Mohr DC, Lyon AR, Lattie EG, Reddy M, Schueller SM. (2017). Accelerating digital mental health research from early design and creation to successful implementation and sustainment. Journal of Medical Internet Research. 19(5): e153. doi: 10.2196/jmir.7725
The authors highlight three major challenges in digital mental health research: lengthy research processes, digital intervention designs that fail to fit clinician and consumer needs and lifestyles, and relatively small samples recruited online that have questionable generalizability to the many members of the target population using the internet (i.e. the denominator problem). To address these challenges, the authors describe the Accelerated Creation-to-Sustainment (ACTS) model. ACTS includes three phases: create, hybrid trial, and sustainment. Each phase involves iterative design and evaluation processes. The create phase involves the development of digital interventions and strategies for implementation and sustainment. The authors emphasize the importance of user-centered design (i.e. collaboration with stakeholders throughout the design process) to ensure that the final products meet stakeholder needs. The OEI hybrid trial phase involves completing optimization, evaluation, and implementation (OEI) trials concurrently. Results from the OEI hybrid trial can inform intervention modifications. OEI hybrid trials can reduce the time needed to evaluate and implement a digital intervention compared to completing the trials sequentially. Finally, the sustainment phase involves gradually removing research support and unobtrusively monitoring sustainment in practice.