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Chen K, Lane E, Burns J, Macrynikola N, Chang S, Torous J. The Digital Navigator: Standardizing Human Technology Support in App-Integrated Clinical Care. Telemed J E Health 2024. [PMID: 38574251 DOI: 10.1089/tmj.2024.0023] [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: 04/06/2024] Open
Abstract
Background: Mental health apps offer scalable care, yet clinical adoption is hindered by low user engagement and integration challenges into clinic workflows. Human support staff called digital navigators, trained in mental health technology, could enhance care access and patient adherence and remove workflow burdens from clinicians. While the potential of this role is clear, training staff to become digital navigators and assessing their impact are primary challenges. Methods: We present a detailed manual/framework for implementation of the Digital Navigator within a short-term, cognitive-behavioral therapy-focused hybrid clinic. We analyze patient engagement, satisfaction, and digital phenotyping data quality outcomes. Data from 83 patients, for the period spanning September 2022 to September 2023, included Digital Navigator satisfaction, correlated with demographics, mindLAMP app satisfaction, engagement, and passive data quality. Additionally, average passive data across 33 clinic patients from November 2023 to January 2024 were assessed for missingness. Results: Digital Navigator satisfaction averaged 18.8/20. Satisfaction was not influenced by sex, race, gender, or education. Average passive data quality across 33 clinic patients was 0.82 at the time this article was written. Digital Navigator satisfaction scores had significant positive correlation with both clinic app engagement and perception of that app. Conclusions: Results demonstrate preliminary support and patient endorsement for the Digital Navigator role and positive outcomes around digital engagement and digital phenotyping data quality. Through sharing training resources and standardizing the role, we aim to enable clinicians and researchers to adapt and utilize the Digital Navigator for their own needs.
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Affiliation(s)
- Kelly Chen
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Erlend Lane
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - James Burns
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Natalia Macrynikola
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Sarah Chang
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Stern E, Micoulaud Franchi JA, Dumas G, Moreira J, Mouchabac S, Maruani J, Philip P, Lejoyeux M, Geoffroy PA. How Can Digital Mental Health Enhance Psychiatry? Neuroscientist 2023; 29:681-693. [PMID: 35658666 DOI: 10.1177/10738584221098603] [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] [Indexed: 11/17/2022]
Abstract
The use of digital technologies is constantly growing around the world. The wider-spread adoption of digital technologies and solutions in the daily clinical practice in psychiatry seems to be a question of when, not if. We propose a synthesis of the scientific literature on digital technologies in psychiatry and discuss the main aspects of its possible uses and interests in psychiatry according to three domains of influence that appeared to us: 1) assist and improve current care: digital psychiatry allows for more people to have access to care by simply being more accessible but also by being less stigmatized and more convenient; 2) develop new treatments: digital psychiatry allows for new treatments to be distributed via apps, and practical guidelines can reduce ethical challenges and increase the efficacy of digital tools; and 3) produce scientific and medical knowledge: digital technologies offer larger and more objective data collection, allowing for more detection and prevention of symptoms. Finally, ethical and efficacy issues remain, and some guidelines have been put forth on how to safely use these solutions and prepare for the future.
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Affiliation(s)
- Emilie Stern
- GHU Paris-Psychiatrie & Neurosciences, Paris, France
| | - Jean-Arthur Micoulaud Franchi
- University of Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Guillaume Dumas
- CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Quebec, Canada
- Mila-Quebec Artificial Intelligence Institute, University of Montreal, Quebec, Canada
| | | | - Stephane Mouchabac
- Department of Psychiatry, Department of Psychiatry Hôpital Saint Antoine-APHP, Sorbonne University, Paris, France
- Infrastructure of Clinical Research in Neurosciences-Psychiatry, Brain and Spine Institute (ICM), Inserm, Sorbonne University, Paris, France
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
- Université de Paris, NeuroDiderot, Inserm U1141, F-75019, Paris, France
| | - Pierre Philip
- University of Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France
- CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Michel Lejoyeux
- GHU Paris-Psychiatrie & Neurosciences, Paris, France
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
- Université de Paris, NeuroDiderot, Inserm U1141, F-75019, Paris, France
| | - Pierre A Geoffroy
- GHU Paris-Psychiatrie & Neurosciences, Paris, France
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat-Claude Bernard, F-75018, Paris, France
- Université de Paris, NeuroDiderot, Inserm U1141, F-75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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Morales-Pillado C, Fernández-Castilla B, Sánchez-Gutiérrez T, González-Fraile E, Barbeito S, Calvo A. Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis. Psychol Med 2023; 53:6304-6315. [PMID: 36472150 PMCID: PMC10520607 DOI: 10.1017/s0033291722003610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/26/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Technology-based interventions (TBIs) are a useful approach when attempting to provide therapy to more patients with psychosis. METHODS Randomized controlled trials of outcomes of TBIs v. face-to-face interventions in psychosis were identified in a systematic search conducted in PubMed/Ovid MEDLINE. Data were extracted independently by two researchers, and standardized mean changes were pooled using a three-level model and network meta-analysis. RESULTS Fifty-eight studies were included. TBIs complementing treatment as usual (TAU) were generally superior to face-to-face interventions (g = 0.16, p ≤ 0.0001) and to specific outcomes, namely, neurocognition (g = 0.13, p ≤ 0.0001), functioning (g = 0.25, p = 0.006), and social cognition (g = 0.32, p ≤ 0.05). Based on the network meta-analysis, the effect of two TBIs differed significantly from zero; these were the TBIs cognitive training for the neurocognitive outcome [g = 0.16; 95% confidence interval (CI) 0.09-0.23] and cognitive behavioral therapy for quality of life (g = 1.27; 95% CI 0.46-2.08). The variables educational level, type of medication, frequency of the intervention, and contact during the intervention moderated the effectiveness of TBIs over face-to-face interventions in neurocognition and symptomatology. CONCLUSIONS TBIs are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis. The results of the network meta-analysis showed the efficacy of some TBIs for neurocognition, symptomatology, and quality of life. Therefore, TBIs should be considered a complement to TAU in patients with psychosis.
