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Nestor BA, Chimoff J, Koike C, Weitzman ER, Riley BL, Uhl K, Kossowsky J. Adolescent and Parent Perspectives on Digital Phenotyping in Youths With Chronic Pain: Cross-Sectional Mixed Methods Survey Study. J Med Internet Res 2024; 26:e47781. [PMID: 38206665 PMCID: PMC10811597 DOI: 10.2196/47781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/28/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Digital phenotyping is a promising methodology for capturing moment-to-moment data that can inform individually adapted and timely interventions for youths with chronic pain. OBJECTIVE This study aimed to investigate adolescent and parent endorsement, perceived utility, and concerns related to passive data stream collection through smartphones for digital phenotyping for clinical and research purposes in youths with chronic pain. METHODS Through multiple-choice and open-response survey questions, we assessed the perspectives of patient-parent dyads (103 adolescents receiving treatment for chronic pain at a pediatric hospital with an average age of 15.6, SD 1.6 years, and 99 parents with an average age of 47.8, SD 6.3 years) on passive data collection from the following 9 smartphone-embedded passive data streams: accelerometer, apps, Bluetooth, SMS text message and call logs, keyboard, microphone, light, screen, and GPS. RESULTS Quantitative and qualitative analyses indicated that adolescents and parent endorsement and perceived utility of digital phenotyping varied by stream, though participants generally endorsed the use of data collected by passive stream (35%-75.7% adolescent endorsement for clinical use and 37.9%-74.8% for research purposes; 53.5%-81.8% parent endorsement for clinical and 52.5%-82.8% for research purposes) if a certain level of utility could be provided. For adolescents and parents, adjusted logistic regression results indicated that the perceived utility of each stream significantly predicted the likelihood of endorsement of its use in both clinical practice and research (Ps<.05). Adolescents and parents alike identified accelerometer, light, screen, and GPS as the passive data streams with the highest utility (36.9%-47.5% identifying streams as useful). Similarly, adolescents and parents alike identified apps, Bluetooth, SMS text message and call logs, keyboard, and microphone as the passive data streams with the least utility (18.5%-34.3% identifying streams as useful). All participants reported primary concerns related to privacy, accuracy, and validity of the collected data. Passive data streams with the greatest number of total concerns were apps, Bluetooth, call and SMS text message logs, keyboard, and microphone. CONCLUSIONS Findings support the tailored use of digital phenotyping for this population and can help refine this methodology toward an acceptable, feasible, and ethical implementation of real-time symptom monitoring for assessment and intervention in youths with chronic pain.
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Affiliation(s)
- Bridget A Nestor
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Justin Chimoff
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Camila Koike
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Elissa R Weitzman
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Division of Addiction Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Bobbie L Riley
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
| | - Kristen Uhl
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, United States
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Anesthesia, Harvard Medical School, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
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Vahia IV, Sava RN, Cray HV, Kim HJ, Dickinson RA, Ressler KJ, Trueba AF. Digital Collateral Information Through Electronic and Social Media in Psychotherapy: Comparing Clinician-reported Trends Before and During the COVID-19 Pandemic. J Psychiatr Pract 2023; 29:367-372. [PMID: 37678366 PMCID: PMC10798232 DOI: 10.1097/pra.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
BACKGROUND Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to virtual care had an impact on therapists' use of patients' electronic and social media to augment clinical information that may inform psychotherapy. METHODS In 2018, we conducted a survey of a cohort of psychotherapists affiliated with McLean Hospital. We then reapproached the same cohort of providers for the current study, gathering survey responses from August 10, 2020, to September 1, 2020, for this analysis. We asked clinicians whether they viewed patients' electronic and social media in the context of their psychotherapeutic relationship, what they viewed, how much they viewed it, and their attitudes about doing so. RESULTS Of the 99 respondents, 64 (64.6%) had viewed at least 1 patient's social media and 8 (8.1%) had viewed a patient's electronic media. Of those who reported viewing patients' media, 70 (97.2%) indicated they believed this information helped them provide more effective treatment. Compared with the 2018 prepandemic data, there were significantly more clinicians with>10 years of experience reporting media use in therapy. There was also a significant increase during the pandemic in the viewing of media of adult patients and a trend toward an increase in viewing of media of older adult patients. CONCLUSIONS Review of patients' electronic and social media in therapy became more common among clinicians at a large psychiatric teaching hospital during the COVID-19 pandemic. These findings support continuing research about how reviewing patients' media can inform and improve clinical care.
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Teepe GW, Lukic YX, Kleim B, Jacobson NC, Schneider F, Santhanam P, Fleisch E, Kowatsch T. Development of a digital biomarker and intervention for subclinical depression: study protocol for a longitudinal waitlist control study. BMC Psychol 2023; 11:186. [PMID: 37349832 PMCID: PMC10288725 DOI: 10.1186/s40359-023-01215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Depression remains a global health problem, with its prevalence rising worldwide. Digital biomarkers are increasingly investigated to initiate and tailor scalable interventions targeting depression. Due to the steady influx of new cases, focusing on treatment alone will not suffice; academics and practitioners need to focus on the prevention of depression (i.e., addressing subclinical depression). AIM With our study, we aim to (i) develop digital biomarkers for subclinical symptoms of depression, (ii) develop digital biomarkers for severity of subclinical depression, and (iii) investigate the efficacy of a digital intervention in reducing symptoms and severity of subclinical depression. METHOD Participants will interact with the digital intervention BEDDA consisting of a scripted conversational agent, the slow-paced breathing training Breeze, and actionable advice for different symptoms. The intervention comprises 30 daily interactions to be completed in less than 45 days. We will collect self-reports regarding mood, agitation, anhedonia (proximal outcomes; first objective), self-reports regarding depression severity (primary distal outcome; second and third objective), anxiety severity (secondary distal outcome; second and third objective), stress (secondary distal outcome; second and third objective), voice, and breathing. A subsample of 25% of the participants will use smartwatches to record physiological data (e.g., heart-rate, heart-rate variability), which will be used in the analyses for all three objectives. DISCUSSION Digital voice- and breathing-based biomarkers may improve diagnosis, prevention, and care by enabling an unobtrusive and either complementary or alternative assessment to self-reports. Furthermore, our results may advance our understanding of underlying psychophysiological changes in subclinical depression. Our study also provides further evidence regarding the efficacy of standalone digital health interventions to prevent depression. Trial registration Ethics approval was provided by the Ethics Commission of ETH Zurich (EK-2022-N-31) and the study was registered in the ISRCTN registry (Reference number: ISRCTN38841716, Submission date: 20/08/2022).
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Affiliation(s)
- Gisbert W. Teepe
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Weinbergstrasse 56/56, 8006 Zürich, Switzerland
| | - Yanick X. Lukic
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Weinbergstrasse 56/56, 8006 Zürich, Switzerland
| | - Birgit Kleim
- Department of Psychology, Experimental Psychopathology and Psychotherapy, Binzmühlestrasse 14, Box 8, 8050 Zürich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland
| | - Nicholas C. Jacobson
- Departments of Biomedical Data Science and Psychiatry, Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, Lebanon, NH 03766 USA
| | - Fabian Schneider
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Weinbergstrasse 56/56, 8006 Zürich, Switzerland
| | - Prabhakaran Santhanam
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Weinbergstrasse 56/56, 8006 Zürich, Switzerland
| | - Elgar Fleisch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Weinbergstrasse 56/56, 8006 Zürich, Switzerland
- Centre for Digital Health Intervention, Institute of Technology Management, University of St.Gallen, Dufourstrasse 40a, 9000 St. Gallen, Switzerland
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Weinbergstrasse 56/56, 8006 Zürich, Switzerland
- Centre for Digital Health Intervention, Institute of Technology Management, University of St.Gallen, Dufourstrasse 40a, 9000 St. Gallen, Switzerland
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Maechling C, Yrondi A, Cambon A. Mobile health in the specific management of first-episode psychosis: a systematic literature review. Front Psychiatry 2023; 14:1137644. [PMID: 37377474 PMCID: PMC10291100 DOI: 10.3389/fpsyt.2023.1137644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Purpose The purpose of this systematic literature review is to assess the therapeutic efficacy of mobile health methods in the management of patients with first-episode psychosis (FEP). Method The participants are patients with FEP. The interventions are smartphone applications. The studies assess the preliminary efficacy of various types of application. Results One study found that monitoring symptoms minimized relapses, visits to A&E and hospital admissions, while one study showed a decrease in positive psychotic symptoms. One study found an improvement in anxiety symptoms and two studies noted an improvement in psychotic symptoms. One study demonstrated its efficacy in helping participants return to studying and employment and one study reported improved motivation. Conclusion The studies suggest that mobile applications have potential value in the management of young patients with FEP through the use of various assessment and intervention tools. This systematic review has several limitations due to the lack of randomized controlled studies available in the literature.
