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Tolou-Shams M, Ramaiya M, Lara Salas J, Ezimora I, Shumway M, Duerr Berrick J, Aguilera A, Borsari B, Dauria E, Friedling N, Holmes C, Grandi A. A Family-Based Mental Health Navigator Intervention for Youth in the Child Welfare System: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49999. [PMID: 37698896 PMCID: PMC10523219 DOI: 10.2196/49999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Youth in the child welfare system (child welfare-involved [CWI] youth) have high documented rates of mental health symptoms and experience significant disparities in mental health care services access and engagement. Adolescence is a developmental stage that confers increased likelihood of experiencing mental health symptoms and the emergence of disorders that can persist into adulthood. Despite a high documented need for evidence-based mental health services for CWI youth, coordination between child welfare and mental health service systems to increase access to care remains inadequate, and engagement in mental health services is low. Navigator models developed in the health care field to address challenges of service access, fragmentation, and continuity that affect the quality of care provide a promising approach to increase linkage to, and engagement in, mental health services for CWI youth. However, at present, there is no empirically supported mental health navigator model to address the unique and complex mental health needs of CWI youth and their families. OBJECTIVE Using a randomized controlled trial, this study aims to develop and test a foster care family navigator (FCFN) model to improve mental health service outcomes for CWI adolescents (aged 12-17 years). METHODS The navigator model leverages an in-person navigator and use of adjunctive digital health technology to engage with, and improve, care coordination, tracking, and monitoring of mental health service needs for CWI youth and families. In total, 80 caregiver-youth dyads will be randomized to receive either the FCFN intervention or standard of care (clinical case management services): 40 (50%) to FCFN and 40 (50%) to control. Qualitative exit interviews will inform the feasibility and acceptability of the services received during the 6-month period. The primary trial outcomes are mental health treatment initiation and engagement. Other pre- and postservice outcomes, such as proportion screened and time to screening, will also be evaluated. We hypothesize that youth receiving the FCFN intervention will have higher rates of mental health treatment initiation and engagement than youth receiving standard of care. RESULTS We propose enrollment of 80 dyads by March 2024, final data collection by September 2024, and the publication of main findings in March 2025. After final data analysis and writing of the results, the resulting manuscripts will be submitted to journals for dissemination. CONCLUSIONS This study will be the first to produce empirically driven conclusions and recommendations for implementing a family mental health navigation model for CWI youth with long-standing and unaddressed disparities in behavioral health services access. The study findings have potential to have large-scale trial applicability and be feasible and acceptable for eventual system implementation and adoption. TRIAL REGISTRATION ClinicalTrials.gov NCT04506437; https://www.clinicaltrials.gov/study/NCT04506437. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49999.
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Affiliation(s)
- Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Megan Ramaiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Jannet Lara Salas
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ifunanya Ezimora
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Jill Duerr Berrick
- Berkeley Social Welfare, University of California at Berkeley, Berkeley, CA, United States
| | - Adrian Aguilera
- Berkeley Social Welfare, University of California at Berkeley, Berkeley, CA, United States
| | - Brian Borsari
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veteran Affairs Medical Center, San Francisco, CA, United States
| | - Emily Dauria
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Naomi Friedling
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Crystal Holmes
- Foster Care Mental Health, San Francisco, CA, United States
| | - Adam Grandi
- Foster Care Mental Health, San Francisco, CA, United States
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Kontar J, Osseiran A, Makki F, El Chammay R. Promoting follow-up attendance among mental health patients at a primary healthcare center in Lebanon: A randomized controlled trial. SAGE Open Med 2022; 10:20503121221135990. [PMID: 36385793 PMCID: PMC9647270 DOI: 10.1177/20503121221135990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/13/2022] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE In 2015, the Lebanese Ministry of Public Health launched the 2015-2020 National Mental Health Strategy in an effort to integrate Mental Health into Primary Healthcare centers. One of the key objectives of the strategy was to increase the detection, assessment, and management of mental disorders including depression. In addition to diagnosis and patient education, a successful management of depression requires that patients systematically follow-up with their healthcare provider to ensure that they are on the optimal path to recovery. This study evaluates the impact of a visual self-assessment card to increase patients' attendance to a follow-up appointment with their healthcare provider. METHODS A clustered randomized controlled trial was implemented at a Primary Healthcare center located in South Lebanon. The final sample consisted of 405 patients (209 treated and 196 untreated patients) who were diagnosed with mild-to-severe depression using the Patient Health Questionnaire (PHQ-9 > 4). Patients were asked to attend a follow-up appointment with their health provider 2-3 weeks following the initial assessment. Treated patients were provided with a visual self-assessment card that tracked their daily mood changes and reminded them of their follow-up appointment. RESULTS Overall, the results provide evidence supporting the use of the self-assessment card to remind mental health patients of their follow-up appointments. Patients who received the card were 9 percentage points more likely to attend their follow-up appointment (p = 0.05), with new patients (vs existing patients) exhibiting a 15 percentage points increase (p < 0.05). CONCLUSION Efforts focused on increasing compliance with follow-up appointments should be at the cornerstone of mental health integration approaches. Not only do our findings suggest a great potential for cost-effective interventions but also highlight new avenues to optimize on the use of reminders to promote compliance.
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Affiliation(s)
| | | | - Fadi Makki
- Nudge Lebanon, Beirut, Lebanon
- B4Development, Doha, Qatar
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Jerrott S, Clark S, Chorney J, Coulombe A, Wozney L. Feasibility of Text Messages for Enhancing Therapeutic Engagement Among Youth and Caregivers Initiating Outpatient Mental Health Treatment: Mixed Methods Study. JMIR Form Res 2022; 6:e35685. [PMID: 35738559 PMCID: PMC9382550 DOI: 10.2196/35685] [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: 12/14/2021] [Revised: 04/27/2022] [Accepted: 05/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pathways to mental health services for youth are generally complex and often involve numerous contact points and lengthy delays. When starting treatment, there are a host of barriers that contribute to low rates of therapeutic engagement. Automated text messages offer a convenient, low-cost option for information sharing and skill building, and they can potentially activate positive behaviors in youth and caregivers prior to beginning formal therapy. To date, there is little evidence for the feasibility of initiating transdiagnostic text messages during the early stages of youth and caregiver contact with community outpatient mental health services. OBJECTIVE To develop and test the feasibility of implementing 2 novel text messaging campaigns aimed at youth clients and their caregivers during the early stages of engaging with outpatient mental health services. METHODS A multidisciplinary panel of experts developed two 12-message interventions with youth and caregivers prior to deployment. Each message included a link to an external interactive or multimedia resource to extend skill development. Enrollment of youth aged 13 to 18 years, their caregivers, or both occurred at 2 early treatment timepoints. At both time points, text messages were delivered automatically 2 times a week for 6 weeks. Analytics and survey data were collected in 2 phases, between January and March 2020 and between January and May 2021. Enrollment, willingness to persist in using the intervention, engagement, satisfaction, perceived value, and impact were measured. Descriptive statistics were used to summarize youth and caregiver outcomes. RESULTS A total of 41 caregivers and 36 youth consented to participate. Follow-up survey response rates were 54% (22/41) and 44%, (16/36) respectively. Over 1500 text messages were sent throughout the study. More than three-quarters (14/16, 88%) of youth reported that they learned something new and noticed a change in themselves due to receiving the texts; the same proportion (14/16, 88%) of youth said they would recommend the text messages to others. Youth ranked the first text message, related to coping with difficult emotions, as the most helpful of the series. Caregivers reported acting differently due to receiving the texts. Over two-thirds of caregivers were satisfied with the texts (16/22, 73%) and would recommend them to others (16/22, 73%). Caregivers perceived diverse levels of value in the text topics, with 9 of the 12 caregiver texts rated by at least one caregiver as the most helpful. CONCLUSIONS Results are preliminary but show that brief, core skill-focused text messages for youth clients and caregivers in community outpatient mental health services are feasible. Both youth and caregivers reported promising knowledge and behavior change with exposure to only 12 messages over 6 weeks. A larger study with statistical power to detect changes in both perceived helpfulness and engagement is required to confirm the effectiveness of this type of transdiagnostic intervention.
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Affiliation(s)
- Susan Jerrott
- Mental Health and Addictions Program, Nova Scotia Health, Dartmouth, NS, Canada
| | | | - Jill Chorney
- IWK Health, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - Lori Wozney
- Mental Health and Addictions Program, Nova Scotia Health, Dartmouth, NS, Canada
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Diaz Maldonado A, Simon A, Barry C, Hassler C, Lenjalley A, Giacobi C, Moro MR, Lachal J. Adolescent attendance at transcultural psychotherapy: a retrospective cohort study. Eur Child Adolesc Psychiatry 2022; 31:1-8. [PMID: 33751239 DOI: 10.1007/s00787-021-01760-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/11/2021] [Indexed: 11/27/2022]
Abstract
Migrant adolescents in therapy for psychological problems are at risk of poor attendance or even of dropping out. Transcultural psychotherapy has been developed in France to take cultural diversity into account in psychological treatment and to deal with the specific difficulties encountered in the psychotherapeutic treatment of this population. This study aims to assess adolescents' attendance rates to this form of psychotherapy and to explore the association of these rates with demographic, cultural, and clinical variables. We conducted a retrospective clinical cohort study of 148 adolescents aged from 11 to 20 years treated between 2008 and 2018 at two transcultural psychotherapy centers in Paris. Statistical analyses tested demographic, cultural, and clinical hypotheses. The main result was the high attendance rate at transcultural psychotherapy sessions among adolescents (77.8%). Attendance rates were not associated with age, gender, family size, generation of migration, or cultural area of origin, but were significantly linked to support in therapy, specifically, the presence at the first transcultural psychotherapy session of the first-line therapist, an interpreter, or both. Transcultural psychotherapy appears to be an effective method for addressing the complex symptoms experienced by migrant adolescents. Better attendance at sessions is statistically significantly associated with factors favoring a therapeutic alliance, specifically, the presence of the first-line therapist or an interpreter in TPT sessions and the existence of support from a social worker. The holistic approach of transcultural psychotherapy to adolescent care may explain the high attendance rates observed.