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Affiliation(s)
- Carla Morales-Pillado
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Universidad Complutense de Madrid, Madrid, Spain
- Faculty of Health Science, Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | - Belén Fernández-Castilla
- Department of Methodology of Behavioral and Health Sciences, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | | | | | - Sara Barbeito
- Faculty of Health Science, Universidad Internacional de La Rioja (UNIR), Madrid, Spain
| | - Ana Calvo
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Universidad Complutense de Madrid, Madrid, Spain
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Klein A, Clucas J, Krishnakumar A, Ghosh SS, Van Auken W, Thonet B, Sabram I, Acuna N, Keshavan A, Rossiter H, Xiao Y, Semenuta S, Badioli A, Konishcheva K, Abraham SA, Alexander LM, Merikangas KR, Swendsen J, Lindner AB, Milham MP. Remote Digital Psychiatry for Mobile Mental Health Assessment and Therapy: MindLogger Platform Development Study. J Med Internet Res 2021; 23:e22369. [PMID: 34762054 PMCID: PMC8663601 DOI: 10.2196/22369] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/03/2021] [Accepted: 03/16/2021] [Indexed: 01/23/2023] Open
Abstract
Background Universal access to assessment and treatment of mental health and learning disorders remains a significant and unmet need. There are many people without access to care because of economic, geographic, and cultural barriers, as well as the limited availability of clinical experts who could help advance our understanding and treatment of mental health. Objective This study aims to create an open, configurable software platform to build clinical measures, mobile assessments, tasks, and interventions without programming expertise. Specifically, our primary requirements include an administrator interface for creating and scheduling recurring and customized questionnaires where end users receive and respond to scheduled notifications via an iOS or Android app on a mobile device. Such a platform would help relieve overwhelmed health systems and empower remote and disadvantaged subgroups in need of accurate and effective information, assessment, and care. This platform has the potential to advance scientific research by supporting the collection of data with instruments tailored to specific scientific questions from large, distributed, and diverse populations. Methods We searched for products that satisfy these requirements. We designed and developed a new software platform called MindLogger, which exceeds the requirements. To demonstrate the platform’s configurability, we built multiple applets (collections of activities) within the MindLogger mobile app and deployed several of them, including a comprehensive set of assessments underway in a large-scale, longitudinal mental health study. Results Of the hundreds of products we researched, we found 10 that met our primary requirements with 4 that support end-to-end encryption, 2 that enable restricted access to individual users’ data, 1 that provides open-source software, and none that satisfy all three. We compared features related to information presentation and data capture capabilities; privacy and security; and access to the product, code, and data. We successfully built MindLogger mobile and web applications, as well as web browser–based tools for building and editing new applets and for administering them to end users. MindLogger has end-to-end encryption, enables restricted access, is open source, and supports a variety of data collection features. One applet is currently collecting data from children and adolescents in our mental health study, and other applets are in different stages of testing and deployment for use in clinical and research settings. Conclusions We demonstrated the flexibility and applicability of the MindLogger platform through its deployment in a large-scale, longitudinal, mobile mental health study and by building a variety of other mental health–related applets. With this release, we encourage a broad range of users to apply the MindLogger platform to create and test applets to advance health care and scientific research. We hope that increasing the availability of applets designed to assess and administer interventions will facilitate access to health care in the general population.