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Affiliation(s)
- Claire Maechling
- Pôle de Psychiatrie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante Fonda Mental, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Amandine Cambon
- Programme d'intervention précoce RePeps, réseau Transition, Clinique Aufrery, Toulouse, France
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Zhao X, Stadnick NA, Ceballos-Corro E, Castro J, Mallard-Swanson K, Palomares KJ, Eikey E, Schneider M, Zheng K, Mukamel DB, Schueller SM, Sorkin DH. Facilitators of and Barriers to Integrating Digital Mental Health Into County Mental Health Services: Qualitative Interview Analyses. JMIR Form Res 2023; 7:e45718. [PMID: 37191975 DOI: 10.2196/45718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Digital mental health interventions (DMHIs) represent a promising solution to address the growing unmet mental health needs and increase access to care. Integrating DMHIs into clinical and community settings is challenging and complex. Frameworks that explore a wide range of factors, such as the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, can be useful for examining multilevel factors related to DMHI implementation efforts. OBJECTIVE This paper aimed to identify the barriers to, facilitators of, and best practice recommendations for implementing DMHIs across similar organizational settings, according to the EPIS domains of inner context, outer context, innovation factors, and bridging factors. METHODS This study stems from a large state-funded project in which 6 county behavioral health departments in California explored the use of DMHIs as part of county mental health services. Our team conducted interviews with clinical staff, peer support specialists, county leaders, project leaders, and clinic leaders using a semistructured interview guide. The development of the semistructured interview guide was informed by expert input regarding relevant inner context, outer context, innovation factors, and bridging factors in the exploration, preparation, and implementation phases of the EPIS framework. We followed a recursive 6-step process to conduct qualitative analyses using inductive and deductive components guided by the EPIS framework. RESULTS On the basis of 69 interviews, we identified 3 main themes that aligned with the EPIS framework: readiness of individuals, readiness of innovations, and readiness of organizations and systems. Individual-level readiness referred to the extent to which clients had the necessary technological tools (eg, smartphones) and knowledge (digital literacy) to support the DMHI. Innovation-level readiness pertained to the accessibility, usefulness, safety, and fit of the DMHI. Organization- and system-level readiness concerned the extent to which providers and leadership collectively held positive views about DMHIs as well as the extent to which infrastructure (eg, staffing and payment model) was appropriate. CONCLUSIONS The successful implementation of DMHIs requires readiness at the individual, innovation, and organization and system levels. To improve individual-level readiness, we recommend equitable device distribution and digital literacy training. To improve innovation readiness, we recommend making DMHIs easier to use and introduce, clinically useful, and safe and adapting them to fit into the existing client needs and clinical workflow. To improve organization- and system-level readiness, we recommend supporting providers and local behavioral health departments with adequate technology and training and exploring potential system transformations (eg, integrated care model). Conceptualizing DMHIs as services allows the consideration of both the innovation characteristics of DMHIs (eg, efficacy, safety, and clinical usefulness) and the ecosystem around DMHIs, such as individual and organizational characteristics (inner context), purveyors and intermediaries (bridging factor), client characteristics (outer context), as well as the fit between the innovation and implementation settings (innovation factor).
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Affiliation(s)
- Xin Zhao
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Nicole A Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Altman Clinical and Translational Research Institute, Dissemination and Implementation Science Center, University of California, San Diego, La Jolla, CA, United States
- Child and Adolescent Services Research Center, San Diego, CA, United States
| | - Eduardo Ceballos-Corro
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Jorge Castro
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Kera Mallard-Swanson
- Altman Clinical and Translational Research Institute, Dissemination and Implementation Science Center, University of California, San Diego, La Jolla, CA, United States
| | - Kristina J Palomares
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Elizabeth Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
- The Design Lab, University of California, San Diego, La Jolla, CA, United States
| | - Margaret Schneider
- Department of Public Health, University of California, Irvine, Irvine, CA, United States
| | - Kai Zheng
- Department of Informatics, University of California, Irvine, Irvine, CA, United States
| | - Dana B Mukamel
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Stephen M Schueller
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Dara H Sorkin
- Department of Medicine, University of California, Irvine, Irvine, CA, United States
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Hendricks-Sturrup R, Lu CY. An Assessment of Perspectives and Concerns Among Research Participants of Childbearing Age Regarding the Health-Relatedness of Data, Online Data Privacy, and Donating Data to Researchers: Survey Study. J Med Internet Res 2023; 25:e41937. [PMID: 36897637 PMCID: PMC10039398 DOI: 10.2196/41937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/26/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The June 2022 US Supreme Court decision to ban abortion care in Dobbs v Jackson Women's Health Organization sparked ominous debate about the privacy and safety of women and families of childbearing age with digital footprints who actively engage in family planning, including abortion and miscarriage care. OBJECTIVE To assess the perspectives of a subpopulation of research participants of childbearing age regarding the health-relatedness of their digital data, their concerns about the use and sharing of personal data online, and their concerns about donating data from various sources to researchers today or in the future. METHODS An 18-item electronic survey was developed using Qualtrics and administered to adults (aged ≥18 years) registered in the ResearchMatch database in April 2021. Individuals were invited to participate in the survey regardless of health status, race, gender, or any other mutable or immutable characteristics. Descriptive statistical analyses were conducted using Microsoft Excel and manual queries (single layer, bottom-up topic modeling) and used to categorize illuminating quotes from free-text survey responses. RESULTS A total of 470 participants initiated the survey and 402 completed and submitted the survey (for an 86% completion rate). Nearly half the participants (189/402, 47%) self-reported to be persons of childbearing age (18 to 50 years). Most participants of childbearing age agreed or strongly agreed that social media data, email data, text message data, Google search history data, online purchase history data, electronic medical record data, fitness tracker and wearable data, credit card statement data, and genetic data are health-related. Most participants disagreed or strongly disagreed that music streaming data, Yelp review and rating data, ride-sharing history data, tax records and other income history data, voting history data, and geolocation data are health-related. Most (164/189, 87%) participants were concerned about fraud or abuse based on their personal information, online companies and websites sharing information with other parties without consent, and online companies and websites using information for purposes that are not explicitly stated in their privacy policies. Free-text survey responses showed that participants were concerned about data use beyond scope of consent; exclusion from health care and insurance; government and corporate mistrust; and data confidentiality, security, and discretion. CONCLUSIONS Our findings in light of Dobbs and other related events indicate there are opportunities to educate research participants about the health-relatedness of their digital data. Developing strategies and best privacy practices for discretion regarding digital-footprint data related to family planning should be a priority for companies, researchers, families, and other stakeholders.
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Affiliation(s)
- Rachele Hendricks-Sturrup
- Duke-Margolis Center for Health Policy, Washington, DC, United States
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, United States
- Department of Interdisciplinary Health Studies, Ohio University, Athens, GA, United States
| | - Christine Y Lu
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, United States
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Drissi N, Ouhbi S, Serhani MA, Marques G, de la Torre Díez I. Connected Mental Health Solutions: Global Attitudes, Preferences, and Concerns. Telemed J E Health 2023; 29:315-330. [PMID: 35730979 DOI: 10.1089/tmj.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Connected mental health (CMH) presents several technology-based solutions, which can help overcome many mental care delivery barriers. However, attitudes toward the use of CMH are diverse and differ from a cohort to another. Objective: The purpose of this study is to investigate the global attitudes toward CMH use and assess the use of technology for mental care. Methods: This study presents a synthesis of literature available in Scopus, Science Direct, and PubMed digital libraries, investigating attitudes toward CMH in different cohorts from different countries, based on a systematic review of relevant publications. This study also analyzes technology use patterns of the cohorts investigated, the reported preferred criteria that should be considered in CMH, and issues and concerns regarding CMH use. Results: One hundred and one publications were selected and analyzed. These publications were originated from different countries, with the majority (n = 23) being conducted in Australia. These studies reported positive attitudes of investigated cohorts toward CMH use and high technology use and ownership. Several preferred criteria were reported, mainly revolving around providing blended care functionalities, educational content, and mental health professionals (MHPs) support. Whereas concerns and issues related to CMH use addressed technical problems related to access to technology and to CMH solutions, the digital divide, lack of knowledge and use of CMH, and general reservations to use CMH. Concerns related to institutional and work barriers were also identified. Conclusions: Attitudes toward CMH show promising results from users and MHP views. However, factors such as providing blended care options and considering technical concerns should be taken into consideration for the successful adoption of CMH.
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Affiliation(s)
- Nidal Drissi
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science and Software Engineering, CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamed Adel Serhani
- Department of Information Systems and Security and CIT, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gonçalo Marques
- Polytechnic of Coimbra, School of Technology and Management of Oliveira do Hospital (ESTGOH), Coimbra, Portugal
| | - Isabel de la Torre Díez
- Department of Signal Theory and Communications and Telematics Engineering, University of Valladolid, Valladolid, Spain
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AboMoslim M, Babili A, Ghaseminejad-Tafreshi N, Manson M, Fattah F, El Joueidi S, Staples JA, Tam P, Lester RT. Mobile phone access and preferences among medical inpatients at an urban Canadian hospital for post-discharge planning: A pre-COVID-19 cross-sectional survey. Front Digit Health 2022; 4:928602. [PMID: 36440462 PMCID: PMC9692091 DOI: 10.3389/fdgth.2022.928602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital health interventions are increasingly used for patient care, yet little data is available on the phone access type and usage preferences amongst medical ward inpatients to inform the most appropriate digital interventions post-discharge. Methods To identify mobile phone ownership, internet access, and cellular use preferences among medical inpatients, we conducted a researcher-administered survey of patients admitted to five internal medicine units at Vancouver General Hospital (VGH) in January 2020. The survey was administered over 2 days separated by a 2-week period. Results A total of 81 inpatients completed the questionnaire. Survey found that 85.2% of survey respondents had mobile phone access where 63.0% owned their own mobile phone, and 22.2% had access to a mobile phone via a proxy (or an authorized third-party) such as a family member. All participants with mobile phone access had cellular plans (i.e., phone and text); however, a quarter of respondents did not have data plans with internet access. Survey showed that 71.1% of males owned a mobile phone compared to only 52.8% of females. All participants at a “high” risk of readmission had access to a mobile phone, either as phone-owners or proxy-dependent users. Conclusion Access to mobile phones among medical ward inpatients, 85.2%, was comparable to smartphone penetration rates amongst Canadians in 2019, 85.1%. More patients had cellular than data plans (i.e., internet and applications). Understanding patient-specific access is key to informing potential uptake of digital health interventions aimed at using patients' mobile phones (mHealth) from an effectiveness and equity lens.