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Affiliation(s)
- Andrea Diaz Maldonado
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
| | - Amalini Simon
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
- Assistance publique-Hôpitaux de Paris (AP-HP), Université de Paris 13, Hôpital Avicenne, service de psychopathologie, 3413, 93009, Bobigny cedex, EA, France
| | - Caroline Barry
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Christine Hassler
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Adrien Lenjalley
- Centre Hospitalier de Niort, Unité Pour Adolescent, 79000, Niort, France
| | - Carole Giacobi
- Groupe Hospitalier Littoral Atlantique, Service de pédopsychiatrie, 17019, La Rochelle, France
| | - Marie Rose Moro
- AP-HP, Cochin Hospital, Maison de Solenn, 75014, Paris, France
- Université de Paris, PCPP, 92100, Boulogne-Billancourt, France
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France
| | - Jonathan Lachal
- Fac. de Médecine - Univ. Paris-Sud, Fac. de Médecine - UVSQ, CESP, INSERM, Université Paris-Saclay, 94807, Villejuif, France.
- CHU de Clermont-Ferrand, Service de Psychiatrie de L'Enfant Et de L'Adolescent, 63000, Clermont-Ferrand, France.
- Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
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Noorwali R, Almotairy S, Akhder R, Mahmoud G, Sharif L, Alasmee N, Mahsoon A, Hafez D. Barriers and Facilitators to Mental Health Help-Seeking among Young Adults in Saudi Arabia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052848. [PMID: 35270539 PMCID: PMC8909985 DOI: 10.3390/ijerph19052848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023]
Abstract
While young Saudi adults are reportedly prone to experiencing a variety of mental health problems, they tend to delay seeking mental health support. Therefore, this study aimed to explore the barriers and facilitators of seeking mental health support among young adults in Saudi Arabia. A qualitative research design was implemented using semi-structured interviews with 12 young adult participants in Saudi Arabia, recruited through social media platforms, and the interviews were then analyzed using thematic analysis. Two major themes emerged: barriers that impede the process of mental health help-seeking and facilitators that assist individuals in seeking mental health support. The barriers included public stigma and lack of awareness, unprofessional mental health practitioners, lack of accessibility to services and information, unsupportive families, intrapersonal dilemmas, and misconceptions based on religious beliefs. Facilitators of help-seeking included increasing societal and family awareness, promoting the accessibility of services, enhancing sources of external support, personal motivation to change, and online therapy. The findings of this study emphasize the importance of promoting mental health literacy among the Saudi public, particularly with regard to young adults and their unique mental health needs. Exploring facilitators and barriers may also assist mental health providers in developing tailored mental health campaigns and interventions directed at young adults.
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Affiliation(s)
- Robena Noorwali
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Sarah Almotairy
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Raneem Akhder
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Ghadi Mahmoud
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.N.); (S.A.); (R.A.); (G.M.)
| | - Loujain Sharif
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia; (N.A.); (A.M.)
- Correspondence:
| | - Nofaa Alasmee
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia; (N.A.); (A.M.)
| | - Alaa Mahsoon
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia; (N.A.); (A.M.)
| | - Duaa Hafez
- Department of Public Health Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia;
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McQuillin SD, Hagler MA, Werntz A, Rhodes JE. Paraprofessional Youth Mentoring: A Framework for Integrating Youth Mentoring with Helping Institutions and Professions. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:201-220. [PMID: 34318526 DOI: 10.1002/ajcp.12546] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The demand for child mental health services, including those provided by psychologists, counselors, and social workers, exceeds the supply. This trend is expected to continue or worsen unless there are substantial structural changes in how mental health services are provided. We propose a framework for paraprofessional youth mentors, defined as a subgroup of professionally supervised, non-expert volunteer or paid mentors to whom aspects of professional helping tasks are delegated. Our proposal is aligned with historical and modern solutions to scaling mental health services, and this framework could simultaneously increase the number of youth receiving evidence-based mental health services and reduce the burden on existing systems of care. The framework defines three plausible tasks for paraprofessional mentors: (1) reducing barriers to mental health service, (2) increasing engagement in services, and (3) providing direct services. The safety and effectiveness of these task-shifting efforts will hinge on competency-based training and evaluation, supervision by professionals, and documentation of services rendered, all of which the field of youth mentoring currently lacks. We describe several requisite scientific, institutional, and regulatory advances that will be necessary to realize this variant of youth mentoring for a subgroup of youth who are presenting for assistance with mental health problems.
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Affiliation(s)
- Samuel D McQuillin
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Matthew A Hagler
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Alexandra Werntz
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Jean E Rhodes
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
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Boone CE, Celhay P, Gertler P, Gracner T, Rodriguez J. How scheduling systems with automated appointment reminders improve health clinic efficiency. JOURNAL OF HEALTH ECONOMICS 2022; 82:102598. [PMID: 35172242 DOI: 10.1016/j.jhealeco.2022.102598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/03/2022] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
Missed clinic appointments or no-shows burden health care systems through inefficient use of staff time and resources. Scheduling software with automatic appointment reminders shows promise to improve clinics' management through timely cancellations and re-scheduling, but at-scale evidence is missing. We study a nationwide text message appointment reminder program in Chile implemented at primary care clinics for patients with chronic disease. Using longitudinal clinic-level data, we find that the program did not change the number of visits by chronic patients eligible to receive the reminder but visits from other patients ineligible to receive reminders increased by 5.0% in the first year and 7.4% in the second. Clinics treating more chronic patients and those with a relatively younger patient population benefited more from the program. Scheduling systems with automatic appointment reminders were effective in increasing clinics' ability to care for more patients, likely due to timely cancellations and re-scheduling.
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Affiliation(s)
| | - Pablo Celhay
- Escuela de Gobierno and Instituto de Economia, Pontifica Universidad Catolica de Chile
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Nowrouzi-Kia B, Stier J, Ayyoub L, Hutchinson L, Laframboise J, Mihailidis A. The Characteristics of Canadian University Students' Mental Health, Engagement in Activities and Use of Smartphones: A descriptive pilot study. Health Psychol Open 2021; 8:20551029211062029. [PMID: 34925871 PMCID: PMC8671687 DOI: 10.1177/20551029211062029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Mental health issues are on the rise which may impede university students’ abilities to perform daily functions and interact with other community members. The objectives of the current study are to explore (1) the characteristics of university students’ mental health and engagement in activities, (2) how students use their smartphones to support their mental health and engagement in activities, (3) student preferences for important features and functions of a smartphone application (app) that promote engagement in activities and (4) student perspectives about what data an app should collect as indicators of change in their mental health and engagement in activities. Methods We designed a pilot study and an online questionnaire with open and closed-ended questions to collect data exploring the association between student mental health and engagement in activities. The questionnaire included four sections: demographics, mental health and activity status and management, general smartphone use, and smartphone use to support mental health and engagement in activities. The data were analysed using descriptive statistics. Results A total of 56 participants were recruited to complete the online survey, with an average completion rate of 77% (n = 43). The majority of participants were 24 years of age or older (n = 34, 65.4%), and less than half were between the ages of 18 and 23 (n = 18, 34.6%). The results of participants’ engagement in self-care, productivity and leisure/play activities are reported. As well, participants’ use of smartphones to support their mental health is described. Conclusions This study provides a greater understanding of what features and functions to include and what data to collect when developing a novel app to support students’ mental health and engagement in activities. Moreover, it clarifies the bidirectional relationship between mental health changes and self-care engagement, productivity/work and leisure/play domains.
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Affiliation(s)
- Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jill Stier
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Luma Ayyoub
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lauren Hutchinson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jamie Laframboise
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alex Mihailidis
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Rehab, University Health Network, Toronto, ON, Canada
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Adolescent Perspectives on How an Adjunctive Mobile App for Social Anxiety Treatment Impacts Treatment Engagement in Telehealth Group Therapy. SOCIAL SCIENCES-BASEL 2021. [DOI: 10.3390/socsci10100397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adjunctive mobile mental health apps to supplement mental health treatment have been growing in recent years given their ability to address treatment engagement barriers. However, few studies have explicitly examined how these mobile apps impact treatment engagement, and even fewer have investigated this topic through adolescents’ perspectives. To this end, we conducted semi-structured interviews with five adolescents who used an adjunctive mobile mental health app in combination with telehealth cognitive behavioral group therapy for social anxiety. Using a multidimensional framework of treatment engagement, we elicited their perspectives on how the app impacted their engagement in telehealth group therapy and gathered their suggestions for improving the app. Using a consensual qualitative research approach, we learned that adolescents felt the app increased their comfort with others in therapy and their expectations about the effectiveness of mental health apps. They also indicated that the app prepared them for in-session participation and facilitated out-of-session skills practice. Adolescents had valuable suggestions such as adding app features to facilitate social connectedness between group members and adding appointment reminders in the app. This preliminary study highlights implications for future adjunctive mobile mental health app developers and researchers to increase adolescents’ treatment engagement in mental health services.