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Affiliation(s)
- Arno Klein
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | - Jon Clucas
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Computational Neuroimaging Lab, Child Mind Institute, New York, NY, United States
| | - Anirudh Krishnakumar
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France.,ETH Library Lab, ETH Zurich and Citizen Science Centre, Zurich, Switzerland
| | - Satrajit S Ghosh
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Cambridge, MA, United States
| | | | - Benjamin Thonet
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France
| | - Ihor Sabram
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | - Nino Acuna
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | - Anisha Keshavan
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Octave Bioscience, Menlo Park, CA, United States
| | - Henry Rossiter
- Computational Engineering, University of Texas at Austin, Austin, TX, United States
| | - Yao Xiao
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States
| | - Sergey Semenuta
- MATTER Lab, Child Mind Institute, New York, NY, United States
| | | | - Kseniia Konishcheva
- MATTER Lab, Child Mind Institute, New York, NY, United States.,Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France
| | - Sanu Ann Abraham
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Lindsay M Alexander
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States
| | | | - Joel Swendsen
- National Center for Scientific Research, University of Bordeaux, EPHE PSL University, Bordeaux, France
| | - Ariel B Lindner
- Université de Paris and INSERM U1284 SEED unit, Centre for Research and Interdisciplinarity (CRI), Paris, France
| | - Michael P Milham
- Center for the Developing Brain, Child Mind Institute, New York, NY, United States.,Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
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5
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Mobile-Health Technologies for a Child Neuropsychiatry Service: Development and Usability of the Assioma Digital Platform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052758. [PMID: 33803179 PMCID: PMC7967477 DOI: 10.3390/ijerph18052758] [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: 01/28/2021] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 11/17/2022]
Abstract
We developed an m-Health platform to support clinical pathways in a child and adolescent neuropsychiatry unit. The Assioma platform was created for tablets, smartphones and PCs, to support data collection and clinical workflow, to promote constant communication between patients, caregivers and clinicians, and to promote active family involvement in day hospital (DH) procedures. Through the Assioma application for tablets, caregivers filled out an anamnestic questionnaire and explored contents on the DH procedures and neurodevelopmental conditions. The application for smartphones included an agenda function for the DH pathways. Through the application for desktops, clinicians could export anamnestic information in text and Excel formats, send real-time notifications, and push relative contents to families' account. We tested the usability and satisfaction of the Assioma platform in a group of children, caregivers (N = 24) and clinicians (N = 6). Both families and clinicians gave high scores to almost all usability items. The overall satisfaction reached the highest levels at 50% satisfied for families and at 33% for clinicians. Our results indicate that the Assioma platform has the potential to optimize clinical pathways, increasing compliance and clinical efficiency, and to reduce in-person contacts supporting social distancing for clinical pathways, a crucial need during the COVID-19 pandemic.
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Buitenweg D, van de Mheen D, Grund JP, van Oers H, van Nieuwenhuizen C. Visual and Personalized Quality of Life Assessment App for People With Severe Mental Health Problems: Qualitative Evaluation. JMIR Ment Health 2020; 7:e19593. [PMID: 33270036 PMCID: PMC7746488 DOI: 10.2196/19593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/16/2020] [Accepted: 07/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND QoL-ME is a digital visual personalized quality of life assessment app for people with severe mental health problems. Research reveals that e-mental health apps frequently suffer from low engagement and fall short of expectations regarding their impact on patients' daily lives. Studies often indicate that e-mental health apps ought to respect the needs and preferences of end users to achieve optimal user engagement. OBJECTIVE The aim of this study was to explore the experiences of users regarding the usability and functionality of QoL-ME and whether the app is actionable and beneficial for patients. METHODS End users (n=8) of QoL-ME contributed to semistructured interviews. An interview guide was used to direct the interviews. All interviews were audiorecorded and transcribed verbatim. Transcriptions were analyzed and coded thematically. RESULTS Analysis revealed 3 main themes: (1) benefit, (2) actionability, and (3) characteristics of the QoL-ME. The first theme reveals that the QoL-ME app was beneficial for the majority of respondents, primarily by prompting them to reflect on their quality of life. The current version is not yet actionable; the actionability of the QoL-ME app may be improved by enabling users to view their scores over time and by supplying practical advice for quality of life improvements. Overall, participants had positive experiences with the usability, design, and content of the app. CONCLUSIONS The QoL-ME app can be beneficial to users as it provides them with insight into their quality of life and elicits reflection. Incorporating more functionalities that facilitate self-management, such as advice and strategies for improving areas that are lacking, will likely make the app actionable. Patients positively regarded the usability, design, and contents of the QoL-ME app.
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Affiliation(s)
- David Buitenweg
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Geestelijke Gezondheids Zorg Eindhoven Institute for Mental Health Care, Eindhoven, Netherlands
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Hans van Oers
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Chijs van Nieuwenhuizen
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Geestelijke Gezondheids Zorg Eindhoven Institute for Mental Health Care, Eindhoven, Netherlands
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Rismawan W, Marchira CR, Rahmat I. Usability, Acceptability, and Adherence Rates of Mobile Application Interventions for Prevention or Treatment of Depression: A Systematic Review. J Psychosoc Nurs Ment Health Serv 2020; 59:41-47. [PMID: 33180949 DOI: 10.3928/02793695-20201104-02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
Mobile health applications (apps) have been growing as a new frontier in mental health care delivery. The objective of the current systematic review was to summarize the evidence regarding usability, acceptability, and adherence rates of mobile app interventions for prevention or treatment of depression. A literature search was conducted in relevant databases, including PubMed, PsycINFO, and Embase, for articles published between January 1, 2009, and August 1, 2019. Key terms used for searching included depression AND smartphone OR mobile AND application AND acceptability OR feasibility. Based on a full-text examination, seven studies were included for review. All studies were conducted in developed countries and five studies were developing a mobile app for depression treatment. The current study highlights the need for developers of mobile apps for individuals with mental health care needs to consider user acceptability and adherence rates. Innovation in designing a mobile app for individuals with depression is needed to improve the adherence rates of users. [Journal of Psychosocial Nursing and Mental Health Services, 59(2), 41-47.].