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Affiliation(s)
- Maryam AboMoslim
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Correspondence: Maryam AboMoslim
| | - Abdulaa Babili
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Matthew Manson
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Fanan Fattah
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Samia El Joueidi
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - John A. Staples
- Division of Vancouver Costal Health Research Institutute, Centre for Clinical Epidemiology & Evaluation, Vancouver, BC, Canada
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Penny Tam
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard T. Lester
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Liu Y, Lu X, Zhao G, Li C, Shi J. Adoption of mobile health services using the unified theory of acceptance and use of technology model: Self-efficacy and privacy concerns. Front Psychol 2022; 13:944976. [PMID: 36033004 PMCID: PMC9403893 DOI: 10.3389/fpsyg.2022.944976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
Mobile health (mHealth) services have been widely used in medical services and health management through mobile devices and multiple channels, such as smartphones, wearable equipment, healthcare applications (Apps), and medical platforms. However, the number of the users who are currently receiving the mHealth services is small. In China, more than 70% of internet users have never used mHealth services. Such imbalanced situation could be attributed to users’ traditional concept of medical treatment, psychological factors (such as low self-efficacy) and privacy concerns. The purpose of this study is to explore the direct and indirect effects of mHealth users’ self-efficacy and privacy concerns on their intention to adopt mHealth services, providing guidelines for mHealth service providers to enhance users’ intention of adoption. A questionnaire was designed by the research team and 386 valid responses were collected from domestic participants in China. Based on the unified theory of acceptance and use of technology (UTAUT) model, a research model integrated self-efficacy and privacy concerns was constructed to investigate their effects on users’ intention to adopt mobile mHealth services. The results show that self-efficacy could facilitate users’ intention to adopt mHealth services, and had a significantly positive effect on perceived ubiquity, effort expectancy, performance expectancy and subjective norm. This study verifies the direct and indirect effects of self-efficacy and privacy concerns on users’ intention to adopt mHealth services, providing a different perspective for studying mHealth adoption behavior. The findings could provide guidelines for mHealth service providers to improve their service quality and enhance users’ intention of adoption.
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Affiliation(s)
- Yizhi Liu
- College of Management, Guizhou University, Guiyang, China
| | - Xuan Lu
- College of Management, Guizhou University, Guiyang, China
| | - Gang Zhao
- School of Engineering, University of Tasmania, Hobart, TAS, Australia
| | - Chengjiang Li
- College of Management, Guizhou University, Guiyang, China
- School of Engineering, University of Tasmania, Hobart, TAS, Australia
- *Correspondence: Chengjiang Li,
| | - Junyi Shi
- School of Humanities and Social Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China
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Schroeder T, Haug M, Gewald H. Data Privacy Concerns Using mHealth Apps and Smart Speakers: Comparative Interview Study Among Mature Adults. JMIR Form Res 2022; 6:e28025. [PMID: 35699993 PMCID: PMC9237761 DOI: 10.2196/28025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/30/2021] [Accepted: 04/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background New technologies such as mobile health (mHealth) apps and smart speakers make intensive use of sensitive personal data. Users are typically aware of this and express concerns about their data privacy. However, many people use these technologies although they think their data are not well protected. This raises specific concerns for sensitive health data. Objective This study aimed to contribute to a better understanding of data privacy concerns of mature adults using new technologies and provide insights into their data privacy expectations and associated risks and the corresponding actions of users in 2 different data contexts: mHealth apps and smart speakers. Methods This exploratory research adopted a qualitative approach, engaging with 20 mature adults (aged >45 years). In a 6-month test period, 10 (50%) participants used a smart speaker and 10 (50%) participants used an mHealth app. In interviews conducted before and after the test period, we assessed the influence of data privacy concerns on technology acceptance, use behavior, and continued use intention. Results Our results show that although participants are generally aware of the need to protect their data privacy, they accept the risk of misuse of their private data when using the technology. Surprisingly, the most frequently stated risk was not the misuse of personal health data but the fear of receiving more personalized advertisements. Similarly, surprisingly, our results indicate that participants value recorded verbal data higher than personal health data. Conclusions Older adults are initially concerned about risks to their data privacy associated with using data-intensive technologies, but those concerns diminish fairly quickly, culminating in resignation. We find that participants do not differentiate between risky behaviors, depending on the type of private data used by different technologies.
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Affiliation(s)
- Tanja Schroeder
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Center for Research on Service Sciences, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Maximilian Haug
- Center for Research on Service Sciences, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Heiko Gewald
- Center for Research on Service Sciences, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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11
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Dolan EH, Shiells K, Goulding J, Skatova A. Public attitudes towards sharing loyalty card data for academic health research: a qualitative study. BMC Med Ethics 2022; 23:58. [PMID: 35672737 PMCID: PMC9171733 DOI: 10.1186/s12910-022-00795-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/04/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A growing number of studies show the potential of loyalty card data for use in health research. However, research into public perceptions of using this data is limited. This study aimed to investigate public attitudes towards donating loyalty card data for academic health research, and the safeguards the public would want to see implemented. The way in which participant attitudes varied according to whether loyalty card data would be used for either cancer or COVID-19 research was also examined. METHODS Participants (N = 40) were recruited via Prolific Academic to take part in semi-structured telephone interviews, with questions focused on data sharing related to either COVID-19 or ovarian/bowel cancer as the proposed health condition to be researched. Content analysis was used to identify sub-themes corresponding to the two a priori themes, attitudes and safeguards. RESULTS Participant attitudes were found to fall into two categories, either rational or emotional. Under rational, most participants were in favour of sharing loyalty card data. Support of health research was seen as an important reason to donate such data, with loyalty card logs being considered as already within the public domain. With increased understanding of research purpose, participants expressed higher willingness to donate data. Within the emotional category, participants shared fears about revealing location information and of third parties obtaining their data. With regards to safeguards, participants described the importance of anonymisation and the level of data detail; the control, convenience and choice they desired in sharing data; and the need for transparency and data security. The change in hypothetical purpose of the data sharing, from Covid-19 to cancer research, had no impact on participants' decision to donate, although did affect their understanding of how loyalty card data could be used. CONCLUSIONS Based on interviews with the public, this study contributes recommendations for those researchers and the wider policy community seeking to obtain loyalty card data for health research. Whilst participants were largely in favour of donating loyalty card data for academic health research, information, choice and appropriate safeguards are all exposed as prerequisites upon which decisions are made.
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Affiliation(s)
- Elizabeth H Dolan
- N/LAB, Nottingham University Business School, University of Nottingham, Si Yuan Building, Jubilee Campus, Nottingham, NG8 1BB, UK.
| | - Kate Shiells
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Alan Turing Institute, London, UK
| | - James Goulding
- N/LAB, Nottingham University Business School, University of Nottingham, Si Yuan Building, Jubilee Campus, Nottingham, NG8 1BB, UK
| | - Anya Skatova
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Alan Turing Institute, London, UK
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12
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Kulkarni P, Kirkham R, McNaney R. Opportunities for Smartphone Sensing in E-Health Research: A Narrative Review. SENSORS 2022; 22:s22103893. [PMID: 35632301 PMCID: PMC9147201 DOI: 10.3390/s22103893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022]
Abstract
Recent years have seen significant advances in the sensing capabilities of smartphones, enabling them to collect rich contextual information such as location, device usage, and human activity at a given point in time. Combined with widespread user adoption and the ability to gather user data remotely, smartphone-based sensing has become an appealing choice for health research. Numerous studies over the years have demonstrated the promise of using smartphone-based sensing to monitor a range of health conditions, particularly mental health conditions. However, as research is progressing to develop the predictive capabilities of smartphones, it becomes even more crucial to fully understand the capabilities and limitations of using this technology, given its potential impact on human health. To this end, this paper presents a narrative review of smartphone-sensing literature from the past 5 years, to highlight the opportunities and challenges of this approach in healthcare. It provides an overview of the type of health conditions studied, the types of data collected, tools used, and the challenges encountered in using smartphones for healthcare studies, which aims to serve as a guide for researchers wishing to embark on similar research in the future. Our findings highlight the predominance of mental health studies, discuss the opportunities of using standardized sensing approaches and machine-learning advancements, and present the trends of smartphone sensing in healthcare over the years.
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13
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Extending the UTAUT2 Model with a Privacy Calculus Model to Enhance the Adoption of a Health Information Application in Malaysia. INFORMATICS 2022. [DOI: 10.3390/informatics9020031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This study validates and extends the latest unified theory of acceptance and use of technology (UTAUT2) with the privacy calculus model. To evaluate the adoption of healthcare and e-government applications, researchers have recommended—in previous literature—the application of technology adoption models with privacy, trust, and security-related constructs. However, the current UTAUT2 model lacks privacy, trust, and security-related constructs. Therefore, the proposed UTAUT2 with the privacy calculus model is incorporated into four constructs: privacy concern, perceived risk, trust in the smart national identity card (SNIC), and perceived credibility. Results from a survey data of 720 respondents show that habit, effort expectancy, performance expectancy, social influence, hedonic motivation, and price value are direct determinants that influence behavioral intentions to use. Results also revealed that behavioral intentions, facilitating conditions, habits, perceived risks, and privacy concerns are direct predictors of ‘use behavior’. The authors also analyzed the interrelationships among the research constructs. The extended model may lead toward establishing better innovative e-health services to cover the desires of the citizens through the use of health information applications embedded in an all-in-one card.