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Assessing the usability and user engagement of Thought Spot - A digital mental health help-seeking solution for transition-aged youth. Internet Interv 2021; 24:100386. [PMID: 33936952 PMCID: PMC8079441 DOI: 10.1016/j.invent.2021.100386] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 03/09/2021] [Accepted: 03/19/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To evaluate the perceived usability of and user engagement with a digital platform (Thought Spot) designed to enhance mental health and wellness help-seeking among transition-aged youth (TAY; 17-29-years old). MATERIALS AND METHODS Survey responses and usage patterns were collected as part of a randomized controlled trial evaluating the efficacy of Thought Spot. Participants given Thought Spot completed an adapted Usefulness, Satisfaction, and Ease of Use (USE) Questionnaire to measure perceived usability of the platform. User engagement patterns on Thought Spot were examined using analytics data collected throughout the study (March 2018-June 2019). RESULTS A total of 131 transition-aged participants completed the USE questionnaire and logged on to Thought Spot at least once. Ease of learning scored higher than ease of use, usefulness and satisfaction. Participants identified numerous strengths and challenges related to usability, visual appeal, functionality and usefulness of the content. In terms of user engagement, most participants stopped using the platform after 3 weeks. Participants searched and were interested in a variety of resources, including mental health, counselling and social services. DISCUSSION Participants reported mixed experiences while using Thought Spot and exhibited low levels of long-term user engagement. User satisfaction, the willingness to recommend Thought Spot to others, and the willingness for future use appeared to be influenced by content relevance, ease of learning, available features, and other contextual factors. Analysis of the types of resources viewed and searches conducted by TAY end-users provided insight into their behaviour and needs. CONCLUSION Users had mixed perceptions about the usability of Thought Spot, which may have contributed to the high attrition rate. User satisfaction and engagement appears to be influenced by content relevance, ease of learning, and the types of features available. Further investigation to understand the contextual factors that affect TAYs' adoption and engagement with digital mental health tools is required.
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MacDougall S, Jerrott S, Clark S, Campbell LA, Murphy A, Wozney L. Text Message Interventions in Adolescent Mental Health and Addiction Services: Scoping Review. JMIR Ment Health 2021; 8:e16508. [PMID: 33416504 PMCID: PMC7822725 DOI: 10.2196/16508] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 09/03/2020] [Accepted: 12/04/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The vast majority of adolescent mental health and substance use disorders go undiagnosed and undertreated. SMS text messaging is increasingly used as a method to deliver adolescent health services that promote psychological well-being and aim to protect adolescents from adverse experiences and risk factors critical for their current and future mental health. To date, there has been no comprehensive synthesis of the existing literature on the extent, range, and implementation contexts of these SMS text message interventions. OBJECTIVE The objective of this scoping review was to map and categorize gaps in the current body of peer-reviewed research around the use of SMS text messaging-based interventions for mental health and addiction services among adolescents. METHODS A scoping review was conducted according to Levac's adaptation of Arksey and O'Malley's methodological framework for scoping reviews in six iterative stages. A search strategy was cocreated and adapted for five unique databases. Studies were screened using Covidence software. The PICO (patient, intervention, comparator, outcome) framework and input from multiple stakeholder groups were used to structure and pilot a data extraction codebook. Data were extracted on study methodology and measures, intervention design, and implementation characteristics, as well as policy, practice, and research implications. RESULTS We screened 1142 abstracts. Of these, 31 articles published between 2013 and 2020 were eligible for inclusion. Intervention engagement was the most common type of outcome measured (18/31), followed by changes in cognitions (16/31; eg, disease knowledge, self-awareness) and acceptability (16/31). Interventions were typically delivered in less than 12 weeks, and adolescents received 1-3 messages per week. Bidirectional messaging was involved in 65% (20/31) of the studies. Limited descriptions of implementation features (eg, cost, policy implications, technology performance) were reported. CONCLUSIONS The use of SMS text messaging interventions is a rapidly expanding area of research. However, lack of large-scale controlled trials and theoretically driven intervention designs limits generalizability. Significant gaps in the literature were observed in relation to implementation considerations, cost, clinical workflow, bidirectionality of texting, and level of personalization and tailoring of the interventions. Given the growth of mobile phone-based interventions for this population, a rigorous program of large-scale, well-designed trials is urgently required.
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Affiliation(s)
| | | | | | - Leslie Anne Campbell
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Andrea Murphy
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Lori Wozney
- Mental Health and Addictions, Policy and Planning, Nova Scotia Health, Dartmouth, NS, Canada
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12
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Winiarski DA, Rufa AK, Bounds DT, Glover AC, Hill KA, Karnik NS. Assessing and treating complex mental health needs among homeless youth in a shelter-based clinic. BMC Health Serv Res 2020; 20:109. [PMID: 32046711 PMCID: PMC7014693 DOI: 10.1186/s12913-020-4953-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 02/04/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Rates of homelessness have been increasing in recent years, thereby necessitating a more direct approach to treating this complex social problem. Homeless youth have disproportionately high rates of untreated mental health problems and are therefore particularly vulnerable to the effects of homelessness during the transition period from adolescence to adulthood. METHODS The study team developed a shelter-based clinic and collected clinical measures on youth who attended this clinic from October 2016 through June 2018. RESULTS Youth attended an average number of three sessions, but there was a significant drop in follow-up after the first (intake) appointment. Depression, anger, and adjustment disorder emerged as the most common presenting mental health concerns identified by clinicians in the intake appointment, and trauma was identified as a significant complaint for those youth who returned for a second session. CONCLUSION Mental health care is needed in this population, but future studies should explore alternative approaches to retaining homeless youth in treatment and in designing targeted trauma-informed interventions.
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Affiliation(s)
- Dominika A. Winiarski
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Anne K. Rufa
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Dawn T. Bounds
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
- College of Nursing, Department of Community, Systems, & Mental Health Nursing, Rush University Medical Center, Chicago, IL USA
| | - Angela C. Glover
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Kristin A. Hill
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
- College of Nursing, Department of Community, Systems, & Mental Health Nursing, Rush University Medical Center, Chicago, IL USA
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13
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Lester R, Park JJ, Bolten LM, Enjetti A, Johnston JC, Schwartzman K, Tilahun B, Delft AV. Mobile phone short message service for adherence support and care of patients with tuberculosis infection: Evidence and opportunity. J Clin Tuberc Other Mycobact Dis 2019; 16:100108. [PMID: 31720432 PMCID: PMC6830136 DOI: 10.1016/j.jctube.2019.100108] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
To attain the Global End Tuberculosis (TB) goals, the treatment of persons with TB requires advancements in coordinated approaches that are low-cost and highly accessible. Treating TB successfully requires prolonged medication regimens with good adherence, which in turn requires patients to be adequately supported. Furthermore, TB care-providers often wish to monitor treatment-taking by patients in order to track the success of their programs and ensure adequate completion of therapies by individuals. The standard-of-care for treatment monitoring in TB programs often includes directly observed therapy (DOT). Video observed therapy (VOT) has emerged as a method to mimic in-person visits or observations, especially in the smartphone era with internet data connections, but remains simply inaccessible to patients in areas where TB is most endemic. Both approaches may be considered more intensive than necessary for many patients, leaving an opportunity for more affordable and acceptable approaches. The rapid increase in mobile phone penetration provides an opportunity to reach patients between clinical visits. Short message services (SMS) are available on almost every mobile phone and are supported by first generation cellular communication networks, thus providing the farthest reach and penetration globally. Evidence from non-TB conditions suggests SMS, used in a variety of ways, may support outpatients for better medication adherence and quality of care but the evidence in TB remains limited. In this paper, we discuss how basic mobile phones and SMS-related services may be used in supporting global care of persons with TB, with a focus on patient-centered approaches.
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Affiliation(s)
| | - Jay Jh Park
- University of British Columbia, Vancouver, Canada
| | | | | | - James C Johnston
- University of British Columbia, Vancouver, Canada.,Provincial TB Services, British Columbia Centre for Disease Control, Vancouver, Canada
| | - Kevin Schwartzman
- Respiratory Division, Montreal Chest Institute, Respiratory Epidemiology and Clinical Research Unit, and McGill International Tuberculosis Centre, McGill University, Montreal, Quebec, Canada
| | | | - Arne von Delft
- TB Proof, 29 Almond Drive, Somerset West, Western Cape 7130, South Africa.,School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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14
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Taylor SL, Meyer JM, Munoz-Abraham AS, Chatoorgoon K. Standardized text messages improve 30-day patient follow-up for ACS pediatric NSQIP cases. Pediatr Surg Int 2019; 35:523-527. [PMID: 30712083 DOI: 10.1007/s00383-019-04436-x] [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] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Thirty-day follow-up is a critical and challenging component of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). We hypothesized the simplicity and immediacy of text messaging would increase response rates while reducing workload. METHODS For 6 months, text messages were the primary form of contact for first and second follow-up attempts. If no response, a phone call was made. Results of this protocol were compared to the previous 6 months when phone calls were the primary method. RESULTS The text message (TM) group had 298 cases and phone call (PC) group had 354. The first contact was successful in 63.8% of the TM group compared to 47.5% of the PC group. The second contact was successful in 15.4% (TM) and 16.9% (PC). In the third attempt, 3.0% answered the call in the TM group versus 9.3% in the PC group. Some families remained unreachable: 17.8% in TM group and 26.3% in PC group (p = 0.01). When totaled, time spent to obtain caregivers' responses was over five times higher in the PC group (910 min) than the TM group (173 min) (p = 0.005). CONCLUSION Patient follow-up using text messaging has improved our follow-up rate while decreasing workload.