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Powell A, Torous J. A Patient-Centered Framework for Measuring the Economic Value of the Clinical Benefits of Digital Health Apps: Theoretical Modeling. JMIR Ment Health 2020; 7:e18812. [PMID: 33124995 PMCID: PMC7665948 DOI: 10.2196/18812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 09/07/2020] [Accepted: 09/15/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND As digital health tools such as smartphone apps evolve and enter clinical use, questions regarding their value must be addressed. Although there are scarce generalizable data on the value of health apps given their nascency and diverse use cases, it is possible to estimate the economic value of the clinical improvement they bring to patients using a quality-adjusted life-year (QALY)-based approach and generalized values from existing literature. OBJECTIVE This paper aims to provide a patient-centered framework for assessing the economic value of the clinical benefits delivered by digital health apps. METHODS We proposed a model based upon 5 levers: country-specific monetary value of a QALY, QALYs lost due to the condition, engagement rate of app users, average effect size of the app's health impact, and duration of the app's impact before remission. RESULTS Using 2 digital health apps from the United States and United Kingdom as examples, we explored how this model could generate country-specific estimates of the economic value of the clinical benefits of health apps. CONCLUSIONS This new framework can help drive research priorities for digital health by elucidating the factors that influence the economic value.
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Affiliation(s)
- Adam Powell
- Payer+Provider Syndicate, Boston, MA, United States
| | - John Torous
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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9
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La Porte LM, Kim JJ, Adams MG, Zagorsky BM, Gibbons R, Silver RK. Feasibility of perinatal mood screening and text messaging on patients' personal smartphones. Arch Womens Ment Health 2020; 23:181-188. [PMID: 31203440 DOI: 10.1007/s00737-019-00981-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 06/03/2019] [Indexed: 01/12/2023]
Abstract
Screens and adjunctive treatments for perinatal mood are available, but barriers prevent many women from receiving them. Mobile technology may help bypass barriers. The purpose of this study was to evaluate the feasibility of screening and texting perinatal women via their personal smartphones. This prospective cohort study enrolled 203 pregnant and postpartum women receiving obstetric care at a Midwestern US academic medical center. Participants received one electronic mood screen and three text messages per week for two weeks. Texts were based on the Mothers and Babies Course, a CBT-based preventative program that addresses limited social support, lack of pleasant activities, and harmful thought patterns. Feasibility was defined as the ability to take the mood screen and receive texts without technical difficulties. Demographic variables were paired with results. Insurance type (private or public) was used as a proxy for socioeconomic status. Pearson chi-squared tests were used to analyze the data. A text-based satisfaction survey was also administered. The sample was 72% privately insured and 28% publicly insured. Sixty-seven percent completed electronic screening. Screen completion was significantly associated with private insurance (OR = 3.8, 95% CI 2.00-7.30) and "married" status (OR = 1.93, 95% CI 1.01-3.70). Most survey respondents (92%) found it easy to receive the texts, and 76% responded with very favorable comments about the texts. Smartphone mood screening and supportive texting were technically feasible. Screen completion was lower among single women with public insurance.
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Affiliation(s)
- Laura M La Porte
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Avenue, Walgreen Suite 1507, Evanston, IL, 60201, USA
| | - J Jo Kim
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Avenue, Walgreen Suite 1507, Evanston, IL, 60201, USA.,Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, 924 E 57th St Suite 104, Chicago, IL, 60637, USA
| | - Marci G Adams
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Avenue, Walgreen Suite 1507, Evanston, IL, 60201, USA
| | | | - Robert Gibbons
- Division of Biological Sciences, University of Chicago, 5801 S Ellis Ave, Chicago, IL, 60637, USA
| | - Richard K Silver
- Department of Obstetrics and Gynecology, NorthShore University HealthSystem, 2650 Ridge Avenue, Walgreen Suite 1507, Evanston, IL, 60201, USA. .,Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, 924 E 57th St Suite 104, Chicago, IL, 60637, USA.
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10
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Ramos RM, Cheng PGF, Jonas SM. Validation of an mHealth App for Depression Screening and Monitoring (Psychologist in a Pocket): Correlational Study and Concurrence Analysis. JMIR Mhealth Uhealth 2019; 7:e12051. [PMID: 31538946 PMCID: PMC6754681 DOI: 10.2196/12051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 03/21/2019] [Accepted: 07/28/2019] [Indexed: 12/30/2022] Open
Abstract
Background Mobile health (mHealth) is a fast-growing professional sector. As of 2016, there were more than 259,000 mHealth apps available internationally. Although mHealth apps are growing in acceptance, relatively little attention and limited efforts have been invested to establish their scientific integrity through statistical validation. This paper presents the external validation of Psychologist in a Pocket (PiaP), an Android-based mental mHealth app which supports traditional approaches in depression screening and monitoring through the analysis of electronic text inputs in communication apps. Objective The main objectives of the study were (1) to externally validate the construct of the depression lexicon of PiaP with standardized psychological paper-and-pencil tools and (2) to determine the comparability of PiaP, a new depression measure, with a psychological gold standard in identifying depression. Methods College participants downloaded PiaP for a 2-week administration. Afterward, they were asked to complete 4 psychological depression instruments. Furthermore, 1-week and 2-week PiaP total scores (PTS) were correlated with (1) Beck Depression Index (BDI)-II and Center for Epidemiological Studies–Depression (CES-D) Scale for congruent construct validation, (2) Affect Balance Scale (ABS)–Negative Affect for convergent construct validation, and (3) Satisfaction With Life Scale (SWLS) and ABS–Positive Affect for divergent construct validation. In addition, concordance analysis between PiaP and BDI-II was performed. Results On the basis of the Pearson product-moment correlation, significant positive correlations exist between (1) 1-week PTS and CES-D Scale, (2) 2-week PTS and BDI-II, and (3) PiaP 2-week PTS and SWLS. Concordance analysis (Bland-Altman plot and analysis) suggested that PiaP’s approach to depression screening is comparable with the gold standard (BDI-II). Conclusions The evaluation of mental health has historically relied on subjective measurements. With the integration of novel approaches using mobile technology (and, by extension, mHealth apps) in mental health care, the validation process becomes more compelling to ensure their accuracy and credibility. This study suggests that PiaP’s approach to depression screening by analyzing electronic data is comparable with traditional and well-established depression instruments and can be used to augment the process of measuring depression symptoms.