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Eis S, Solà-Morales O, Duarte-Díaz A, Vidal-Alaball J, Perestelo-Pérez L, Robles N, Carrion C. Mobile Applications in Mood Disorders and Mental Health: Systematic Search in Apple App Store and Google Play Store and Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042186. [PMID: 35206373 PMCID: PMC8871536 DOI: 10.3390/ijerph19042186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The main objective of this work was to explore and characterize the current landscape of mobile applications available to treat mood disorders such as depression, bipolar disorder, and dysthymia. METHODS We developed a tool that makes both the Apple App Store and the Google Play Store searchable using keywords and that facilitates the extraction of basic app information of the search results. All app results were filtered using various inclusion and exclusion criteria. We characterized all resultant applications according to their technical details. Furthermore, we searched for scientific publications on each app's website and PubMed, to understand whether any of the apps were supported by any type of scientific evidence on their acceptability, validation, use, effectiveness, etc. Results: Thirty apps were identified that fit the inclusion and exclusion criteria. The literature search yielded 27 publications related to the apps. However, these did not exclusively concern mood disorders. 6 were randomized studies and the rest included a protocol, pilot-, feasibility, case-, or qualitative studies, among others. The majority of studies were conducted on relatively small scales and 9 of the 27 studies did not explicitly study the effects of mobile application use on mental wellbeing. CONCLUSION While there exists a wealth of mobile applications aimed at the treatment of mental health disorders, including mood disorders, this study showed that only a handful of these are backed by robust scientific evidence. This result uncovers a need for further clinically oriented and systematic validation and testing of such apps.
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Affiliation(s)
- Sophie Eis
- Fundació HiTT (Health Innovation Technology Transfer), 08015 Barcelona, Spain;
| | - Oriol Solà-Morales
- Fundació HiTT (Health Innovation Technology Transfer), 08015 Barcelona, Spain;
- Correspondence:
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain;
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain;
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | | | - Noemí Robles
- eHealth Lab Research Group, School of Health Sciences and eHealth Centre, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain; (N.R.); (C.C.)
| | - Carme Carrion
- eHealth Lab Research Group, School of Health Sciences and eHealth Centre, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain; (N.R.); (C.C.)
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15
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Chan AHY, Honey MLL. User perceptions of mobile digital apps for mental health: Acceptability and usability - An integrative review. J Psychiatr Ment Health Nurs 2022; 29:147-168. [PMID: 33604946 DOI: 10.1111/jpm.12744] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 01/16/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mobile mental health apps are increasingly being used by both mental health nurses to promote individual self-managemental of mental health conditions and by consumers. Perceptions about specific apps are known, but the overarching acceptability and usability of mental health apps in general less understood. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper identified consumer perceptions of mobile mental health apps. Six key areas were identified that future mobile app developers should consider to maximize consumer engagement with mental health apps. Consumers also highlighted that apps do not replace traditional mental health nursing-rather these supplement existing care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This review found that mental health apps are generally viewed positively by consumers; however, factors such as ease of use, usefulness of content and privacy need to be considered to maximise and sustain app engagement. ABSTRACT: Introduction There is increasing interest in the use of mobile mental health applications (apps) to manage mental health conditions. Understanding user perceptions is key to maximise app engagement and inform how apps can be used to support mental health nursing care. Aim This integrative review explores consumers' perceptions of mobile mental health apps to gain insight into user preferences and acceptability. Methods This integrative review was based on searching four databases: CINAHL, EMBASE, Medline, PsycInfo. Inclusion criteria were: (i) articles published after 2000; (ii) focused on apps for mental health disorders; (iii) explored consumers' perception of using a mental health app. Abstracts were screened and eligible papers reviewed. Data on user perceptions were extracted and analysed thematically. Results Seventeen articles were identified. Overall, consumers did not feel that app use replaced traditional health care. Six themes were identified: "Helpfulness," "Improvements/enhancements," "Technical issues," "Easy to use," "Satisfaction with the app" and "Perceived issues." Consumers indicated a preference for personalization for the app to meet individual needs. Discussion and Implications for Practice Mental health apps are generally viewed positively by consumers; however, factors such as ease of use, usefulness of content and privacy need to be considered to maximise and sustain app engagement.
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Affiliation(s)
- Amy Hai Yan Chan
- School of Pharmacy, University of Auckland, Auckland, New Zealand
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16
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Global Collaboration Around Digital Mental Health: The LAMP Consortium. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:227-233. [PMID: 35071742 PMCID: PMC8764174 DOI: 10.1007/s41347-022-00240-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/02/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022]
Abstract
Despite the great potential, there has been a lack of progress in the development of sharable and scalable tools for digital mental health due to difficulty in reproducibility and clinical application. The LAMP Platform was developed to address this gap by creating a single platform that works for a variety of clinical and research use cases. The study aims to understand how a consortium of clinical and research sites can help onboard, execute, and expand digital health research, software, and use cases. The Division of Digital Psychiatry implemented a formal consortium with goal of expanding the reach of mindLAMP as a digital mental health platform, enabling diverse studies and expanded use cases, and supportint growth of mindLAMP and consortium members’ research. The LAMP Consortium has brought together 54 sites from across the world, encouraging collaboration and idea sharing. These sites’ locations range from the USA to the Czech Republic to Australia, and apply the many features of LAMP to research, clinical, research and clinical, and industry use. The most popular features were surveys, sharing/viewing data, and GPS passive data collection. A user support network is necessary to encourage research and clinical use of the LAMP Platform. Resources like documentation, an online forum, and newsletters are essential to promote cooperation between many types of sites that is essential to advancing the field of digital mental health.
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17
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Yoo DW, Ernala SK, Saket B, Weir D, Arenare E, Ali AF, Van Meter AR, Birnbaum ML, Abowd GD, De Choudhury M. Clinician Perspectives on Using Computational Mental Health Insights From Patients' Social Media Activities: Design and Qualitative Evaluation of a Prototype. JMIR Ment Health 2021; 8:e25455. [PMID: 34783667 PMCID: PMC8663497 DOI: 10.2196/25455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/11/2021] [Accepted: 06/22/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Previous studies have suggested that social media data, along with machine learning algorithms, can be used to generate computational mental health insights. These computational insights have the potential to support clinician-patient communication during psychotherapy consultations. However, how clinicians perceive and envision using computational insights during consultations has been underexplored. OBJECTIVE The aim of this study is to understand clinician perspectives regarding computational mental health insights from patients' social media activities. We focus on the opportunities and challenges of using these insights during psychotherapy consultations. METHODS We developed a prototype that can analyze consented patients' Facebook data and visually represent these computational insights. We incorporated the insights into existing clinician-facing assessment tools, the Hamilton Depression Rating Scale and Global Functioning: Social Scale. The design intent is that a clinician will verbally interview a patient (eg, How was your mood in the past week?) while they reviewed relevant insights from the patient's social media activities (eg, number of depression-indicative posts). Using the prototype, we conducted interviews (n=15) and 3 focus groups (n=13) with mental health clinicians: psychiatrists, clinical psychologists, and licensed clinical social workers. The transcribed qualitative data were analyzed using thematic analysis. RESULTS Clinicians reported that the prototype can support clinician-patient collaboration in agenda-setting, communicating symptoms, and navigating patients' verbal reports. They suggested potential use scenarios, such as reviewing the prototype before consultations and using the prototype when patients missed their consultations. They also speculated potential negative consequences: patients may feel like they are being monitored, which may yield negative effects, and the use of the prototype may increase the workload of clinicians, which is already difficult to manage. Finally, our participants expressed concerns regarding the prototype: they were unsure whether patients' social media accounts represented their actual behaviors; they wanted to learn how and when the machine learning algorithm can fail to meet their expectations of trust; and they were worried about situations where they could not properly respond to the insights, especially emergency situations outside of clinical settings. CONCLUSIONS Our findings support the touted potential of computational mental health insights from patients' social media account data, especially in the context of psychotherapy consultations. However, sociotechnical issues, such as transparent algorithmic information and institutional support, should be addressed in future endeavors to design implementable and sustainable technology.
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Affiliation(s)
- Dong Whi Yoo
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Sindhu Kiranmai Ernala
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Bahador Saket
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Domino Weir
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
| | - Elizabeth Arenare
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Asra F Ali
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
| | - Anna R Van Meter
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Michael L Birnbaum
- The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States
- The Feinstein Institutes for Medical Research, Manhasset, NY, United States
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Gregory D Abowd
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
- College of Engineering, Northeastern University, Boston, MA, United States
| | - Munmun De Choudhury
- School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA, United States
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18
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Sheikh M, Qassem M, Kyriacou PA. Wearable, Environmental, and Smartphone-Based Passive Sensing for Mental Health Monitoring. Front Digit Health 2021; 3:662811. [PMID: 34713137 PMCID: PMC8521964 DOI: 10.3389/fdgth.2021.662811] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/02/2021] [Indexed: 12/21/2022] Open
Abstract
Collecting and analyzing data from sensors embedded in the context of daily life has been widely employed for the monitoring of mental health. Variations in parameters such as movement, sleep duration, heart rate, electrocardiogram, skin temperature, etc., are often associated with psychiatric disorders. Namely, accelerometer data, microphone, and call logs can be utilized to identify voice features and social activities indicative of depressive symptoms, and physiological factors such as heart rate and skin conductance can be used to detect stress and anxiety disorders. Therefore, a wide range of devices comprising a variety of sensors have been developed to capture these physiological and behavioral data and translate them into phenotypes and states related to mental health. Such systems aim to identify behaviors that are the consequence of an underlying physiological alteration, and hence, the raw sensor data are captured and converted into features that are used to define behavioral markers, often through machine learning. However, due to the complexity of passive data, these relationships are not simple and need to be well-established. Furthermore, parameters such as intrapersonal and interpersonal differences need to be considered when interpreting the data. Altogether, combining practical mobile and wearable systems with the right data analysis algorithms can provide a useful tool for the monitoring and management of mental disorders. The current review aims to comprehensively present and critically discuss all available smartphone-based, wearable, and environmental sensors for detecting such parameters in relation to the treatment and/or management of the most common mental health conditions.