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Affiliation(s)
- Stephanie L Taylor
- Division of Pediatric Surgery, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University, 1465 S Grand Blvd, St. Louis, MO, 63104-6454, USA.,Division of Pediatric Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Jenna M Meyer
- Division of Pediatric Surgery, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University, 1465 S Grand Blvd, St. Louis, MO, 63104-6454, USA.,Division of Pediatric Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Armando Salim Munoz-Abraham
- Division of Pediatric Surgery, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University, 1465 S Grand Blvd, St. Louis, MO, 63104-6454, USA.,Division of Pediatric Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Kaveer Chatoorgoon
- Division of Pediatric Surgery, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University, 1465 S Grand Blvd, St. Louis, MO, 63104-6454, USA. .,Division of Pediatric Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
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15
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Cummings JR, Gaydos LM, Mensa-Kwao A, Song M, Blake SC. Perspectives on caregiver-focused MHealth Technologies to improve mental health treatment for low-income youth with ADHD. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2019; 4:6-16. [PMID: 31106258 PMCID: PMC6519954 DOI: 10.1007/s41347-018-0066-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To examine stakeholder perspectives regarding: (1) whether mobile health (MHealth) tools can improve the mental health (MH) treatment process for low-income youth with ADHD in safety net settings; and (2) what functions would be helpful to improve the treatment process. METHODS This study analyzed qualitative data from a larger project that collected information from key stakeholders at four safety-net clinics across Georgia. We conducted five focus groups with caregivers who had a Medicaid-insured child receiving treatment for ADHD, and 17 semi-structured interviews with clinic administrators and providers. Stakeholders shared their perspectives on strategies to improve the MH treatment process, including the use of mHealth tools. Caregivers also completed a brief survey about technology use. We present findings from a thematic analysis of the qualitative data and descriptive findings from the survey. RESULTS Participants in each group of stakeholders expressed interest in mHealth tools that would: (1) deliver reminders for caregivers (including appointment and medication refill reminders); (2) help caregivers obtain information about ADHD symptoms and treatment options; (3) help caregivers track information about their child's symptoms and treatment progress; and (4) facilitate communication between caregivers and providers. While more than three-fourths of caregivers had a smartphone, providers and administrators expressed concern that access to mHealth technologies may be inconsistent if low-income families are unable to pay cellular phone bills. CONCLUSIONS Caregivers, clinic administrators, and providers were supportive of enhanced mHealth technologies to improve MH care for this population.
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Affiliation(s)
- Janet R. Cummings
- Department of Health Policy and Management, Rollins School of Public Health, Emory University
| | - Laura M. Gaydos
- Department of Health Policy and Management, Rollins School of Public Health, Emory University
| | - Augustina Mensa-Kwao
- Department of Behavioral Health Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Minna Song
- Department of Behavioral Health Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Sarah C. Blake
- Department of Health Policy and Management, Rollins School of Public Health, Emory University
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16
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Ramlucken L, Sibiya MN. Frequency and reasons for missed appointments of outpatient mental health care users in the uMgungundlovu District. Curationis 2018; 41:e1-e4. [PMID: 30198291 PMCID: PMC6111624 DOI: 10.4102/curationis.v41i1.1835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 05/03/2018] [Accepted: 05/30/2018] [Indexed: 11/25/2022] Open
Abstract
Background Over the years, there has been a rapid growth in the use of mobile technology which has been proven to increase treatment adherence. Short message services may improve service delivery through appointment reminders and improve communication between health care workers and patients. Missed appointments are becoming common amongst mental health care users, and this has a significant economic burden on mental health symptoms. Objectives The aim of the study was to determine the frequency and reasons for missed appointments of outpatient mental health care users for their follow-up care in the uMgungundlovu District. Method This study used a quantitative survey. A non-probability convenient sampling method was used to select 182 participants at the psychiatric clinics. Results Of the 182 participants, results of the study indicated that n = 84 (46.2%) respondents had missed their appointment at some stage. Of the n = 84 (46.2%) respondents who had missed appointments, n = 28 (33.3%) had missed their appointment once, and n = 45 (53.6%) had missed their appointment 2–3 times. Most common reasons for missed appointments included mental health care users forgetting (n = 58; 69%), work commitments (n = 14; 16.7%), no transportation (n = 4; 4.8%) and financial constraints (n = 5; 6%). Conclusion The main reasons for missed appointments that were identified included forgetfulness, work commitments, lack of transportation and financial constraints. A significant number of participants (53.6%) had missed their appointments 2–3 times.
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17
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Schwebel FJ, Larimer ME. Using text message reminders in health care services: A narrative literature review. Internet Interv 2018; 13:82-104. [PMID: 30206523 PMCID: PMC6112101 DOI: 10.1016/j.invent.2018.06.002] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Despite the extensive use of mHealth behavior change interventions, questions remain about the use of technology-based reminders in delivering health care services. Text messaging, or short message service (SMS), is one reminder method that has been extensively researched. Most SMS-reminder research is distributed across a range of health care outcomes. The aim of this article is to systematically review the aggregate impact of these reminders on overall health care outcomes. METHODS A systematic literature review was conducted and yielded 2316 articles. Studies were included if they used SMS reminders to support patient health care outcomes. Study methodology was aligned with the PRISMA guidelines for systematic reviews. RESULTS Following screening, 162 articles met inclusion criteria. Of these studies, 93 investigated medical compliance reminders and 56 investigated appointment reminders. The review found that nearly all the SMS-reminder studies helped improve patient medical compliance and appointment reminders. Additionally, researchers reported numerous benefits from using SMS reminders, including ease of use, relative inexpensiveness, and rapid and automated message delivery. Minimal risks were reported and most participants found the reminders to be acceptable. DISCUSSION Text messages appear to be an effective reminder mechanism to promote improved patient appointment and medical compliance. Reminders should continue to be evaluated and improved to determine the most effective timing and frequency of messages for improving outcomes.
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Affiliation(s)
- Frank J. Schwebel
- University of Washington, Department of Psychology, 119A Guthrie Hall Box 351525, Seattle, WA 98195-1525, United States of America,Corresponding author.
| | - Mary E. Larimer
- University of Washington, Department of Psychology, 119A Guthrie Hall Box 351525, Seattle, WA 98195-1525, United States of America,University of Washington, Department of Psychiatry and Behavioral Sciences, 1100 NE 45th, Suite 300, Office 312, Box 354944, Seattle, WA 98105, United States of America
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18
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Saez L, Langlois J, Legrand K, Quinet MH, Lecomte E, Omorou AY, Briançon S. Reach and Acceptability of a Mobile Reminder Strategy and Facebook Group Intervention for Weight Management in Less Advantaged Adolescents: Insights From the PRALIMAP-INÈS Trial. JMIR Mhealth Uhealth 2018; 6:e110. [PMID: 29776897 PMCID: PMC5984273 DOI: 10.2196/mhealth.7657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/20/2017] [Accepted: 02/03/2018] [Indexed: 01/01/2023] Open
Abstract
Background Although information and communication technology interventions appear to be a promising means of reducing the health inequality gap in overweight and obesity prevention, research on information and communication technology interventions is lacking outside the Anglo-Saxon world. Objective The aim of this study was to assess the reach and acceptability of 2 information and communication technology interventions delivered as part of a French nutritional program: an SMS text messaging (short message service, SMS) attendance-reminder for collective sessions strategy and a Facebook challenge group. Methods This study sample comprised 262 socially less advantaged overweight adolescents aged between 13 and 18 years. The information and communication technology interventions were carried out during the 2013-2014 academic year in 33 French state-run schools. For the SMS attendance-reminder for collective sessions strategy, at the start of the academic year, adolescents were asked to give their mobile number. SMS attendance-reminders were sent shortly before each of the 5 collective sessions. For the Facebook challenge group, adolescents were invited to join a closed Facebook group in which challenges on physical activity and on diet were posted weekly. Process data and 2 sets of face-to-face interviews were also used to interpret participation rates and access to Facebook. Appreciation for both interventions was evaluated by a questionnaire at the end of the academic year. Results Of the recruited adolescents, 79.0% (207/262) gave their mobile number, reflecting high access to a mobile phone. Giving a number was significantly more likely for girls (odds ratio [OR] 2.1, 95% CI 1.1-3.9; P=.02) and adolescents in a vocational or general high school as opposed to middle school (OR 1.0, 95% CI 0.4-2.7; OR 0.2, 95% CI 0.1-0.5; P<.001). Indicating a mobile number at the start of the year was not significantly associated with participation in collective sessions. Of the adolescents seen at the start-of-year face-to-face interviews, 78.1% (153/196) declared an interest in the Facebook challenge group, which implies having a Facebook account or being able to have access to one. However, only 21 adolescents went through the process of joining the group. Although there was satisfaction with the Facebook group among the participants, the low participation rate in the Facebook group does not allow conclusions to be drawn with confidence. Conclusions The results are in line with the claim that using information and communication technologies in health programs is unlikely to widen health inequalities. However, in this population of French adolescents, mobile phone strategies seem more adapted to a high school context, and caution should be exercised with a younger audience. Although there is positive appreciation of the SMS attendance-reminders and a Facebook intervention is initially highly appealing to less advantaged adolescents, no evidence of impact could be demonstrated. These results highlight the difficulty in assessing the impact of specific interventions in complex health programs. Trial Registration Clinicaltrials.gov NCT01688453; https://clinicaltrials.gov/ct2/show/NCT01688453 (Archived by WebCite at http://www.webcitation.org/6yy6EQ0SM)
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Affiliation(s)
- Laura Saez
- APEMAC EA4360, University of Lorraine, Nancy, France
| | - Johanne Langlois
- APEMAC EA4360, University of Lorraine, Nancy, France.,National Conservatory of Arts and Crafts, Nancy, France
| | - Karine Legrand
- APEMAC EA4360, University of Lorraine, Nancy, France.,Clinical Epidemiology, Clinical Investigation Center, National Institute for Health and Medical Research, University Hospital Regional Center, Nancy, France
| | | | - Edith Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| | - Abdou Y Omorou
- APEMAC EA4360, University of Lorraine, Nancy, France.,Clinical Epidemiology, Clinical Investigation Center, National Institute for Health and Medical Research, University Hospital Regional Center, Nancy, France
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- APEMAC EA4360, University of Lorraine, Nancy, France.,National Conservatory of Arts and Crafts, Nancy, France.,Clinical Epidemiology, Clinical Investigation Center, National Institute for Health and Medical Research, University Hospital Regional Center, Nancy, France.,Academy Rector of Nancy and Metz, Nancy, France.,APEMAC EA4360, University of Lorraine, Metz, France
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19
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Kravariti E, Reeve-Mates C, Da Gama Pires R, Tsakanikos E, Hayes D, Renshaw S, McAllister S, Bhavsar V, Patterson P, Daley E, Stewart J, Pritchard M, Shetty H, Ramsay R, Perez-Iglesias R, McGuire P. Effectiveness of automated appointment reminders in psychosis community services: a randomised controlled trial. BJPsych Open 2018; 4:15-17. [PMID: 29388909 PMCID: PMC6020281 DOI: 10.1192/bjo.2017.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report on the first open-label, parallel group randomised controlled trial of automated appointment reminders in a psychosis community service in the UK. Ninety-five patients were randomly allocated to receiving/not receiving automated messaging reminders 7 days and 1 day before appointments. All 'Attended' and 'Missed' appointment outcomes over 6 months were analysed using cluster regression analysis. Reminded appointments were significantly more frequently attended than non-reminded appointments (unadjusted odds ratio (OR) = 3.54, 95% CI 1.36-9.22, P = 0.01; adjusted OR = 2.95, 95% CI 1.05-8.85, P < 0.05). Automated messaging reminders can provide a robust strategy for promoting engagement with psychosis services. Declaration of interest The authors have no competing financial interests to declare in relation to the current work. Sarah McAllister was supported by a King's Undergraduate Research Fellowship.
