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Tag: acceptability

Training Staff Across the Veterans Affairs Health Care System to Use Mobile Mental Health Apps: A National Quality Improvement Project

McGee-Vincent P, Mackintosh M, Jamison A, Juhasz K, Becket-Davenport C, Bosch J, Avery T, Glamb L, Hampole S. Training Staff Across the Veterans Affairs Health Care System to Use Mobile Mental Health Apps: A National Quality Improvement Project. JMIR Ment Health 2023;10:e41773 DOI: 10.2196/41773

This paper described and evaluated a training program for staff in the Veterans Affairs (VA) healthcare system to increase the reach of mobile mental health apps for veterans. Sites from all VA’s geographic regions were enrolled in this study with at least 25 staff members with direct contact with veterans recruited to participate. A total of 1110 staff from 19 VA sites completed the training program. Sixty-seven percent of participants provided mental health care. Staff training was delivered via a live, web-based format and consisted of a 3-hour core module for all staff and 1-hour module designed specifically for mental health clinicians. Program reach, satisfaction, and effectiveness of the training were assessed pre- and post-training by staff self-reported surveys. Most participants (93.9%) were satisfied with the training and 92.4% would recommend it to other staff. Knowledge about mobile apps and confidence in ability to demonstrate to veterans how to install and use mental health apps significantly increased after training (p<.001). Participants also expressed motivation to refer veterans to apps and encourage other VA staff to share apps with veterans. Overall, this study exceeded their recruitment target, indicating a higher-than-anticipated interest among staff. Further, the training program was well received and effective in promoting awareness about and motivation to recommend mobile health apps. About a third of participants came from other settings besides mental health, which suggests the value of VA mental health apps across the healthcare system. Future work is needed to evaluate the extent to which providers follow up on recommending mobile health apps to patients and patients accessing the mobile health apps.


A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination

Shroff A, Roulston C, Fassler J, Dierschke N, Todd J, Ríos-Herrera Á, Plastino K, Schleider J. A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination. JMIR Ment Health 2023;10:e43062. DOI: 10.2196/43062

An academic-community partnership was created to culturally adapt, disseminate, and gauge the acceptability and utility of an evidence-based digital mental health platform, Project Youth Empowerment and Support (YES), among English and Spanish speaking youth in south Texas. The three digital self-guided single-session interventions (SSIs) in Project YES were culturally adapted and revised in collaboration with youth stakeholders and translated to Spanish. pre-post exploratory study investigated acceptability and efficacy of Project YES on hopelessness, agency, perceived control, and self-hate. Participants aged 11 to 17 years and residing in San Antonio, Texas and the surrounding areas were recruited via social media ads, referrals, schools, and community centers. A total of 1801 youths began and 894 (49.6%) selected and completed one 30-minute SSI within the Project YES website. Data was collected via self-reported surveys before participants started a SSI and following the completion of the SSI. Participants rated the Project YES as enjoyable, easy to understand, easy to use, helpful, and would recommend to others (mean at least 3.5 out of 5.0) for both language versions Youth in Project YES (English version) reported significant improvements in hopelessness (Cohen d=0.33, p<.001), self-hate (Cohen d=0.27, p<.001) and agency (Cohen d=0.25, p<.001) post-intervention, relative to pre-intervention. Youth in Project YES (Spanish version) reported significant improvements in self-hate (Cohen d=0.37, p=.05) from before to after the intervention. Overall, the culturally adapted Project YES demonstrated to be an acceptable, accessible, and effective mental health support for English and Spanish speaking youth. The San Antonio community partnerships fostered broad recruitment and retention rates.


The Feasibility, Acceptability, and Initial Efficacy of a Remotely Delivered, Financial-Incentive Intervention to Initiate Vaping Abstinence in Young Adults

Raiff BR, Newman ST, Upton CR & Burrows CA. (2022). The feasibility, acceptability, and initial efficacy of a remotely delivered, financial-incentive intervention to initiate vaping abstinence in young adults. Experimental and Clinical Psychopharmacology, 30(5), 632–641.

