring using smartphone technology to passively collect data from individuals to rapidly detect the worsening of serious mental illness (SMI). This technology may benefit patients with SMI, but little is known about health IT acceptability among this population or their mental health clinicians. OBJECTIVE We used the Health Information Technology Acceptability Model to analyze the acceptability and usability of passive mobile monitoring and self-tracking among patients with serious mental illness and their mental health clinicians. METHODS Data collection took place between December 2020 and June 2021 in 1 Veterans Administration health care system. Interviews with mental health clinicians (n=16) assessed the acceptability of mobile sensing, its usefulness as a tool to improve clinical assessment and care, and recommendations for program refinements. Focus groups with patients with SMI (n=3 groups) and individual usability tests (n=8) elucidated patient attitudes about engaging in health IT and perceptions of its usefulness as a tool for self-tracking and improving mental health assessments. RESULTS Clinicians discussed the utility of web-based data dashboards to monitor patients with SMI health behaviors and receiving alerts about their worsening health. Potential benefits included improving clinical care, capturing behaviors patients do not self-report, watching trends, and receiving alerts. Clinicians' concerns included increased workloads tied to dashboard data review, lack of experience using health IT in clinical care, and how SMI patients' associated paranoia and financial instability would impact patient uptake. Despite concerns, all mental health clinicians stated that they would recommend it. Almost all patients with SMI were receptive to using smartphone dashboards for self-monitoring and having behavioral change alerts sent to their mental health clinicians. They found the mobile app easy to navigate and dashboards easy to find and understand. Patient concerns centered on privacy and "government tracking," and their phone's battery life and data plans. Despite concerns, most reported that they would use it. CONCLUSIONS Many people with SMI would like to have mobile informatics tools that can support their illness and recovery. Similar to other populations (eg, older adults, people experiencing homelessness) this population presents challenges to adoption and implementation. Health care organizations will need to provide resources to address these and support successful illness management. Clinicians are supportive of technological approaches, with adapting informatics data into their workflow as the primary challenge. Despite clear challenges, technological developments are increasingly designed to be acceptable to patients. The research development-clinical deployment gap must be addressed by health care systems, similar to computerized cognitive training. It will ensure clinicians operate at the top of their skill set and are not overwhelmed by administrative tasks, data summarization, or reviewing data that do not indicate a need for intervention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/39010.
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Affiliation(s)
- Melissa Medich
- Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, North Hills, CA, United States
- The Lundquist Institute for Biomedical Research, Torrance, CA, United States
| | - Shay L Cannedy
- Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, North Hills, CA, United States
| | - Lauren C Hoffmann
- Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, Los Angeles, CA, United States
| | - Melissa Y Chinchilla
- Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, Los Angeles, CA, United States
| | - Jose M Pila
- Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, Los Angeles, CA, United States
| | - Stephanie A Chassman
- Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, Los Angeles, CA, United States
| | - Ronald A Calderon
- Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, Los Angeles, CA, United States
| | - Alexander S Young
- Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, U.S. Department of Veteran Affairs, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University California Los Angeles Geffen School of Medicine, Los Angeles, CA, United States
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Bongers IL, Buitenweg DC, van Kuijk REFM, van Nieuwenhuizen C. I Need to Know: Using the CeHRes Roadmap to Develop a Treatment Feedback Tool for Youngsters with Mental Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10834. [PMID: 36078564 PMCID: PMC9518175 DOI: 10.3390/ijerph191710834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Patient-Reported Outcome Measures (PROMs) are often used to monitor treatment outcomes in youth mental health care. Unfortunately, youngsters are rarely informed about the results of their PROMs or, when they are, it is in an insufficient manner. Therefore, a web application was developed-together with youngsters-aimed at giving them feedback about their PROMs. The aim of this study is to describe the development process of the application. An expert panel consisting of youngsters, web designers and researchers, as well as a representative from a client organisation, developed the e-health application INK (short for 'I Need to Know') in an iterative process based on the Centre for eHealth Research roadmap (CeHRes roadmap). Youngsters prefer, among other aspects, a simple, easy-to-use e-health application with a colourful appearance and want to be able to compare their results across different time points and informants. The INK tool provides youngsters with insight into their PROM results. Based on the youngsters' preferences, INK users can choose which feedback information is visible. INK facilitates youngsters' active participation in their treatment as well as shared decision-making with their professional caregivers.