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Affiliation(s)
- Mahsa Sheikh
- Research Centre for Biomedical Engineering, School of Mathematics, Computer Science & Engineering, City, University of London, London, United Kingdom
| | - M Qassem
- Research Centre for Biomedical Engineering, School of Mathematics, Computer Science & Engineering, City, University of London, London, United Kingdom
| | - Panicos A Kyriacou
- Research Centre for Biomedical Engineering, School of Mathematics, Computer Science & Engineering, City, University of London, London, United Kingdom
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19
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Nunes Vilaza G, Coyle D, Bardram JE. Public Attitudes to Digital Health Research Repositories: Cross-sectional International Survey. J Med Internet Res 2021; 23:e31294. [PMID: 34714253 PMCID: PMC8590194 DOI: 10.2196/31294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/05/2022] Open
Abstract
Background Digital health research repositories propose sharing longitudinal streams of health records and personal sensing data between multiple projects and researchers. Motivated by the prospect of personalizing patient care (precision medicine), these initiatives demand broad public acceptance and large numbers of data contributors, both of which are challenging. Objective This study investigates public attitudes toward possibly contributing to digital health research repositories to identify factors for their acceptance and to inform future developments. Methods A cross-sectional online survey was conducted from March 2020 to December 2020. Because of the funded project scope and a multicenter collaboration, study recruitment targeted young adults in Denmark and Brazil, allowing an analysis of the differences between 2 very contrasting national contexts. Through closed-ended questions, the survey examined participants’ willingness to share different data types, data access preferences, reasons for concern, and motivations to contribute. The survey also collected information about participants’ demographics, level of interest in health topics, previous participation in health research, awareness of examples of existing research data repositories, and current attitudes about digital health research repositories. Data analysis consisted of descriptive frequency measures and statistical inferences (bivariate associations and logistic regressions). Results The sample comprises 1017 respondents living in Brazil (1017/1600, 63.56%) and 583 in Denmark (583/1600, 36.44%). The demographics do not differ substantially between participants of these countries. The majority is aged between 18 and 27 years (933/1600, 58.31%), is highly educated (992/1600, 62.00%), uses smartphones (1562/1600, 97.63%), and is in good health (1407/1600, 87.94%). The analysis shows a vast majority were very motivated by helping future patients (1366/1600, 85.38%) and researchers (1253/1600, 78.31%), yet very concerned about unethical projects (1219/1600, 76.19%), profit making without consent (1096/1600, 68.50%), and cyberattacks (1055/1600, 65.94%). Participants’ willingness to share data is lower when sharing personal sensing data, such as the content of calls and texts (1206/1600, 75.38%), in contrast to more traditional health research information. Only 13.44% (215/1600) find it desirable to grant data access to private companies, and most would like to stay informed about which projects use their data (1334/1600, 83.38%) and control future data access (1181/1600, 73.81%). Findings indicate that favorable attitudes toward digital health research repositories are related to a personal interest in health topics (odds ratio [OR] 1.49, 95% CI 1.10-2.02; P=.01), previous participation in health research studies (OR 1.70, 95% CI 1.24-2.35; P=.001), and awareness of examples of research repositories (OR 2.78, 95% CI 1.83-4.38; P<.001). Conclusions This study reveals essential factors for acceptance and willingness to share personal data with digital health research repositories. Implications include the importance of being more transparent about the goals and beneficiaries of research projects using and re-using data from repositories, providing participants with greater autonomy for choosing who gets access to which parts of their data, and raising public awareness of the benefits of data sharing for research. In addition, future developments should engage with and reduce risks for those unwilling to participate.
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Affiliation(s)
- Giovanna Nunes Vilaza
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - David Coyle
- School of Computer Science, University College Dublin, Dublin, Ireland
| | - Jakob Eyvind Bardram
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
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Bougeard A, Guay Hottin1 R, Houde V, Jean T, Piront T, Potvin S, Bernard P, Tourjman V, De Benedictis L, Orban P. Le phénotypage digital pour une pratique clinique en santé mentale mieux informée. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081513ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectifs Cette revue trouve sa motivation dans l’observation que la prise de décision clinique en santé mentale est limitée par la nature des mesures typiquement obtenues lors de l’entretien clinique et la difficulté des cliniciens à produire des prédictions justes sur les états mentaux futurs des patients. L’objectif est de présenter un survol représentatif du potentiel du phénotypage digital couplé à l’apprentissage automatique pour répondre à cette limitation, tout en en soulignant les faiblesses actuelles.
Méthode Au travers d’une revue narrative de la littérature non systématique, nous identifions les avancées technologiques qui permettent de quantifier, instant après instant et dans le milieu de vie naturel, le phénotype humain au moyen du téléphone intelligent dans diverses populations psychiatriques. Des travaux pertinents sont également sélectionnés afin de déterminer l’utilité et les limitations de l’apprentissage automatique pour guider les prédictions et la prise de décision clinique. Finalement, la littérature est explorée pour évaluer les barrières actuelles à l’adoption de tels outils.
Résultats Bien qu’émergeant d’un champ de recherche récent, de très nombreux travaux soulignent déjà la valeur des mesures extraites des senseurs du téléphone intelligent pour caractériser le phénotype humain dans les sphères comportementale, cognitive, émotionnelle et sociale, toutes étant affectées par les troubles mentaux. L’apprentissage automatique permet d’utiles et justes prédictions cliniques basées sur ces mesures, mais souffre d’un manque d’interprétabilité qui freinera son emploi prochain dans la pratique clinique. Du reste, plusieurs barrières identifiées tant du côté du patient que du clinicien freinent actuellement l’adoption de ce type d’outils de suivi et d’aide à la décision clinique.
Conclusion Le phénotypage digital couplé à l’apprentissage automatique apparaît fort prometteur pour améliorer la pratique clinique en santé mentale. La jeunesse de ces nouveaux outils technologiques requiert cependant un nécessaire processus de maturation qui devra être encadré par les différents acteurs concernés pour que ces promesses puissent être pleinement réalisées.
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Affiliation(s)
- Alan Bougeard
- Étudiant, Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Rose Guay Hottin1
- Étudiante, Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Valérie Houde
- M.D., étudiante, Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Thierry Jean
- Étudiant, Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Thibault Piront
- Professionnel de recherche, Centre de recherche de l’Institut universitaire en santé mentale de Montréal
| | - Stéphane Potvin
- Ph. D., chercheur, Centre de recherche de l’Institut universitaire en santé mentale de Montréal – professeur sous octroi titulaire, Département de psychiatrie et d’addictologie, Université de Montréal
| | - Paquito Bernard
- Ph. D., chercheur, Centre de recherche de l’Institut universitaire en santé mentale de Montréal – professeur régulier, Département des sciences de l’activité physique, Université du Québec à Montréal
| | - Valérie Tourjman
- M.D., psychiatre, Institut universitaire en santé mentale de Montréal – professeure agrégée de clinique, Département de psychiatrie et d’addictologie, Université de Montréal
| | - Luigi De Benedictis
- M.D., psychiatre, Institut universitaire en santé mentale de Montréal – professeur adjoint de clinique, Département de psychiatrie et d’addictologie, Université de Montréal
| | - Pierre Orban
- Ph. D., chercheur, Centre de recherche de l’Institut universitaire en santé mentale de Montréal – professeur sous octroi adjoint, Département de psychiatrie et d’addictologie, Université de Montréal
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Southwick L, Suh R, Kranzler E, Bradley M, Merchant RM. Characterizing Social Media and Digital Data Use in Mental Health Therapy from Patient and Therapist Perspectives (Preprint). JMIR Form Res 2021; 6:e32103. [PMID: 35797103 PMCID: PMC9305395 DOI: 10.2196/32103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/13/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Incorporating insights from social media into the patient-provider encounter is increasingly being explored in health care settings. Less is known about the utility of these data in mental health therapy. Objective This study aims to prospectively investigate and characterize how social media and digital data are used in mental health therapy from both the patient and mental health therapist perspective. Methods Patients enrolled in mental health therapy and mental health therapists were interviewed using a semistructured interview guide. All interviews were transcribed and coded using a deductive framework analysis. Themes and subthemes were identified. Participants completed a sociodemographic survey, while mental health therapists also completed a behavioral norms and elicitation survey. Results Seventeen participants, that is, 8 (48%) mental health therapists and 9 (52%) patients were interviewed. Overall, participants identified 4 themes and 9 subthemes. Themes were current data collection practices, social media and digital data in therapy, advantages of social media and digital data in therapy, and disadvantages of social media and digital data in therapy. Most subthemes were related to the advantages and disadvantages of incorporating digital data in mental health therapy. Advantage subthemes included convenience, objective, builds rapport, and user-friendliness while disadvantage subthemes were nonreflective, ethically ambiguous, and nongeneralizable. The mental health therapists' behavioral norms and elicitation survey found that injunctive and descriptive normative beliefs mapped onto 2 advantage subthemes: convenience and objectivity. Conclusions This qualitative pilot study established the advantages and disadvantages of social media and digital data use in mental health therapy. Patients and therapists highlighted similar concerns and uses. This study indicated that overall, both patients and therapists are interested in and are comfortable to use and discuss social media and digital data in mental health therapy.