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Affiliation(s)
- Eugenia Kravariti
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK
| | - Christopher Reeve-Mates
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK
| | - Rafaela Da Gama Pires
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK
| | | | - Daniel Hayes
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK,and Evidence Based Practice Unit,UCL and Anna Freud National Centre for Children and Families,London,UK
| | - Siobhan Renshaw
- Brunel University London,Department of Psychology,Middlesex,UK
| | - Sarah McAllister
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK,and South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Vishal Bhavsar
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK,and South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Pam Patterson
- South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Emily Daley
- South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Jane Stewart
- South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Megan Pritchard
- King's College London,Department of Psychological Medicine,Institute of Psychiatry,Psychology & Neuroscience,London,UK,and The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry,Psychology & Neuroscience at King's College London,King's Health Partners Academic Health Sciences Centre,London,UK
| | - Hitesh Shetty
- The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry,Psychology & Neuroscience at King's College London,King's Health Partners Academic Health Sciences Centre,London,UK
| | - Rosalind Ramsay
- South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Rocio Perez-Iglesias
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK,and South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
| | - Philip McGuire
- King's College London,Department of Psychosis Studies,Institute of Psychiatry,Psychology & Neuroscience,London,UK,and South London and Maudsley NHS Foundation Trust,Bethlem Royal Hospital,Kent,UK
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Vengadesan N, Ahmad M, Sindal MD, Sengupta S. Delayed follow-up in patients with diabetic retinopathy in South India: Social factors and impact on disease progression. Indian J Ophthalmol 2017; 65:376-384. [PMID: 28573993 PMCID: PMC5565887 DOI: 10.4103/ijo.ijo_620_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: To identify social factors associated with delayed follow-up in South Indian patients with diabetic retinopathy (DR) and to study DR progression during the delayed follow-up period. Materials and Methods: In this cross-sectional study, 500 consecutive patients with DR returning after greater than twice the advised follow-up period were identified from a tertiary referral center in South India. A previously validated 19-item questionnaire was administered to study patients to assess causes for the follow-up delay. Patient demographics, DR status, and treatment plan were recorded at the study visit and the visit immediately before the delay. The eye with the most severe disease was included in the analysis. Results: Complete data were available for 491 (98.2%) patients. Among these, 248 (50.5%) cited “my eyes were okay at the time,” 201 (41.0%) cited “no attender to accompany me,” and 190 (38.6%) cited “financial cost” as causes of the follow-up delay. Those with vision-threatening DR (VTDR, n = 233) predominantly reported “financial cost” (47% vs. 32%, P = 0.001), whereas those with non-VTDR more frequently reported “my eyes were okay at the time” (58% vs. 42%, P = 0.001). Evidence of disease progression from non-VTDR to VTDR was seen in 67 (26%) patients. Almost 1/3rd (29%) of patients who were previously advised regular examination required additional intervention. Conclusion: Many patient-level factors affect poor compliance with follow-up in DR, and these factors vary by disease severity. Targeting these barriers to care through patient education and clinic procedures may promote timely follow-up and better outcomes in these patients.
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Affiliation(s)
| | - Meleha Ahmad
- Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Manavi D Sindal
- Department of VitreoRetina, Aravind Eye Hospital, Puducherry, India
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Bruehlman-Senecal E, Aguilera A, Schueller SM. Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance. Behav Ther 2017; 48:614-623. [PMID: 28711112 PMCID: PMC5512460 DOI: 10.1016/j.beth.2017.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 12/13/2016] [Accepted: 01/02/2017] [Indexed: 11/15/2022]
Abstract
Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective "just-in-time" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy.
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Affiliation(s)
| | - Adrian Aguilera
- University of California, Berkeley, School of Social Welfare; University of California, San Francisco, San Francisco General Hospital.
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22
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Gehring ND, McGrath P, Wozney L, Soleimani A, Bennett K, Hartling L, Huguet A, Dyson MP, Newton AS. Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents. Implement Sci 2017. [PMID: 28637479 PMCID: PMC5479013 DOI: 10.1186/s13012-017-0608-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. Methods A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0–18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues’ implementation outcomes—acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability—and grouped separately for studies and documents. Results Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6), and low (n = 1). These documents focused on cost (100%, n = 9), penetration (89%, n = 8), feasibility (78%, n = 7), and sustainability (67%, n = 6) of implementing eMental healthcare technology. Conclusion To date, research studies have largely focused on acceptability and appropriateness, while government/organizational documents state goals and recommendations regarding costs, feasibility, and sustainability of eMental healthcare technologies. These differences suggest that the research evidence available for pediatric eMental healthcare technologies does not reflect the focus of governments and organizations. Partnerships between researchers, healthcare planners, and policymakers may help to align implementation research with policy development, decision-making, and funding foci. Electronic supplementary material The online version of this article (doi:10.1186/s13012-017-0608-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicole D Gehring
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Patrick McGrath
- IWK Health Centre, 5850-5980 University Avenue, Halifax, NS, Canada
| | - Lori Wozney
- Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada
| | - Amir Soleimani
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact (Formally Clinical Epidemiology and Biostatistics), and Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Anna Huguet
- IWK Health Centre, 5850-5980 University Avenue, Halifax, NS, Canada.,Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Michele P Dyson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Amanda S Newton
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
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Wahle F, Bollhalder L, Kowatsch T, Fleisch E. Toward the Design of Evidence-Based Mental Health Information Systems for People With Depression: A Systematic Literature Review and Meta-Analysis. J Med Internet Res 2017; 19:e191. [PMID: 28566267 PMCID: PMC5471345 DOI: 10.2196/jmir.7381] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 03/10/2017] [Accepted: 04/06/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Existing research postulates a variety of components that show an impact on utilization of technology-mediated mental health information systems (MHIS) and treatment outcome. Although researchers assessed the effect of isolated design elements on the results of Web-based interventions and the associations between symptom reduction and use of components across computer and mobile phone platforms, there remains uncertainty with regard to which components of technology-mediated interventions for mental health exert the greatest therapeutic gain. Until now, no studies have presented results on the therapeutic benefit associated with specific service components of technology-mediated MHIS for depression. OBJECTIVE This systematic review aims at identifying components of technology-mediated MHIS for patients with depression. Consequently, all randomized controlled trials comparing technology-mediated treatments for depression to either waiting-list control, treatment as usual, or any other form of treatment for depression were reviewed. Updating prior reviews, this study aims to (1) assess the effectiveness of technology-supported interventions for the treatment of depression and (2) add to the debate on what components in technology-mediated MHIS for the treatment of depression should be standard of care. METHODS Systematic searches in MEDLINE, PsycINFO, and the Cochrane Library were conducted. Effect sizes for each comparison between a technology-enabled intervention and a control condition were computed using the standard mean difference (SMD). Chi-square tests were used to test for heterogeneity. Using subgroup analysis, potential sources of heterogeneity were analyzed. Publication bias was examined using visual inspection of funnel plots and Begg's test. Qualitative data analysis was also used. In an explorative approach, a list of relevant components was extracted from the body of literature by consensus between two researchers. RESULTS Of 6387 studies initially identified, 45 met all inclusion criteria. Programs analyzed showed a significant trend toward reduced depressive symptoms (SMD -0.58, 95% CI -0.71 to -0.45, P<.001). Heterogeneity was large (I2≥76). A total of 15 components were identified. CONCLUSIONS Technology-mediated MHIS for the treatment of depression has a consistent positive overall effect compared to controls. A total of 15 components have been identified. Further studies are needed to quantify the impact of individual components on treatment effects and to identify further components that are relevant for the design of future technology-mediated interventions for the treatment of depression and other mental disorders.