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Affiliation(s)
- Roann Munoz Ramos
- Department of Medical Informatics, RWTH Aachen University Hospital, Aachen, Germany.,College of Education, Graduate Studies, De La Salle University-Dasmarinas, Dasmarinas City, Cavite, Philippines
| | - Paula Glenda Ferrer Cheng
- Vivech System Solutions Inc, Manila, Philippines.,Department of Psychology, College of Science, University of Santo Tomas, Manila, Philippines
| | - Stephan Michael Jonas
- Department of Medical Informatics, RWTH Aachen University Hospital, Aachen, Germany.,Department of Informatics, Technical University of Münich, Münich, Germany
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11
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Carlo AD, Hosseini Ghomi R, Renn BN, Areán PA. By the numbers: ratings and utilization of behavioral health mobile applications. NPJ Digit Med 2019; 2:54. [PMID: 31304400 PMCID: PMC6572775 DOI: 10.1038/s41746-019-0129-6] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/24/2019] [Indexed: 01/10/2023] Open
Abstract
Although >10,000 behavioral health applications ("apps") are currently available on the Apple and Google Play marketplaces, they have been minimally evaluated or regulated and little is known about "real world" usage patterns. This investigation combined data from online behavioral health app rating frameworks and a mobile health market research firm to identify the most downloaded apps as well as determine rating and ranking concordance between frameworks. Findings demonstrated that the most commonly downloaded apps focus on relaxation, mindfulness, and meditation skills and that they often have notably discordant reviews across rating frameworks. Our results suggest that there is a growing need for: (1) standardized behavioral health app quality and effectiveness measures, (2) up-to-date behavioral health app guidance for clinicians and consumers, and (3) evidence-based apps that incorporate revealed consumer preferences.
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Affiliation(s)
- Andrew D. Carlo
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA USA
| | | | - Brenna N. Renn
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA USA
| | - Patricia A. Areán
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA USA
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12
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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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13
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Gruszka P, Burger C, Jensen MP. Optimizing Expectations via Mobile Apps: A New Approach for Examining and Enhancing Placebo Effects. Front Psychiatry 2019; 10:365. [PMID: 31214057 PMCID: PMC6554680 DOI: 10.3389/fpsyt.2019.00365] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/13/2019] [Indexed: 12/12/2022] Open
Abstract
There is growing interest in interventions that enhance placebo responses in clinical practice, given the possibility that this would lead to better patient health and more effective therapy outcomes. Previous studies suggest that placebo effects can be maximized by optimizing patients' outcome expectations. However, expectancy interventions are difficult to validate because of methodological challenges, such as reliable blinding of the clinician providing the intervention. Here we propose a novel approach using mobile apps that can provide highly standardized expectancy interventions in a blinded manner, while at the same time assessing data in everyday life using experience sampling methodology (e.g., symptom severity, expectations) and data from smartphone sensors. Methodological advantages include: 1) full standardization; 2) reliable blinding and randomization; 3) disentangling expectation effects from other factors associated with face-to-face interventions; 4) assessing short-term (days), long-term (months), and cumulative effects of expectancy interventions; and 5) investigating possible mechanisms of change. Randomization and expectancy interventions can be realized by the app (e.g., after the clinic/lab visit). As a result, studies can be blinded without the possibility for the clinician to influence study outcomes. Possible app-based expectancy interventions include, for example, verbal suggestions and imagery exercises, although a large number of possible interventions (e.g., hypnosis) could be evaluated using this innovative approach.