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Affiliation(s)
| | - Rebecca Suh
- University of Pennsylvania, Philadelphia, PA, United States
| | | | - Megan Bradley
- University of Pennsylvania, Philadelphia, PA, United States
| | - Raina M Merchant
- University of Pennsylvania, Philadelphia, PA, United States
- Department of Emergency Medicine, Perelman School of Medicine, Philadelphia, PA, United States
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22
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Iliescu R, Kumaravel A, Smurawska L, Torous J, Keshavan M. Smartphone ownership and use of mental health applications by psychiatric inpatients. Psychiatry Res 2021; 299:113806. [PMID: 33667947 DOI: 10.1016/j.psychres.2021.113806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/11/2021] [Indexed: 12/20/2022]
Abstract
Little is known about the use of mental health smartphone applications during the greatest period of vulnerability - immediately following discharge from a psychiatric inpatient unit. Currently, no data are available regarding smartphone ownership or technology literacy of individuals who receive inpatient psychiatric treatment. The goal of this study was to determine psychiatric inpatients' smartphone ownership, current uses of, and interest in utilizing apps to aid in mental health treatment after discharge. A single time point self-report survey was given to patients prior to discharge from a psychiatric inpatient unit at a major academic hospital in a metropolitan area of the United States. Of the 101 survey respondents, 82.8% indicated that they own a smartphone, and over 70% indicated that they use smartphone apps, can access the internet from their phones, and use social media. While only 25.3% reported that they currently use a mental health app, a majority of respondents (53.2%) expressed interest in using such apps in the future, and almost 60% would use those apps to track their mental health. Our data suggest that there is significant untapped potential for utilizing smartphone applications for psychiatric monitoring and treatment following discharge from an inpatient psychiatric unit.
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Affiliation(s)
- Radu Iliescu
- Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Avenue, Boston, MA 02215, United States.
| | - Arthi Kumaravel
- Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Avenue, Boston, MA 02215, United States
| | - Liliana Smurawska
- Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Avenue, Boston, MA 02215, United States
| | - John Torous
- Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Avenue, Boston, MA 02215, United States
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center, Department of Psychiatry, 330 Brookline Avenue, Boston, MA 02215, United States
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23
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Bhattarai P, Newton-John T, Phillips JL. Apps for Older People's Pain Self-Management: Perspectives of Primary Care and Allied Health Clinicians. PAIN MEDICINE 2021; 21:686-694. [PMID: 31502649 DOI: 10.1093/pm/pnz218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Chronic arthritic pain is one of the major causes of physical suffering and disability among older people. Primary care and allied health clinicians use various approaches to help their older clients better manage their arthritic pain. The growing uptake of technology among older people offers the potential for clinicians to integrate an arthritic pain app into their patients' self-management plans. This study explored the perspectives of Australian primary care and allied health clinicians regarding the use of pain self-management apps to help their older patients/clients better manage their arthritic pain. METHODS Qualitative design using a semistructured interview approach. Interviews were conducted via telephone with primary and allied health clinicians (N = 17) across Australia. RESULTS The overarching theme underlying participants' views on integration of apps into older people's pain self-management strategy was that this approach is an idealistic but uniquely challenging endeavor. Four subthemes emerged, namely: 1) self-management apps are a potentially useful tool but require careful consideration; 2) clinicians' involvement is crucial yet potentially onerous; 3) no single app is right for every older person with arthritic pain; and 4) patient data access is beneficial, but caution is needed for real-time data access. DISCUSSION The predominant clinician perspective of integrating apps into their older patients/clients' pain self-management strategies was that this approach is an idealistic but uniquely challenging endeavor. Apps were seen as having potential to support various aspects of patients' self-management behaviors; however, there were notable concerns with regards to the challenges inherent in this approach for both clinicians and older users (patients/clients).
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Affiliation(s)
- Priyanka Bhattarai
- School of Nursing, University of Notre Dame Australia, Sydney, NSW, Australia
| | | | - Jane L Phillips
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Influencing Factors of Acceptance and Use Behavior of Mobile Health Application Users: Systematic Review. Healthcare (Basel) 2021; 9:healthcare9030357. [PMID: 33809828 PMCID: PMC8004182 DOI: 10.3390/healthcare9030357] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose/Significance: Mobile health applications provide a convenient way for users to obtain health information and services. Studying the factors that influence users’ acceptance and use of mobile health applications (apps or Apps) will help to improve users’ actual usage behavior. Method/Process: Based on the literature review method and using the Web of Science core database as the data source, this paper summarizes the relevant research results regarding the influencing factors of the acceptance and use behavior of mobile health application users and makes a systematic review of the influencing factors from the perspectives of the individual, society, and application (app or App) design. Result/Conclusion: In terms of the individual dimension, the users’ behavior is influenced by demographic characteristics and motivations. Social attributes, source credibility, and legal issues all affect user behavior in the social dimension. In the application design dimension, functionality, perceived ease of use and usefulness, security, and cost are the main factors. At the end of the paper, suggestions are given to improve the users’ acceptability of mobile health applications and improve their use behavior.
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25
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Schlage J, Perich T. Mental health mobile application usage in young adults with a family history of mental illness. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jasmin Schlage
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Psychology, Western Sydney University, Sydney, NSW, Australia,
| | - Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Psychology, Western Sydney University, Sydney, NSW, Australia,
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26
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Beard C, Ramadurai R, McHugh RK, Pollak JP, Björgvinsson T. HabitWorks: Development of a CBM-I Smartphone App to Augment and Extend Acute Treatment. Behav Ther 2021; 52:365-378. [PMID: 33622506 PMCID: PMC9720670 DOI: 10.1016/j.beth.2020.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 11/26/2022]
Abstract
The month following discharge from acute psychiatric care is associated with increased risk of relapse, rehospitalization, and suicide. Effective and accessible interventions tailored to this critical transition are urgently needed. Cognitive bias modification for interpretation (CBM-I) is a low-intensity intervention that targets interpretation bias, a transdiagnostic process implicated in the development and maintenance of emotional disorders. We describe the development of a CBM-I smartphone app called HabitWorks as an augmentation to acute care that extends through the high-risk month postdischarge. We first obtained input from various stakeholders, including adults who had completed partial hospital treatment (patient advisory board), providers, CBM experts, and clinic program directors. We then iteratively tested versions of the app, incorporating feedback over three waves of users. Participants were recruited from a partial hospital program and completed CBM-I sessions via the HabitWorks app while attending the hospital program and during the month postdischarge. In this Stage 1A treatment development work, we obtained preliminary data regarding feasibility and acceptability, adherence during acute care, and target engagement. Pilot data met our a priori benchmarks. While adherence during acute treatment was good, it decreased during the postacute period. Qualitative feedback was generally positive and revealed themes of usability and helpfulness of app features. Participants varied in their perception of skill generalization to real-life situations. The feasibility and acceptability data suggest that a controlled trial of HabitWorks is warranted.
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Zhou L, Parmanto B. User Preferences for Privacy Protection Methods in Mobile Health Apps: A Mixed-Methods Study. Int J Telerehabil 2020; 12:13-26. [PMID: 33520091 PMCID: PMC7757650 DOI: 10.5195/ijt.2020.6319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Mobile health (mHealth) apps have the potential to facilitate convenient health care delivery and self-management of health. However, many users have concerns about their privacy when they use mHealth apps. Different apps provide different solutions for protecting users' privacy. Objective The purpose of this study was to determine user preferences among the several privacy protection methods used in current mHealth apps and the reasons behind their preferences. Methods Five privacy protection methods currently used in mHealth apps were presented to a group of study participants who had mild or moderate depression and expressed concerns about privacy of information when they used mental health apps. After a demonstration of the methods, study participants were asked to fill out a questionnaire and indicate their perceived privacy protection level (PPPL) of each method, their preference rating for each method, and the privacy protection methods they had used in the past. A brief interview was then conducted to collect study participants' comments on these methods and elicit the reasons for their preference ratings. Statistical analysis was performed to determine the statistical significance of differences in participants' preference ratings and in the PPPLs obtained for the five methods. Study participants' comments on the privacy protection methods and suggestions were noted and summarized. Results Forty (40) study participants were selected from a large candidate pool using the IRB approved selection criteria. All study participants viewed the app demonstration and understood the five privacy protection methods properly, which was indicated by their correct sorting of the PPPL of the five methods in their answers to the questionnaire. All study participants specified their preferences with respect to these methods and provided the rationale behind their selections on the questionnaire and during the brief interview. The results indicate that the users preferred privacy protection methods with customizable modules in multi-purpose apps because of their convenience and strong privacy protection, where the customization can be done either in the app or via a Web portal. Conclusions This study identified user preferred privacy protection methods. These identified privacy protection methods may be used in many types of apps that perform sensitive health information management to better protect users' privacy and encourage more users to adopt these mHealth apps.
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Affiliation(s)
- Leming Zhou
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bambang Parmanto
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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28
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Drissi N, Ouhbi S, Janati Idrissi MA, Fernandez-Luque L, Ghogho M. Connected Mental Health: Systematic Mapping Study. J Med Internet Res 2020; 22:e19950. [PMID: 32857055 PMCID: PMC7486675 DOI: 10.2196/19950] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/02/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers. OBJECTIVE The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database. METHODS A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted. RESULTS The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted. CONCLUSIONS CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.
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Affiliation(s)
- Nidal Drissi
- Department of Computer Science and Software Engineering, United Arab Emirates University, Al Ain, United Arab Emirates.,National School For Computer Science, Mohammed V University in Rabat, Rabat, Morocco
| | - Sofia Ouhbi
- Department of Computer Science and Software Engineering, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | - Mounir Ghogho
- TICLab, International University of Rabat, Rabat, Morocco
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29
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Hochheiser H, Valdez RS. Human-Computer Interaction, Ethics, and Biomedical Informatics. Yearb Med Inform 2020; 29:93-98. [PMID: 32823302 PMCID: PMC7442500 DOI: 10.1055/s-0040-1701990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Objectives
: To provide an overview of recent work at the intersection of Biomedical Informatics, Human-Computer Interaction, and Ethics.
Methods
: Search terms for Human-Computer Interaction, Biomedical Informatics, and Ethics were used to identify relevant papers published between 2017 and 2019.Relevant papers were identified through multiple methods, including database searches, manual reviews of citations, recent publications, and special collections, as well as through peer recommendations. Identified articles were reviewed and organized into broad themes.