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Affiliation(s)
- Fabian Wahle
- Center for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zürich, Zürich, Switzerland
| | - Lea Bollhalder
- Institute of Technology Management, University of St Gallen, St Gallen, Switzerland
| | - Tobias Kowatsch
- Center for Digital Health Interventions, Institute of Technology Management, University of St Gallen, St Gallen, Switzerland
| | - Elgar Fleisch
- Institute of Technology Management, University of St Gallen, St Gallen, Switzerland
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Badawy SM, Kuhns LM. Texting and Mobile Phone App Interventions for Improving Adherence to Preventive Behavior in Adolescents: A Systematic Review. JMIR Mhealth Uhealth 2017; 5:e50. [PMID: 28428157 PMCID: PMC5415660 DOI: 10.2196/mhealth.6837] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/16/2017] [Accepted: 03/05/2017] [Indexed: 11/23/2022] Open
Abstract
Background Many preventable behaviors contribute to adolescent mortality and morbidity. Non-adherence to preventive measures represents a challenge and has been associated with worse health outcomes in this population. The widespread use of electronic communication technologies by adolescents, particularly the use of text messaging (short message service, SMS) and mobile phones, presents new opportunities to intervene on risk and preventive risk behavior, but little is known about their efficacy. Objective This study aimed to systematically evaluate evidence for the efficacy of text messaging and mobile phone app interventions to improve adherence to preventive behavior among adolescents and describe intervention approaches to inform intervention development. Methods This review covers literature published between 1995 and 2015. Searches included PubMed, Embase, CENTRAL, PsycINFO, CINAHL, INSPEC, Web of Science, Google Scholar, and additional databases. The search strategy sought articles on text messaging and mobile phone apps combined with adherence or compliance, and adolescents and youth. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. Two reviewers independently screened titles and abstracts, assessed full-text articles, and extracted data from articles that met inclusion criteria. Included studies reflect original research—experimental or preexperimental designs with text messaging or mobile phone app interventions—targeting adherence to preventive behavior among adolescents (12-24 years old). The preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines were followed for reporting results, and findings were critically appraised against the Oxford Centre for Evidence-based Medicine criteria. Results Of 1454 records, 19 met inclusion criteria, including text messaging (n=15) and mobile phone apps (n=4). Studies targeted clinic attendance, contraceptive use, oral health, physical activity and weight management, sun protection, human papillomavirus (HPV) vaccination, smoking cessation, and sexual health. Most studies were performed in the United States (47%, 9/19), included younger adolescents (63%, 12/19), and had sample size <100 (63%, 12/19). Although most studies were randomized controlled trials (RCTs; 58%, 11/19), only 5 followed an intent-to-treat analysis. Only 6 of 19 studies (32%) incorporated a theoretical framework in their design. Most studies reported good feasibility with high acceptability and satisfaction. About half of the included studies (42%, 8/19) demonstrated significant improvement in preventive behavior with moderate standardized mean differences. As early efforts in this field to establish feasibility and initial efficacy, most studies were low to moderate in quality. Studies varied in sample size and methods of preventive behavior adherence or outcome assessment, which prohibited performing a meta-analysis. Conclusions Despite the promising feasibility and acceptability of text messaging and mobile phone apps in improving preventive behavior among adolescents, overall findings were modest in terms of efficacy. Further research evaluating the efficacy, effectiveness, and cost-effectiveness of these intervention approaches in promoting preventive behavior among adolescents is needed.
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Affiliation(s)
- Sherif M Badawy
- Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Division of Hematology, Oncology, and Stem Cell Transplant, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Pediatrics, Division of Hematology/Oncology, Zagazig University Faculty of Medicine, Zagazig, Egypt
| | - Lisa M Kuhns
- Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Division of Adolescent Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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25
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Eagleson R, Altamirano-Diaz L, McInnis A, Welisch E, De Jesus S, Prapavessis H, Rombeek M, Seabrook JA, Park T, Norozi K. Implementation of clinical research trials using web-based and mobile devices: challenges and solutions. BMC Med Res Methodol 2017; 17:43. [PMID: 28302050 PMCID: PMC5356263 DOI: 10.1186/s12874-017-0324-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the increasing implementation of web-based, mobile health interventions in clinical trials, it is crucial for researchers to address the security and privacy concerns of patient information according to high ethical standards. The full process of meeting these standards is often made more complicated due to the use of internet-based technology and smartphones for treatment, telecommunication, and data collection; however, this process is not well-documented in the literature. RESULTS The Smart Heart Trial is a single-arm feasibility study that is currently assessing the effects of a web-based, mobile lifestyle intervention for overweight and obese children and youth with congenital heart disease in Southwestern Ontario. Participants receive telephone counseling regarding nutrition and fitness; and complete goal-setting activities on a web-based application. This paper provides a detailed overview of the challenges the study faced in meeting the high standards of our Research Ethics Board, specifically regarding patient privacy. CONCLUSION We outline our solutions, successes, limitations, and lessons learned to inform future similar studies; and model much needed transparency in ensuring high quality security and protection of patient privacy when using web-based and mobile devices for telecommunication and data collection in clinical research.
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Affiliation(s)
- Roy Eagleson
- Faculty of Engineering, Western University, London, Canada
| | - Luis Altamirano-Diaz
- Department of Paediatrics, Western University, London, Canada.,Children's Health Research Institute, London, Canada.,Paediatric Cardiopulmonary research laboratory, London Health science centre, London, Canada
| | - Alex McInnis
- Department of Paediatrics, Western University, London, Canada
| | - Eva Welisch
- Department of Paediatrics, Western University, London, Canada.,Children's Health Research Institute, London, Canada.,Paediatric Cardiopulmonary research laboratory, London Health science centre, London, Canada
| | | | | | - Meghan Rombeek
- Department of Paediatrics, Western University, London, Canada
| | - Jamie A Seabrook
- Children's Health Research Institute, London, Canada.,Brescia University College, Western University, London, ON, Canada
| | - Teresa Park
- Department of Paediatrics, Western University, London, Canada
| | - Kambiz Norozi
- Department of Paediatrics, Western University, London, Canada. .,Children's Health Research Institute, London, Canada. .,Paediatric Cardiopulmonary research laboratory, London Health science centre, London, Canada. .,Department of Paediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany. .,Department of Paediatric Cardiology and Intensive Care Medicine, University of Goettingen, Goettingen, Germany. .,Department of Paediatrics, Division of Paediatric Cardiology, Western University, 800 Commissioners Rd E, PO Box 5010, London, ON, N6A 5W9, Canada.
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Text Message Reminders Increase Appointment Adherence in a Pediatric Clinic: A Randomized Controlled Trial. Int J Pediatr 2016; 2016:8487378. [PMID: 28127311 PMCID: PMC5227159 DOI: 10.1155/2016/8487378] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/26/2016] [Accepted: 12/06/2016] [Indexed: 11/17/2022] Open
Abstract
Background. High no-show rates can burden clinic productivity and affect patient care. Although multiple studies have shown that text messages improve appointment adherence, very little research has focused on low-income and predominantly African American populations in resident clinic settings. Objectives. To determine whether incorporating a text message reminder reduces the no-show rate at an urban, pediatric resident clinic. Methods. A randomized controlled trial was conducted at a tertiary level ambulatory pediatric practice between August 2014 and February 2015. Following a demographic survey, 170 patients were enrolled. Patients were randomized into control or intervention groups. All patients received the standard voice message appointment reminder, but the intervention group additionally received a text message reminder. The primary outcome was no-show rate. Results. 95.3% of the participants were African American, and the overall no-show rate was 30.8%. No-show rate was significantly lower in the intervention group (23.5%) than the control group (38.1%) representing a difference of 14.6% (p = 0.04). No demographic factors were found to alter the association between no-show rate and text message intervention. Conclusions. Text message reminders effectively improve show rates at a resident pediatric practice with high no-show rates, representing a promising approach to improving appointment adherence.
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Loescher LJ, Rains SA, Kramer SS, Akers C, Moussa R. A Systematic Review of Interventions to Enhance Healthy Lifestyle Behaviors in Adolescents Delivered via Mobile Phone Text Messaging. Am J Health Promot 2016; 32:865-879. [PMID: 27923885 DOI: 10.1177/0890117116675785] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review healthy lifestyle interventions targeted to adolescents and delivered using text messaging (TM). DATA SOURCE PubMed, Embase, CINAHL, PsycINFO, and Web of Science databases. Study Inclusion Criteria: Research articles published during 2011 to 2014; analyses focused on intervention targeting adolescents (10-19 years), with healthy lifestyle behaviors as main variables, delivered via mobile phone-based TM. DATA EXTRACTION The authors extracted data from 27 of 281 articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. DATA SYNTHESIS Adolescent and setting characteristics, study design and rigor, intervention effectiveness, challenges, and risk of bias. RESULTS Across studies, 16 (59.3%) of 27 included non-Caucasians. The gender was split for 22 (81.5%) of 27 studies. Thirteen studies were randomized controlled trials. There was heterogeneity among targeted conditions, rigor of methods, and intervention effects. Interventions for monitoring/adherence (n = 8) reported more positive results than those for health behavior change (n = 19). Studies that only included message delivered via TM (n = 14) reported more positive effects than studies integrating multiple intervention components. Interventions delivered using TM presented minimal challenges, but selection and performance bias were observed across studies. CONCLUSION Interventions delivered using TM have the potential, under certain conditions, to improve healthy lifestyle behaviors in adolescents. However, the rigor of studies varies, and established theory and validated measures have been inconsistently incorporated.