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Affiliation(s)
- Piotr Gruszka
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Christoph Burger
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
- Department of Applied Psychology: Work, Education and Economy, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
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14
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Hidalgo-Mazzei D, Nikolova VL, Kitchen S, Young AH. Internet-connected devices ownership, use and interests in bipolar disorder: from desktop to mobile mental health. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/2575517x.2019.1616476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Diego Hidalgo-Mazzei
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Mental Health Group, IMIM-Hospital del Mar, Barcelona, CA, Spain
| | - Viktoriya L. Nikolova
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Allan H. Young
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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15
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Chiauzzi E, Newell A. Mental Health Apps in Psychiatric Treatment: A Patient Perspective on Real World Technology Usage. JMIR Ment Health 2019; 6:e12292. [PMID: 31008711 PMCID: PMC6658296 DOI: 10.2196/12292] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/29/2019] [Accepted: 03/12/2019] [Indexed: 01/06/2023] Open
Abstract
For many people who use mobile apps, the primary motivations are entertainment, news, gaming, social connections, or productivity. For those experiencing health problems, particularly those with chronic conditions such as psychiatric disorders, the stakes are much higher. The digital tools that they select may be the difference between improvement and decompensation or even life and death. Although there has been a wide expansion of mental health apps with promise as well as hype, the current means of researching, evaluating, and deploying effective tools have been problematic. As a means of gaining a perspective that moves beyond usability testing, surveys, and app ratings, the primary objective of this patient perspective is to question the killer app and condition-specific mentality of current mental health app development. We do this by reviewing the current mobile mental health app literature, identifying ways in which psychiatric patients use apps in their lives, and then exploring how these issues are experienced by a software engineer who has struggled with her bipolar disorder for many years. Her lived experience combined with a technology perspective offers potential avenues for using technology productively in psychiatric treatment. We believe that this responds to JMIR Publications' call for patient perspective papers and provides encouragement for patients to share their views on mental health and technology.
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16
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Satinsky EN, Driessens C, Crepaz-Keay D, Kousoulis A. Mental health service users' perceptions of data sharing and data protection: a qualitative report. JOURNAL OF INNOVATION IN HEALTH INFORMATICS 2018; 25:239-242. [PMID: 30672404 DOI: 10.14236/jhi.v25i4.1033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To improve health services, social, economic and health data should be shared and linked to create a full narrative of lived experience. Mental health data sharing is often considered a particularly sensitive area. OBJECTIVE To assess mental health service users' perceptions regarding the current practice of administrative data-driven research. METHOD We conducted a focus group using case study scenarios. Themes and subthemes were analysed using qualitative methods. RESULTS Participants were generally happy for data owners to share their health, social and economic data if the purpose was transparent and if the information would inform and improve health policy and practice. Participants were less keen on sharing data through digital applications. CONCLUSION This case study informs a data linkage study protocol. Research teams and database owners should strive to educate service users on data protection and create dissent opportunities.
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17
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Hidalgo-Mazzei D, Reinares M, Mateu A, Nikolova VL, Bonnín CDM, Samalin L, García-Estela A, Pérez-Solá V, Young AH, Strejilevich S, Vieta E, Colom F. OpenSIMPLe: A real-world implementation feasibility study of a smartphone-based psychoeducation programme for bipolar disorder. J Affect Disord 2018; 241:436-445. [PMID: 30145515 DOI: 10.1016/j.jad.2018.08.048] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/19/2018] [Accepted: 08/12/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Few evidence-based mental health apps are widely available to patients and, conversely, many of the available apps have not been appropriately evaluated. Given that the ultimate goal is to scale-up and open internet-based platforms (IBP), it is crucial to appropriately evaluate their real-world feasibility beforehand. We aimed to evaluate the implementation feasibility of a smartphone-based psychoeducational programme for bipolar disorder, exploring its long-term retention, usability, perceived helpfulness and satisfaction, alongside its impact on secondary health outcomes. METHODS Participants were recruited via the project website after completing an online screening questionnaire. They were requested to complete web-based questionnaires before using the app and after 6 months of use which included sociodemographic, illness and treatment variables, the world health organisation-five well-being index (WHO-5) and the short form health survey (SF-36). The follow-up questionnaires also contained satisfaction and usefulness questions. RESULTS 201 participants took part in the study. According to their retention, 66.2% of the participants were classified as noncompleters and 33.8% as completers. The only predictor significantly associated with higher odds of retention was older age (OR = 1.021, p < 0.001). 62% of the users reported they were satisfied with the programme with a higher percentage among completers. Who-5 baseline and follow-up scores showed a significant improvement as well as 6 out of 8 domains of the SF-36. LIMITATIONS Screening and outcome measures were administered using exclusively self-reported online methods. CONCLUSION The 6-month attrition rate of the programme was high. Positive outcomes regarding satisfaction were found predominantly among completers. The optimal dosage and retention of IBP mental health programmes remain challenging issues that need further research.
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Affiliation(s)
- Diego Hidalgo-Mazzei
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - María Reinares
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ainoa Mateu
- Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Viktoriya L Nikolova
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Caterina Del Mar Bonnín
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Auvergne, EA 7280, Clermont-Ferrand, France
| | - Aitana García-Estela
- Mental Health Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques)-Hospital del Mar,CIBERSAM, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- Mental Health Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques)-Hospital del Mar,CIBERSAM, Barcelona, Catalonia, Spain
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sergio Strejilevich
- Bipolar Disorder Programme, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina
| | - Eduard Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Francesc Colom
- Mental Health Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques)-Hospital del Mar,CIBERSAM, Barcelona, Catalonia, Spain
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18
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Kim JW, Torous J, Chan S, Gipson SYMT. Developing a Digitally Informed Curriculum in Psychiatry Education and Clinical Practice. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:782-790. [PMID: 29473134 DOI: 10.1007/s40596-018-0895-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Jung Won Kim
- University of Alabama at Birmingham, Birmingham, AL, USA.