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Affiliation(s)
- Ilja L. Bongers
- Institute for Mental Health Care Eindhoven (GGzE), Centre for Child and Adolescent Psychiatry, P.O. Box 909, 5626 ND Eindhoven, The Netherlands
- Scientific Center for Care & Wellbeing (Tranzo), Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
| | - David C. Buitenweg
- Institute for Mental Health Care Eindhoven (GGzE), Centre for Child and Adolescent Psychiatry, P.O. Box 909, 5626 ND Eindhoven, The Netherlands
| | - Romy E. F. M. van Kuijk
- Scientific Center for Care & Wellbeing (Tranzo), Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
| | - Chijs van Nieuwenhuizen
- Institute for Mental Health Care Eindhoven (GGzE), Centre for Child and Adolescent Psychiatry, P.O. Box 909, 5626 ND Eindhoven, The Netherlands
- Scientific Center for Care & Wellbeing (Tranzo), Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands
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Manning JB, Blandford A, Edbrooke-Childs J. Digital Companion Choice to Support Teachers' Stress Self-management: Systematic Approach Through Taxonomy Creation. JMIR Form Res 2022; 6:e32312. [PMID: 35171106 PMCID: PMC8892277 DOI: 10.2196/32312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are thousands of digital companions designed for emotional well-being and stress, including websites, wearables, and smartphone apps. Although public evaluation frameworks and ratings exist, they do not facilitate digital companion choice based on contextual or individual information, such as occupation or personal management strategies. OBJECTIVE The aim of this study is to establish a process for creating a taxonomy to support systematic choice of digital companions for teachers' stress self-management. METHODS We used a 4-step study design. In step 1, we identified the dimension of stress self-management and strategic classifications. In step 2, we identified the dimension of the digital techniques and conceptual descriptions. In step 3, we created 6 criteria for the inclusion of digital companions. In step 4, we used the taxonomy framework created by steps 1 and 2 and populated it with digital companions for stress self-management, as identified in step 3. RESULTS First, in the dimension of stress self-management, we identified four classes of strategies: educational, physiological, cognitive, and social. Second, in the digital techniques dimension, we derived four conceptual descriptions for the digital companions' mechanisms of action: fostering reflection, suggesting treatment, peer-to-peer support, and entertainment. Third, we created six criteria for digital companion inclusion in the taxonomy: suitability, availability, evaluation, security, validity, and cost. Using the taxonomy framework and criteria, we populated it with digital companions for stress management ahead of presentation to teachers in a stress study workshop. CONCLUSIONS The elements of our approach can be generalized as principles for the creation of taxonomies for other occupations or conditions. Taxonomies such as this could be a valuable resource for individuals to understand which digital companion could be of help in their personal context.
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Affiliation(s)
- Julia B Manning
- Interaction Centre, Department of Computer Science, University College London, London, United Kingdom
| | - Ann Blandford
- Institute of Healthcare Engineering, University College London, London, United Kingdom
| | - Julian Edbrooke-Childs
- Evidence-based Practice Unit, University College London and Anna Freud Centre, London, United Kingdom
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Brzoska P, Erdsiek F, Aksakal T, Mader M, Ölcer S, Idris M, Altinok K, Wahidie D, Padberg D, Yilmaz-Aslan Y. Pictorial Assessment of Health-Related Quality of Life. Development and Pre-Test of the PictoQOL Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031620. [PMID: 35162642 PMCID: PMC8835013 DOI: 10.3390/ijerph19031620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 12/03/2022]
Abstract
The aim of the present study was to develop a pictorial questionnaire for the assessment of health-related quality of life (PictoQOL) and to examine its content validity and usability across three exemplary population groups of different origin residing in Germany (non-migrants, Turkish migrants and Arabic-speaking migrants). A mixed-methods design combining qualitative and quantitative methods was used, comprising 6 focus group discussions with a total of 17 participants, 37 cognitive interviews and a quantitative pretest with 15 individuals. The PictoQOL consists of a pictorial representation of a total of 15 different situations. Using a visual Likert scale, respondents indicate how much each situation applies to them. Some representations proved to be culturally sensitive and were adapted. Respondents found the use of an additional graphic layer in the form of symbols in addition to pictures helpful for interpretation. The PictoQOL is considered to allow a more accessible assessment and better comparability of HRQOL across different population groups regardless of their literacy level. It is therefore considered to be superior to existing instruments for routine use in health research and practice. Future studies need to examine its convergent and factorial validity.
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Affiliation(s)
- Patrick Brzoska
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
- Correspondence:
| | - Fabian Erdsiek
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Tuğba Aksakal
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Maria Mader
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
| | - Sabahat Ölcer
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Munzir Idris
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Kübra Altinok
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Diana Wahidie
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Dennis Padberg
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
| | - Yüce Yilmaz-Aslan
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany; (F.E.); (T.A.); (M.M.); (S.Ö.); (M.I.); (K.A.); (D.W.); (D.P.); (Y.Y.-A.)
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
- Department of Nursing and Health Services Research, School of Public Health, Bielefeld University, 33501 Bielefeld, Germany
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