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Affiliation(s)
- Lois J Loescher
- 1 Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.,2 College of Nursing, The University of Arizona, Tucson, AZ, USA
| | - Stephen A Rains
- 3 Department of Communication, The University of Arizona, Tucson, AZ, USA
| | - Sandra S Kramer
- 4 Arizona Health Sciences Library-Tucson, The University of Arizona, Tucson, AZ, USA
| | - Chelsie Akers
- 3 Department of Communication, The University of Arizona, Tucson, AZ, USA
| | - Renee Moussa
- 1 Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
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Thomason DL, Lukkahatai N, Kawi J, Connelly K, Inouye J. A Systematic Review of Adolescent Self-Management and Weight Loss. J Pediatr Health Care 2016; 30:569-582. [PMID: 26818905 DOI: 10.1016/j.pedhc.2015.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 11/13/2015] [Accepted: 11/30/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this review is to evaluate self-management interventions among overweight and obese adolescents to direct future research and practice. METHODS Studies published between 2008 and 2014 were identified by electronic database searches. The Jadad Scoring of Quality Reports of Randomized Clinical Trials was used to evaluate the quality of the studies with subsequent reviews. RESULTS Out of 69 studies, 10 randomized controlled trials were reviewed after all inclusion and exclusion criteria were met. Quality scores ranged from 7 to 11 out of 13 (M = 9.2, SD = 1.13). For the majority of studies, self-management strategies for weight loss were found to be significant for a mix of behavioral, psychological, anthropometric, and metabolic outcomes. DISCUSSION Findings indicated that interventions were most successful when incorporating family members. Self-management interventions that include a combination of appropriate diet, physical activity, and behavioral strategies with a family component are recommended.
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Seamark D, Gabriel L. Barriers to support: a qualitative exploration into the help-seeking and avoidance factors of young adults. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2016. [DOI: 10.1080/03069885.2016.1213372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Lynne Gabriel
- Faculty of Health and Life Sciences, York St John University, York, UK
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30
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Berrouiguet S, Baca-García E, Brandt S, Walter M, Courtet P. Fundamentals for Future Mobile-Health (mHealth): A Systematic Review of Mobile Phone and Web-Based Text Messaging in Mental Health. J Med Internet Res 2016; 18:e135. [PMID: 27287668 PMCID: PMC4920962 DOI: 10.2196/jmir.5066] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/30/2016] [Indexed: 01/02/2023] Open
Abstract
Background Mobile phone text messages (short message service, SMS) are used pervasively as a form of communication. Almost 100% of the population uses text messaging worldwide and this technology is being suggested as a promising tool in psychiatry. Text messages can be sent either from a classic mobile phone or a web-based application. Reviews are needed to better understand how text messaging can be used in mental health care and other fields of medicine. Objective The objective of the study was to review the literature regarding the use of mobile phone text messaging in mental health care. Methods We conducted a thorough literature review of studies involving text messaging in health care management. Searches included PubMed, PsycINFO, Cochrane, Scopus, Embase and Web of Science databases on May 25, 2015. Studies reporting the use of text messaging as a tool in managing patients with mental health disorders were included. Given the heterogeneity of studies, this review was summarized using a descriptive approach. Results From 677 initial citations, 36 studies were included in the review. Text messaging was used in a wide range of mental health situations, notably substance abuse (31%), schizophrenia (22%), and affective disorders (17%). We identified four ways in which text messages were used: reminders (14%), information (17%), supportive messages (42%), and self-monitoring procedures (42%). Applications were sometimes combined. Conclusions We report growing interest in text messaging since 2006. Text messages have been proposed as a health care tool in a wide spectrum of psychiatric disorders including substance abuse, schizophrenia, affective disorders, and suicide prevention. Most papers described pilot studies, while some randomized clinical trials (RCTs) were also reported. Overall, a positive attitude toward text messages was reported. RCTs reported improved treatment adherence and symptom surveillance. Other positive points included an increase in appointment attendance and in satisfaction with management and health care services. Insight into message content, preventative strategies, and innovative approaches derived from the mental health field may be applicable in other medical specialties.
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Affiliation(s)
- Sofian Berrouiguet
- Brest Medical University Hospital at Bohars, Adult Psychiatry, Brest, France.
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31
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Aboujaoude E, Salame W. Technology at the Service of Pediatric Mental Health: Review and Assessment. J Pediatr 2016; 171:20-4. [PMID: 26743496 DOI: 10.1016/j.jpeds.2015.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/30/2015] [Accepted: 12/03/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Elias Aboujaoude
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
| | - Wael Salame
- Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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32
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Miller-Matero LR, Clark KB, Brescacin C, Dubaybo H, Willens DE. Depression and literacy are important factors for missed appointments. PSYCHOL HEALTH MED 2015; 21:686-95. [PMID: 26695719 DOI: 10.1080/13548506.2015.1120329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kannisto KA, Adams CE, Koivunen M, Katajisto J, Välimäki M. Feedback on SMS reminders to encourage adherence among patients taking antipsychotic medication: a cross-sectional survey nested within a randomised trial. BMJ Open 2015; 5:e008574. [PMID: 26553830 PMCID: PMC4654352 DOI: 10.1136/bmjopen-2015-008574] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To explore feedback on tailored SMS reminders to encourage medication adherence and outpatient treatment among patients taking antipsychotic medication, and associations related to the feedback. DESIGN A cross-sectional survey nested within a nationwide randomised clinical trial ("Mobile.Net" ISRCTN27704027). SETTING Psychiatric outpatient care in Finland. PARTICIPANTS Between September 2012 and December 2013, 403 of 558 adults with antipsychotic medication responded after 12 months of SMS intervention. MAIN OUTCOME MEASURE Feedback was gathered with a structured questionnaire based on Technology Acceptance Model theory. Data were analysed by Pearson's χ(2) test, binary logistic regression and stepwise multiple regression analyses. RESULTS Almost all participants (98%) found the SMS reminders easy to use and 87% felt that the SMS did not cause harm. About three-quarters (72%) were satisfied with the SMS received, and 61% found it useful. Divorced people were particularly prone to find SMS reminders useful (χ(2)=13.17, df=6, p=0.04), and people seeking employment were more often 'fully satisfied' with the SMS compared with other groups (χ(2)=10.82, df=4, p=0.029). People who were older at first contact with psychiatric services were more often 'fully satisfied' than younger groups (OR=1.02, 95% CI 1.01 to 1.04, p=0.007). CONCLUSIONS The feedback of patients taking antipsychotic medication on SMS services was generally positive. Overall, people were quite satisfied despite considerable variation in their sociodemographic background and illness history. Our results endorse that the use of simple easy-to-use existing technology, such as mobile phones and SMS, is acceptable in psychiatric outpatient services. Moreover, people using psychiatric outpatient services are able to use this technology. This acceptable and accessible technology can be easily tailored to each patient's needs and could be customised to the needs of the isolated or jobless. This is an area in which much careful evaluation is needed.
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Affiliation(s)
- Kati Anneli Kannisto
- Department of Nursing Science, University of Turku, Turku, Finland
- Satakunta Hospital District Pori, Finland
| | - Clive E Adams
- Division of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Marita Koivunen
- Department of Nursing Science, University of Turku, Turku, Finland
- Satakunta Hospital District Pori, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
- Hong Kong Polytechnic University, Hong Kong
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34
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Kauppi K, Kannisto KA, Hätönen H, Anttila M, Löyttyniemi E, Adams CE, Välimäki M. Mobile phone text message reminders: Measuring preferences of people with antipsychotic medication. Schizophr Res 2015; 168:514-22. [PMID: 26293215 DOI: 10.1016/j.schres.2015.07.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 06/10/2015] [Accepted: 07/24/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED Mobile technology use, including Short Messaging Service (SMS) text messaging, has increased in health care services. Preferences regarding the type or timing of text messages sent by healthcare providers to people with antipsychotic medication have not yet been fully investigated. This study examines the relationship between patients' demographic characteristics and the tailored messages they select. The study ("Mobile.Net", ISRCTN 27704027) includes a structured analysis of a random sub-sample of participants who received messages for 12months. The data were collected in 24 sites and 45 psychiatric hospitals in Finland and analyzed with descriptive statistics and Poisson regression models. The study sample involved 562 people on antipsychotic medication, and a total of 2112 text messages (2 to 25 monthly) were analysed. Regarding message content, there was no significant variation in the proportions relating to 'medication', 'treatment appointments' or 'free time'. Monday was the most popular day to receive messages and morning was preferred to later in the day. Age was most closely associated with 'number of messages' and 'time of messages'. Older women and younger men preferred higher numbers of messages (p=0.0031). Participants preferred positive, encouraging and slightly humorous messages. The findings suggest that messages may be acceptable for difficult to access groups in follow-up. This type of intervention may be useful for various types of patients especially for younger males. To further support the evidence about factors related to message utilization and use, it is important to evaluate the effectiveness of text messages in psychiatric care.