| | | | - Steven Chan
- University of California at San Francisco, San Francisco, CA, USA
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19
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Yellowlees P. The Need to Develop Specialized Formularies of Apps and Web-Based Tools. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:677-678. [PMID: 30155602 DOI: 10.1007/s40596-018-0971-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 06/08/2023]
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20
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The Emerging Imperative for a Consensus Approach Toward the Rating and Clinical Recommendation of Mental Health Apps. J Nerv Ment Dis 2018; 206:662-666. [PMID: 30020203 DOI: 10.1097/nmd.0000000000000864] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
With over 10,000 mental health- and psychiatry-related smartphone apps available today and expanding, there is a need for reliable and valid evaluation of these digital tools. However, the updating and nonstatic nature of smartphone apps, expanding privacy concerns, varying degrees of usability, and evolving interoperability standards, among other factors, present serious challenges for app evaluation. In this article, we provide a narrative review of various schemes toward app evaluations, including commercial app store metrics, government initiatives, patient-centric approaches, point-based scoring, academic platforms, and expert review systems. We demonstrate that these different approaches toward app evaluation each offer unique benefits but often do not agree to each other and produce varied conclusions as to which apps are useful or not. Although there are no simple solutions, we briefly introduce a new initiative that aims to unify the current controversies in app elevation called CHART (Collaborative Health App Rating Teams), which will be further discussed in a second article in this series.
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21
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Myers K, Cummings JR, Zima B, Oberleitner R, Roth D, Merry SM, Bohr Y, Stasiak K. Advances in Asynchronous Telehealth Technologies to Improve Access and Quality of Mental Health Care for Children and Adolescents. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s41347-018-0055-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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22
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Parish MB, Fazio S, Chan S, Yellowlees PM. Managing Psychiatrist-Patient Relationships in the Digital Age: a Summary Review of the Impact of Technology-enabled Care on Clinical Processes and Rapport. Curr Psychiatry Rep 2017; 19:90. [PMID: 29075951 DOI: 10.1007/s11920-017-0839-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Participatory medicine and the availability of commercial technologies have given patients more options to view and track their health information and to communicate with their providers. This shift in the clinical process may be of particular importance in mental healthcare where rapport plays a significant role in the therapeutic process. RECENT FINDINGS In this review, we examined literature related to the impact of technology on the clinical workflow and patient-provider rapport in the mental health field between January 2014 and June 2017. Thirty three relevant articles, of 226 identified articles, were summarized. The use of technology clinically has evolved from making care more accessible and efficient to leveraging technology to improve care, communication, and patient-provider rapport. Evidence exists demonstrating that information and communication technologies may improve care by better connecting patients and providers and by improving patient-provider rapport, although further research is needed.
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Affiliation(s)
- Michelle Burke Parish
- Department of Psychiatry, University of California Davis, Sacramento, CA, USA.
- Betty Irene Moore School of Nursing, University of California Davis, 2570 48th St, Sacramento, CA, 95817, USA.
| | - Sarina Fazio
- Betty Irene Moore School of Nursing, University of California Davis, 2570 48th St, Sacramento, CA, 95817, USA
| | - Steven Chan
- Department of Psychiatry, University of California Davis, Sacramento, CA, USA
- Division of Hospital Medicine, Clinical Informatics, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Peter M Yellowlees
- Department of Psychiatry, University of California Davis, Sacramento, CA, USA
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23
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Biagianti B, Hidalgo-Mazzei D, Meyer N. Developing digital interventions for people living with serious mental illness: perspectives from three mHealth studies. EVIDENCE-BASED MENTAL HEALTH 2017; 20:98-101. [PMID: 29025862 PMCID: PMC5750413 DOI: 10.1136/eb-2017-102765] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/10/2017] [Accepted: 09/13/2017] [Indexed: 12/29/2022]
Abstract
The rapidly expanding field of mobile health (mHealth) seeks to harness increasingly affordable and ubiquitous mobile digital technologies including smartphones, tablets, apps and wearable devices to enhance clinical care. Accumulating evidence suggests that mHealth interventions are increasingly being adopted and valued by people living with serious mental illnesses such as schizophrenia and bipolar disorder, as a means of better understanding and managing their condition. We draw on experiences from three geographically and methodologically distinct mHealth studies to provide a pragmatic overview of the key challenges and considerations relating to the process of developing digital interventions for this population.
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Affiliation(s)
- Bruno Biagianti
- Department of Psychiatry, University of California at San Francisco, San Francisco, California, USA.,Department of Health Sciences, University of Milan, Milan, Italy.,Research and Development, Posit Science Inc., San Francisco, California, USA
| | - Diego Hidalgo-Mazzei
- Department of Psychiatry and Psychology, Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Nicholas Meyer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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24
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Anton MT, Jones DJ. Adoption of Technology-Enhanced Treatments: Conceptual and Practical Considerations. ACTA ACUST UNITED AC 2017; 24:223-240. [PMID: 28966479 DOI: 10.1111/cpsp.12197] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As the efficacy of technology-enhanced mental health service delivery models (i.e., supportive or adjunctive technological tools) are examined, we must inform and guide clinician decision-making regarding acceptance and, in turn, uptake. Accordingly, this review aims to move beyond traditional discussions of geographic barriers by integrating, reconciling, and extending literatures on dissemination and implementation, as well as technology uptake, in order to anticipate and address organizational and clinician barriers to adoption of technology-enhancements. Specifically, a five-stage model is proposed to address organizational readiness for and clinician acceptance of technology-enhancements to evidence-based treatments, as well as the relevance of current adoption strategies for technology-enhanced services. Our aim is to provide a guiding framework for future research and practice.