Results
: We identified relevant papers at the intersection of Biomedical Informatics, Human-Computer Interactions, and Ethics in over a dozen journals. The content of these papers was organized into three broad themes: ethical issues associated with systems in use, systems design, and responsible conduct of research.
Conclusions
: The results of this overview demonstrate an active interest in exploring the ethical implications of Human-Computer Interaction concerns in Biomedical Informatics. Papers emphasizing ethical concerns associated with patient-facing tools, mobile devices, social media, privacy, inclusivity, and e-consent reflect the growing prominence of these topics in biomedical informatics research. New questions in these areas will likely continue to arise with the growth of precision medicine and citizen science.
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Affiliation(s)
- Harry Hochheiser
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania USA
| | - Rupa S Valdez
- Public Health Sciences & Engineering Systems and Environment, University of Virginia, Charlottesville, Virginia USA
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30
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DeForte S, Huang Y, Bourgeois T, Hussain SA, Lin S. The Association Between App-Administered Depression Assessments and Suicidal Ideation in User Comments: Retrospective Observational Study. JMIR Mhealth Uhealth 2020; 8:e18392. [PMID: 32663158 PMCID: PMC7435620 DOI: 10.2196/18392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/20/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background Many people use apps to help understand and manage their depression symptoms. App-administered questionnaires for the symptoms of depression, such as the Patient Health Questionnaire-9, are easy to score and implement in an app, but may not be accompanied by essential resources and access needed to provide proper support and avoid potential harm. Objective Our primary goal was to evaluate the differences in risks and helpfulness associated with using an app to self-diagnose depression, comparing assessment-only apps with multifeatured apps. We also investigated whether, what, and how additional app features may mitigate potential risks. Methods In this retrospective observational study, we identified apps in the Google Play store that provided a depression assessment as a feature and had at least five user comments. We separated apps into two categories based on those having only a depression assessment versus those that offered additional supportive features. We conducted theoretical thematic analyses over the user reviews, with thematic coding indicating the helpfulness of the app, the presence of suicidal ideation, and how and why the apps were used. We compared the results across the two categories of apps and analyzed the differences using chi-square statistical tests. Results We evaluated 6 apps; 3 provided only a depression assessment (assessment only), and 3 provided features in addition to self-assessment (multifeatured). User comments for assessment-only apps indicated significantly more suicidal ideation or self-harm (n=31, 9.4%) compared to comments for multifeatured apps (n=48, 2.3%; X21=43.88, P<.001). Users of multifeatured apps were over three times more likely than assessment-only app users to comment in favor of the app’s helpfulness, likely due to features like mood tracking, journaling, and informational resources (n=56, 17% vs n=1223, 59% respectively; X21=200.36, P<.001). The number of users under the age of 18 years was significantly higher among assessment-only app users (n=40, 12%) than multifeatured app users (n=9, 0.04%; X21=189.09, P<.001). Conclusions Apps that diagnose depression by self-assessment without context or other supportive features are more likely to be used by those under 18 years of age and more likely to be associated with increased user distress and potential harm. Depression self-assessments in apps should be implemented with caution and accompanied by evidence-based capabilities that establish proper context, increase self-empowerment, and encourage users to seek clinical diagnostics and outside help.
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Affiliation(s)
- Shelly DeForte
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Yungui Huang
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Tran Bourgeois
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Syed-Amad Hussain
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Simon Lin
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
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31
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Understanding the evolving preferences for use of health information technology among adults with self reported anxiety and depression in the U.S. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jbct.2020.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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32
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Bauer M, Glenn T, Geddes J, Gitlin M, Grof P, Kessing LV, Monteith S, Faurholt-Jepsen M, Severus E, Whybrow PC. Smartphones in mental health: a critical review of background issues, current status and future concerns. Int J Bipolar Disord 2020; 8:2. [PMID: 31919635 PMCID: PMC6952480 DOI: 10.1186/s40345-019-0164-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/24/2019] [Indexed: 02/06/2023] Open
Abstract
There has been increasing interest in the use of smartphone applications (apps) and other consumer technology in mental health care for a number of years. However, the vision of data from apps seamlessly returned to, and integrated in, the electronic medical record (EMR) to assist both psychiatrists and patients has not been widely achieved, due in part to complex issues involved in the use of smartphone and other consumer technology in psychiatry. These issues include consumer technology usage, clinical utility, commercialization, and evolving consumer technology. Technological, legal and commercial issues, as well as medical issues, will determine the role of consumer technology in psychiatry. Recommendations for a more productive direction for the use of consumer technology in psychiatry are provided.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Tasha Glenn
- ChronoRecord Association, Fullerton, CA, USA
| | - John Geddes
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Michael Gitlin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Lars V Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Scott Monteith
- Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Emanuel Severus
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Peter C Whybrow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Kidd SA, Feldcamp L, Adler A, Kaleis L, Wang W, Vichnevetski K, McKenzie K, Voineskos A. Feasibility and outcomes of a multi-function mobile health approach for the schizophrenia spectrum: App4Independence (A4i). PLoS One 2019; 14:e0219491. [PMID: 31306439 PMCID: PMC6629069 DOI: 10.1371/journal.pone.0219491] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 06/15/2019] [Indexed: 12/19/2022] Open
Abstract
Relative to the large investments in mobile health (mHealth) strategies for mental illnesses such as anxiety and depression, the development of technology to facilitate illness self-management for people with schizophrenia spectrum illnesses is limited. This situation falls out of step with the opportunity mHealth represents for providing inexpensive and accessible self-care resources and the routine use of mobile technologies by people with schizophrenia. Accordingly, the focus of this study was upon the feasibility of a schizophrenia-focused mobile application: App4Independence (A4i). A4i is a multi-feature app that uses feed, scheduling, and text-based functions co-designed with service users to enhance illness self-management. This study was completed in a large urban Canadian centre and employed pre-post assessments over a 1-month period that examined medication adherence, personal recovery, and psychiatric symptomatology. App use metrics were assessed as was qualitative feedback through semi-structured interview. Findings are reported in line with the World Health Organization mHealth Evidence and Assessment (mERA) checklist. Among the 38 individuals with a primary psychosis who participated, there was no research attrition and classic retention on the app was 52.5%. Significant improvement was observed in some psychiatric symptom domains with small-medium effects. Significant change in recovery engagement and medication adherence were not observed after controlling for multiple comparisons. Those who interacted with the app more frequently were more depressed and had higher hostility and interpersonal sensitivity at baseline. Satisfaction with the app was high and qualitative feedback provided insights regarding feature enhancements. This research suggested that A4i is feasible in terms of outcome and process indicators and is a technology that is ready to move on to clinical trial and validation testing. This study contributes to the small but emergent body of work investigating digital health approaches in severe mental illness populations.
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Affiliation(s)
- Sean A. Kidd
- University of Toronto, Department of Psychiatry, Toronto, Canada
- * E-mail:
| | | | | | | | - Wei Wang
- University of Toronto, Department of Psychiatry, Toronto, Canada
| | | | - Kwame McKenzie
- University of Toronto, Department of Psychiatry, Toronto, Canada
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Hobbs KW, Monette PJ, Owoyemi P, Beard C, Rauch SL, Ressler KJ, Vahia IV. Incorporating Information From Electronic and Social Media Into Psychiatric and Psychotherapeutic Patient Care: Survey Among Clinicians. J Med Internet Res 2019; 21:e13218. [PMID: 31301127 PMCID: PMC6659389 DOI: 10.2196/13218] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/26/2019] [Accepted: 05/17/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obtaining collateral information from a patient is an essential component of providing effective psychiatric and psychotherapeutic care. Research indicates that patients' social and electronic media contains information relevant to their psychotherapy and clinical care. However, it remains unclear to what degree this content is being actively utilized by clinicians as a part of diagnosis or therapy. Moreover, clinicians' attitudes around this practice have not been well characterized. OBJECTIVE This survey aimed to establish the current attitudes and behaviors of outpatient clinicians regarding the incorporation of patients' social and electronic media into psychotherapy. METHODS A Web-based survey was sent to outpatient psychotherapists associated with McLean Hospital in Belmont, Massachusetts. The survey asked clinicians to indicate to what extent and with which patients they reviewed patients' social and electronic media content as part of their clinical practice, as well as their reasons for or against doing so. RESULTS Of the total 115 respondents, 71 (61.7%) indicated that they had viewed at least one patient's social or electronic media as part of psychotherapy, and 65 of those 71 (92%) endorsed being able to provide more effective treatment as a result of this information. The use of either short message service text messages or email was significantly greater than the use of other electronic media platforms (χ21=24.1, n=115, P<.001). Moreover, the analysis of survey responses found patterns of use associated with clinicians' years of experience and patient demographics, including age and primary diagnosis. CONCLUSIONS The incorporation of patients' social and electronic media into therapy is currently common practice among clinicians at a large psychiatric teaching hospital. The results of this survey have informed further questions about whether reviewing patient's media impacts the quality and efficacy of clinical care.