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Affiliation(s)
- Kaisa Kauppi
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Kati A Kannisto
- Department of Nursing Science, University of Turku, Turku, Finland; Satakunta Hospital District, Pori, Finland
| | - Heli Hätönen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland
| | | | - Clive E Adams
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, University of Nottingham, United Kingdom
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland
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Kobak KA, Mundt JC, Kennard B. Integrating technology into cognitive behavior therapy for adolescent depression: a pilot study. Ann Gen Psychiatry 2015; 14:37. [PMID: 26535048 PMCID: PMC4630889 DOI: 10.1186/s12991-015-0077-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/20/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rapid advances in information technology and telecommunications have resulted in a dramatic increase in the use of mobile devices and the internet to enhance and facilitate access to treatment. Cognitive behavior therapy (CBT) is an empirically based treatment that is well suited for enhancement by new technologies, particularly with youth. To facilitate the dissemination of this evidence-based treatment, we developed a technology-enhanced CBT intervention for the treatment of adolescent depression consisting of (1) online therapist training (2) in-session use of tablets for teaching clients CBT concepts and skills, and (3) text messaging for between session homework reminders and self-monitoring. METHODS Eighteen licensed clinicians (social workers n = 7, psychologists n = 9) were randomized to have their patients receive either the intervention (CBT) or treatment as usual (TAU). Each clinician treated four adolescents for 12 weeks. Clinicians in the CBT arm completed an online tutorial on CBT treatment of adolescent depression, then received an iPad with access to patient education materials for teaching CBT concepts to patients during sessions. Individualized text messages were integrated into treatment for homework reminders, support, and outcomes measurement. Outcome measures included a 49-item multiple choice test for tutorial effectiveness; the system usability scale (SUS) for user satisfaction; quick inventory of depressive symptomatology-adolescent version (QIDS-A-Pat); and clinician and patient ratings on the therapeutic alliance scale for adolescents (TASA). RESULTS A significant increase in knowledge of CBT concepts was found after completing the tutorial, t(8) = 7.02, p < 0.001. Clinician and patient ratings of user satisfaction were high for both the iPad teaching tools, and the text messaging. Ninety-five percent of teens said reviewing their text messages with their therapist was helpful, and all said they would use text messaging in treatment again. Ratings of the therapeutic alliance were higher in the CBT arm t(131) = 4.03, p = 0.001. A significant reduction in depression was found in both groups [t(34) = 8.453, p < 0.001 and t(29) = 6.67, p < 0.001 for CBT and TAU, respectively). Clinical ratings of improvement were greater on all outcome measures for the CBT arm; however, none reached statistical significance. Effect sizes (Cohen's d) ranged from small (QIDS-A) to large (TASA). CONCLUSIONS Results support the feasibility of this technology-enhanced CBT intervention as a means of improving CBT treatment of adolescent depression and may help address the critical shortage of therapists trained on empirically based treatments.
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Affiliation(s)
- Kenneth A Kobak
- Center for Telepsychology, 22 North Harwood, Madison, WI 53717 USA
| | - James C Mundt
- Center for Telepsychology, 22 North Harwood, Madison, WI 53717 USA
| | - Betsy Kennard
- UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390 USA
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Kannisto KA, Koivunen MH, Välimäki MA. Use of mobile phone text message reminders in health care services: a narrative literature review. J Med Internet Res 2014; 16:e222. [PMID: 25326646 PMCID: PMC4211035 DOI: 10.2196/jmir.3442] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/30/2014] [Accepted: 08/25/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile text messages are a widely recognized communication method in societies, as the global penetration of the technology approaches 100% worldwide. Systematic knowledge is still lacking on how the mobile telephone text messaging (short message service, SMS) has been used in health care services. OBJECTIVE This study aims to review the literature on the use of mobile phone text message reminders in health care. METHODS We conducted a systematic literature review of studies on mobile telephone text message reminders. The data sources used were PubMed (MEDLINE), CINAHL, Proquest Databases/ PsycINFO, EMBASE, Cochrane Library, Scopus, and hand searching since 2003. Studies reporting the use of SMS intended to remind patients in health services were included. Given the heterogeneity in the studies, descriptive characteristics, purpose of the study, response rates, description of the intervention, dose and timing, instruments, outcome measures, and outcome data from the studies were synthesized using a narrative approach. RESULTS From 911 initial citations, 60 studies were included in the review. The studies reported a variety of use for SMS. Mobile telephone text message reminders were used as the only intervention in 73% (44/60) of the studies, and in 27% (16/60) of the remaining studies, SMS was connected to another comprehensive health intervention system. SMS reminders were sent to different patient groups: patients with HIV/AIDS (15%, 9/60) and diabetes (13%, 8/60) being the most common groups. The response rates of the studies varied from 22-100%. Typically, the text message reminders were sent daily. The time before the specific intervention to be rendered varied from 10 minutes (eg, medication taken) to 2 weeks (eg, scheduled appointment). A wide range of different evaluation methods and outcomes were used to assess the impact of SMS varying from existing databases (eg, attendance rate based on medical records), questionnaires, and physiological measures. About three quarters of the studies (77%, 46/60) reported improved outcomes: adherence to medication or to treatment reportedly improved in 40% (24/60) of the studies, appointment attendance in 18% (11/60) of the studies, and non-attendance rates decreased in 18% (11/60) of the studies. Other positive impacts were decreased amount of missed medication doses, more positive attitudes towards medication, and reductions in treatment interruptions. CONCLUSIONS We can conclude that although SMS reminders are used with different patient groups in health care, SMS is less systematically studied with randomized controlled trial study design. Although the amount of evidence for SMS application recommendations is still limited, having 77% (46/60) of the studies showing improved outcomes may indicate its use in health care settings. However, more well-conducted SMS studies are still needed.
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Milward J, Lynskey M, Strang J. Solving the problem of non-attendance in substance abuse services. Drug Alcohol Rev 2014; 33:625-36. [PMID: 25196817 DOI: 10.1111/dar.12194] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 07/15/2014] [Indexed: 11/29/2022]
Abstract
ISSUES Rates of non-attendance are among the highest in substance misuse services. Non-attendance is costly and results in the inefficient use of limited resources. Patients who frequently miss their appointments have worse outcomes including treatment dropout and decreased likelihood of achieving long-term abstinence. APPROACH This narrative review evaluates interventions targeting non-attendance in addiction services and draws upon the wider health-care literature to identify interventions that could be adapted for substance-abusing populations. KEY FINDINGS Both fixed value and intermittent reinforcement contingency management demonstrate potential for improving attendance. However, small sample sizes and heterogeneous populations make it difficult to draw firm conclusions. Appointment reminders by letter or telephone have demonstrated moderate evidence for improving attendance in substance-abusing populations. Text message appointment reminders are extensively utilised in general health-care settings and consistently improve attendance; however, there is a paucity of research examining the feasibility and effectiveness of text message reminders in addiction services. IMPLICATIONS A lack of evidence for methods to improve attendance is reflected in the continuing challenge faced by addiction services attempting to manage high rates of non-attendance. CONCLUSIONS Non-attendance remains a persistent issue for addiction services. While there is limited evidence that contingency management improves attendance, more rigorous research is needed to determine the optimal intervention components and effectiveness in different populations, particularly those receiving maintenance treatments. Multicomponent text message interventions incorporating different delivery and content strategies demonstrate a promise for improving non-attendance and poor engagement.
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Affiliation(s)
- Joanna Milward
- Institute of Psychiatry, King's College London, London, UK
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Rafla M, Carson NJ, DeJong SM. Adolescents and the internet: what mental health clinicians need to know. Curr Psychiatry Rep 2014; 16:472. [PMID: 25070673 DOI: 10.1007/s11920-014-0472-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The Internet's permeation into daily life has profoundly changed the practice of psychiatry with adolescents, who mobilize online social media and related technologies in their efforts to develop identity and "hang out" with peers. Technology offers both challenges and opportunities to mental health professionals working with teens. Practitioners will need a new skill-set, including keeping abreast of technological developments; professionally incorporating technology into clinical assessment and practice; identifying the negative impacts of technology on teens' physical and mental health and the particular vulnerabilities of at-risk patients in a digital world; and guiding patients and parents about interventions. Particular patient factors related to race/ethnicity, gender and sexual orientation, mental health and trauma history, family culture, parenting style, and personality traits will need to be considered. This article provides an overview of the literature on adolescents and the Internet focusing on recent research on Internet and digital technologies used for social communication among youth.
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Affiliation(s)
- Malak Rafla
- Division of Child and Adolescent Psychiatry, Cambridge Health Alliance/Harvard Medical School, 1493 Cambridge Street, Cambridge, MA, 02139, USA
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Seko Y, Kidd S, Wiljer D, McKenzie K. Youth mental health interventions via mobile phones: a scoping review. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2014; 17:591-602. [PMID: 25007383 DOI: 10.1089/cyber.2014.0078] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mobile phone technologies have been hailed as a promising means for delivering mental health interventions to youth and adolescents, the age group with high cell phone penetration and with the onset of 75% of all lifetime mental disorders. Despite the growing evidence in physical health and adult mental health, however, little information is available about how mobile phones are implemented to deliver mental health services to the younger population. The purpose of this scoping study was to map the current state of knowledge regarding mobile mental health (mMental Health) for young people (age 13-24 years), identify gaps, and consider implications for future research. Seventeen articles that met the inclusion criteria provided evidence for mobile phones as a way to engage youth in therapeutic activities. The flexibility, interactivity, and spontaneous nature of mobile communications were also considered advantageous in encouraging persistent and continual access to care outside clinical settings. Four gaps in current knowledge were identified: the scarcity of studies conducted in low and middle income countries, the absence of information about the real-life feasibility of mobile tools, the need to address the issue of technical and health literacy of both young users and health professionals, and the need for critical discussion regarding diverse ethical issues associated with mobile phone use. We suggest that mMental Health researchers and clinicians should carefully consider the ethical issues related to patient-practitioner relationship, best practices, and the logic of self-surveillance.
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Affiliation(s)
- Yukari Seko
- 1 Self-Injury and e-Mental Health Lab, Department of Psychology, University of Guelph , Ontario, Canada
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