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Affiliation(s)
- Margaret T Anton
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Deborah J Jones
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
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25
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Torous J, Levin ME, Ahern DK, Oser ML. Cognitive Behavioral Mobile Applications: Clinical Studies, Marketplace Overview, and Research Agenda. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2016.05.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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26
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Breitborde NJK, Moe AM, Ered A, Ellman LM, Bell EK. Optimizing psychosocial interventions in first-episode psychosis: current perspectives and future directions. Psychol Res Behav Manag 2017; 10:119-128. [PMID: 28490910 PMCID: PMC5414722 DOI: 10.2147/prbm.s111593] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Psychotic-spectrum disorders such as schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features are devastating illnesses accompanied by high levels of morbidity and mortality. Growing evidence suggests that outcomes for individuals with psychotic-spectrum disorders can be meaningfully improved by increasing the quality of mental health care provided to these individuals and reducing the delay between the first onset of psychotic symptoms and the receipt of adequate psychiatric care. More specifically, multicomponent treatment packages that 1) simultaneously target multiple symptomatic and functional needs and 2) are provided as soon as possible following the initial onset of psychotic symptoms appear to have disproportionately positive effects on the course of psychotic-spectrum disorders. Yet, despite the benefit of multicomponent care for first-episode psychosis, clinical and functional outcomes among individuals with first-episode psychosis participating in such services are still suboptimal. Thus, the goal of this review is to highlight putative strategies to improve care for individuals with first-episode psychosis with specific attention to optimizing psychosocial interventions. To address this goal, we highlight four burgeoning areas of research with regard to optimization of psychosocial interventions for first-episode psychosis: 1) reducing the delay in receipt of evidence-based psychosocial treatments; 2) synergistic pairing of psychosocial interventions; 3) personalized delivery of psychosocial interventions; and 4) technological enhancement of psychosocial interventions. Future research on these topics has the potential to optimize the treatment response to evidence-based psychosocial interventions and to enhance the improved (but still suboptimal) treatment outcomes commonly experienced by individuals with first-episode psychosis.
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Affiliation(s)
- Nicholas JK Breitborde
- Department of Psychiatry and Behavioral Health
- Department of Psychology, The Ohio State University, Columbus, OH
| | | | - Arielle Ered
- Department of Psychology, Temple University, Philadelphia, PA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA
| | - Emily K Bell
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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27
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Confidentiality and Privacy for Smartphone Applications in Child and Adolescent Psychiatry: Unmet Needs and Practical Solutions. Child Adolesc Psychiatr Clin N Am 2017; 26:117-124. [PMID: 27837937 DOI: 10.1016/j.chc.2016.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This article summarizes the current literature on clinical knowledge and practical gaps regarding the confidentiality and privacy for smartphone and connected devices in child and adolescent psychiatry and offers practical solutions and consideration for the next steps for the field. Important issues to consider include disclosure of information sharing, access privilege, privacy and trust, risk and benefit analysis, and the need for standardization. Through understanding the privacy and confidentiality concerns regarding digital devices, child and adolescent psychiatrists can guide patients and parents though informed decision-making and also help shape how the field creates the next generation of these tools.
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28
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The Interactive Mobile App Review Toolkit (IMART): a Clinical Practice-Oriented System. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s41347-016-0005-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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29
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Electronic monitoring of self-reported mood: the return of the subjective? Int J Bipolar Disord 2016; 4:28. [PMID: 27900735 PMCID: PMC5127918 DOI: 10.1186/s40345-016-0069-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 11/19/2016] [Indexed: 11/10/2022] Open
Abstract
This narrative review describes recent developments in the use of technology for utilizing the self-monitoring of mood, provides some relevant background, and suggests some promising directions. Subjective experience of mood is one of the valuable sources of information about the state of an integrated mind/brain system. During the past century, psychiatry and psychology moved away from subjectivity, emphasizing external observation, precise measurement, and laboratory techniques. This shift, however, provided only a limited improvement in the understanding of mood disorders, and it appears that self-monitoring of mood has the potential to enrich our knowledge, particularly when combined with the advances in technology. Modern technology, with its ability to transfer information from the individual directly to the researcher via electronic applications, enables us now to study mood regulation more thoroughly. Frequent subjective ratings can be helpful in identifying individualized treatment with effective mood stabilizers and recognizing subtypes of mood disorders. The variability of subjective ratings may also help us estimate the increased risk of recurrence and guide a tailored treatment.
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30
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Torous J, Powell A, Knable MB. Quality Assessment of Self-Directed Software and Mobile Applications for the Treatment of Mental Illness. Psychiatr Ann 2016. [DOI: 10.3928/00485713-20160908-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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