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Affiliation(s)
| | | | | | - Courtney Beard
- McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Cambridge, MA, United States
| | - Scott L Rauch
- McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Cambridge, MA, United States
| | - Kerry J Ressler
- McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Cambridge, MA, United States
| | - Ipsit V Vahia
- McLean Hospital, Belmont, MA, United States.,Harvard Medical School, Cambridge, MA, United States
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Beard C, Silverman AL, Forgeard M, Wilmer MT, Torous J, Björgvinsson T. Smartphone, Social Media, and Mental Health App Use in an Acute Transdiagnostic Psychiatric Sample. JMIR Mhealth Uhealth 2019; 7:e13364. [PMID: 31199338 PMCID: PMC6592519 DOI: 10.2196/13364] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 01/11/2023] Open
Abstract
Background Despite high rates of smartphone ownership in psychiatric populations, there are very little data available characterizing smartphone use in individuals with mental illness. In particular, few studies have examined the interest and use of smartphones to support mental health. Objective This study aimed to (1) characterize general smartphone app and social media usage in an acute transdiagnostic psychiatric sample with high smartphone ownership, (2) characterize current engagement and interest in the use of smartphone apps to support mental health, and (3) test demographic and clinical predictors of smartphone use. Methods The survey was completed by all patients attending an adult partial hospital program, with no exclusion criteria. The primary outcomes were frequency of use of general and mental health smartphone apps (smartphone use survey) and the frequency of social media use and phone-checking behavior (mobile technology engagement scale). Results Overall, 322 patients (aged mean 33.49, SD 13.87 years; 57% female) reported that their most frequently used app functions were texting, email, and social media. Younger individuals reported more frequent use across most types of apps. Baseline depression and anxiety symptoms were not associated with the frequency of app use. Participants reported health care, calendar, and texting apps as most supportive of their mental health and social media apps as most negatively affecting their mental health. Most patients reported an interest in (73.9% [238/322]) and willingness to use (81.3% [262/322]) a smartphone app to monitor their mental health condition. Less than half (44%) of the patients currently had a mental health app downloaded on their smartphone, with mindfulness and meditation apps being the most common type. Conclusions The high interest in and willingness to use mental health apps, paired with the only moderate current reported usage, indicate a potential unmet treatment opportunity in psychiatric populations. There is potential to optimize non-mental health–specific apps to better support the needs of those with mental illness and to design a new wave of mental health apps that match the needs of these populations as well as the way they use smartphones in daily life.
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Affiliation(s)
- Courtney Beard
- McLean Hospital/Harvard Medical School, Belmont, MA, United States
| | | | - Marie Forgeard
- McLean Hospital/Harvard Medical School, Belmont, MA, United States.,William James College, Newton, MA, United States
| | - M Taylor Wilmer
- McLean Hospital/Harvard Medical School, Belmont, MA, United States
| | - John Torous
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MD, United States
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Bentley KH, Kleiman EM, Elliott G, Huffman JC, Nock MK. Real-time monitoring technology in single-case experimental design research: Opportunities and challenges. Behav Res Ther 2019; 117:87-96. [DOI: 10.1016/j.brat.2018.11.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 10/08/2018] [Accepted: 11/26/2018] [Indexed: 12/16/2022]
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Wykes T, Schueller S. Why Reviewing Apps Is Not Enough: Transparency for Trust (T4T) Principles of Responsible Health App Marketplaces. J Med Internet Res 2019; 21:e12390. [PMID: 31045497 PMCID: PMC6521210 DOI: 10.2196/12390] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 12/15/2022] Open
Abstract
The overselling of health apps that may provide little benefit and even harm needs the health community’s immediate attention. With little formal regulation, a light-touch approach to consumer protection is now warranted to give customers a modicum of information to help them choose from the vast array of so-called health apps. We suggest 4 guiding principles that should be adopted to provide the consumer with information that can guide their choice at the point of download. We call these the Transparency for Trust (T4T) principles, which are derived from experimental studies, systematic reviews, and reports of patient concerns. The T4T principles are (1) privacy and data security, (2) development characteristics, (3) feasibility data, and (4) benefits. All our questions are in a simple form so that all consumers can understand them. We suggest that app stores should take responsibility for providing this information and store it with any app marketed as a health app. Even the absence of information would provide consumers with some understanding and fuel their choice. This would also provide some commercial impetus for app developers to consider this requested information from the outset.
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Affiliation(s)
- Til Wykes
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Stephen Schueller
- Center for Behavioral Intervention Technologies, North Western University, Chicago, IL, United States
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Torous J, Woodyatt J, Keshavan M, Tully LM. A new hope for early psychosis care: the evolving landscape of digital care tools. Br J Psychiatry 2019; 214:269-272. [PMID: 30739613 PMCID: PMC6478506 DOI: 10.1192/bjp.2019.8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Improving understanding of and outcomes for early-course psychosis (ECP) is a recognised global mental health priority. We argue digital health technologies can advance care for ECP by better accounting for clinical heterogeneity, offering better predictive models, increasing access to early interventions and enhancing existing treatment options.Declaration of interestL.M.T. owns shares in Safari Health Inc - a digital health technology company.
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Affiliation(s)
- John Torous
- Director of the Digital Psychiatry Division,Department of Psychiatry,Beth Israel Deaconess Medical Center,Harvard Medical School,USA
| | - Jessica Woodyatt
- Lab Manager,Social Cognition in Psychopathology Lab,Department of Psychology,University of Rochester,USA
| | - Matcheri Keshavan
- Vice Chair of Public Psychiatry,Department of Psychiatry,Beth Israel Deaconess Medical Center and the Massachusetts Mental Health Center,Harvard Medical School,USA
| | - Laura M Tully
- Assistant Professor in Psychiatry,Department of Psychiatry,University of California; andDirector of Clinical Training,UC Davis Imaging Research Center,USA
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Torous J, Wisniewski H, Bird B, Carpenter E, David G, Elejalde E, Fulford D, Guimond S, Hays R, Henson P, Hoffman L, Lim C, Menon M, Noel V, Pearson J, Peterson R, Susheela A, Troy H, Vaidyam A, Weizenbaum E, Naslund JA, Keshavan M. Creating a Digital Health Smartphone App and Digital Phenotyping Platform for Mental Health and Diverse Healthcare Needs: an Interdisciplinary and Collaborative Approach. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41347-019-00095-w] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Zhou L, Bao J, Watzlaf V, Parmanto B. Barriers to and Facilitators of the Use of Mobile Health Apps From a Security Perspective: Mixed-Methods Study. JMIR Mhealth Uhealth 2019; 7:e11223. [PMID: 30990458 PMCID: PMC6488955 DOI: 10.2196/11223] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 02/23/2019] [Accepted: 03/04/2019] [Indexed: 01/13/2023] Open
Abstract
Background A large number of mobile health (mHealth) apps have been created to help users to manage their health or receive health care services. Many of these mHealth apps have proven to be helpful for maintaining or improving their users’ health. However, many people still choose not to use mHealth apps or only use them for a short period. One of the reasons behind this lack of use is the concern for their health information security and privacy. Objective The goal of this study was to determine the relationship between users’ characteristics and their security and privacy concerns and to identify desired security features in mHealth apps, which could reduce these concerns. Methods A questionnaire was designed and validated by the research team. This questionnaire was then used to determine mobile app users’ security and privacy concerns regarding personal health data in mHealth apps as well as the security features most users’ desire. A semistructured interview was used to identify barriers to and facilitators of adopting mHealth apps. Results In total, 117 randomly selected study participants from a large pool took part in this study and provided responses to the validated questionnaire and the semistructured interview questions. The results indicate that most study participants did have concerns about their privacy when using mHealth apps. They also expressed their preferences regarding several security features in mHealth apps, such as regular password updates, remote wipe, user consent, and access control. An association between their demographic characteristics and their concerns and preferences in security and privacy was identified; however, in most cases, the differences among the different demographic groups were not statistically significant, except for a few very specific aspects. These study participants also indicated that the cost of apps and lack of security features in mHealth apps were barriers for adoption, whereas having free apps, strong but easy-to-use security features, and clear user protection privacy policies might encourage them to use mHealth apps in their health management. Conclusions This questionnaire and interview study verified the security and privacy concerns of mHealth app users, identified the desired security and privacy features, and determined specific barriers to and facilitators of users adopting mHealth apps. The results can be used to guide mHealth app developers to create apps that would be welcomed by users.
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Affiliation(s)
- Leming Zhou
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jie Bao
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, United States
| | - Valerie Watzlaf
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bambang Parmanto
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, United States
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Torous J, Wisniewski H, Liu G, Keshavan M. Mental Health Mobile Phone App Usage, Concerns, and Benefits Among Psychiatric Outpatients: Comparative Survey Study. JMIR Ment Health 2018; 5:e11715. [PMID: 30446484 PMCID: PMC6269625 DOI: 10.2196/11715] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite the popularity of mental health apps, it is unknown if they are actually used by those with mental illness. This study assessed whether differences in clinic setting may influence the use of mental health apps and which factors influence patient perception of apps. OBJECTIVE The objective of this study was to gain an understanding of how individuals with mental illness use their mobile phones by exploring their access to mobile phones and their use of mental health apps. METHODS A single time point survey study was conducted over a 2-week period in February 2018 at two nearby outpatient psychiatry clinics: one serving largely mood and anxiety disorder patients with private insurance staffed by both faculty and residents and the other serving largely psychotic disorder patients in a state Department of Mental Health (DMH) setting. A total of 25 patients at the state DMH clinic also consented for a single time point observation of apps currently installed on their personal mobile phone. RESULTS A total of 113 patients at the private insurance clinic and 73 at the state DMH clinic completed the survey. Those in the private insurance clinic were more likely to download a mental health app compared to the state DMH clinic, but actual rates of reported current app usage were comparable at each clinic, approximately 10%. Verifying current apps on patients' mobile phones at the state DMH clinic confirmed that approximately 10% had mental health apps installed. Patients at both clinics were most concerned about privacy of mental health apps, although those at the state DMH clinic viewed cost savings as the greatest benefit while those at the private clinic reported time as the greatest benefit. CONCLUSIONS High interest in mental health apps does not automatically translate into high use. Our results of low but similar rates of mental health app use at diverse clinics suggests DMH patients with largely psychotic disorders are as interested and engaged with apps as those in a private insurance clinic treating largely mood and anxiety disorders. Results from our study also highlight the importance of understanding how actual patients are using apps instead of relying on internet-based samples, which often yield higher results due to their likelihood of being selected.
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Affiliation(s)
- John Torous
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Hannah Wisniewski
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Gang Liu
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Matcheri Keshavan
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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