This study investigated the feasibility, acceptability, and preliminary efficacy of a remotely delivered intervention with financial incentives to promote vaping abstinence among young adults. Participants were recruited via a university email listserv and were between 18-35 years old, reported current vaping, and a desire to quit vaping. Eight participants were enrolled, given home cotinine saliva test kits (NicAlert and iScreen), and asked to abstain from vaping for 14 days. Live video meetings were scheduled every other day and provided the opportunity for participants to share their quitting process and receive support and guidance. All participants earned financial rewards for submission of their cotinine tests and escalating bonus rewards (increasing by $5 for each subsequent negative sample) for each cotinine negative sample at baseline and during the 14-day study. At the end of the study, participants completed exit survey questions on vaping behavior change and acceptability of study procedures. All participants completed 100% of video calls and were abstinent from vaping during the 2-week treatment period. Participants reported high favorability scores for the intervention (9.75-10 out of 10) related to convenience, effectiveness to help quit vaping, and fairness, and would recommend the intervention to someone else. Results also showed that cotinine levels decreased as financial bonuses for negative tests increased. This study provides a promising, acceptable, and safe approach to helping people stop vaping for 2 weeks. Future research should focus on exploring strategies for long-term sustainability of incentive-based interventions for vaping abstinence.


Augmenting project ECHO for opioid use disorder with data‑informed quality improvement

Murray OB, Doyle M, McLeman BM, Marsch LA, Saunders EC, Cox KM, Watts D, Ryder J. Augmenting project ECHO for opioid use disorder with data-informed quality improvement. Addict Sci Clin Pract 18, 24 (2023).

Learning collaboratives can address barriers to medication for opioid use disorder availability by training clinic staff on best-practice performance data collection and quality improvement (QI). Project ECHO is an evidence-based method using teleconferencing to link experts with community-based providers to enhance opioid use disorder (OUD) care. This study examined the feasibility of training of 18 clinics in New Hampshire using an additional component, ECHO-AMPLIFI, to collect and review performance data and develop QI initiatives for best practice of OUD care. Feasibility was assessed descriptively through each clinic’s participation in training sessions, data collection, and QI initiatives. At the end of the project, clinic staff completed surveys on their perspectives of usability and acceptability of the project. Five of the 18 clinics joined the ECHO-AMPLIFI project for 8 months and met the minimum engagement requirements (completed at least one training session, at least one month of performance data, and at least one QI initiative). Results from staff surveys showed the training and data collection was useful. However, there were several problems identified with data collection, including lack of staff time and lack of standardization of documentation in electronic health records. Findings indicate that implementing performance data-informed QI as a supplement to Project ECHO has potential to inform best practices, but challenges to collecting consistent performance data must be addressed. Future assessments could provide further information on the utility of performance data in helping clinics.


Combined Laboratory and Field Test of a Smartphone Breath Alcohol Device and Blood Alcohol Concentration Estimator to Facilitate Moderate Drinking Among Young Adults

Leeman RF, Berey BL, Frohe T, Rowland BHP, Martens MP, Fucito LM, Stellefson M, Nixon SJ, & O’Malley SS. (2022). A combined laboratory and field test of a smartphone breath alcohol device and blood alcohol concentration estimator to facilitate moderate drinking among young adults. Psychology of Addictive Behaviors, 36(6), 710–723.

This paper evaluated feasibility, usability, acceptability, and efficacy of blood alcohol content (BAC) related moderate drinking technology during a laboratory alcohol self-administration session and follow-up field test in real-world situations. Participants were randomly assigned to 1 of 3 technologies to use during a laboratory alcohol drinking session: (1) breathalyzer alcohol device connected to an app, (2) BAC estimator app where participants make entries about drinking behavior, and (3) a self-texting control condition where participants send a text after each alcoholic drink consumed. All participants completed a laboratory alcohol-drinking session while using the assigned technology procedure. After this session, participants were instructed to use all three forms of technologies for two weeks. At the end of the field-testing period, acceptability, usability, and perspectives on all three technologies were The breathalyzer and BAC estimator app both had favorable acceptability and usability ratings. Participants used at least one form of technology on 67% of drinking days. Based on self-reported data, as also significantly lower during the field-test period than at baseline. Overall, combining lab and field methods to test drinking technologies was feasible among young adults. Results support the potential of mobile interventions to help young adults in motivating behavior change given their willingness to use apps.


I-CARE: Feasibility, Acceptability, and Appropriateness of a Digital Health Intervention for Youth Experiencing Mental Health Boarding

Leyenaar JK, Arakelyan M, Acquilano SC, Gilbert TL, Craig JT, Lee CN, Kodak SG, Ignatova E, Mudge LA, House SA, Brady RE. I-CARE: Feasibility, Acceptability, and Appropriateness of a Digital Health Intervention for Youth Experiencing Mental Health Boarding. J Adolesc Health. 2023 Mar 2:S1054-139X(23)00062-9. doi: 10.1016/j.jadohealth.2023.01.015. Epub ahead of print. PMID: 36870901.

A modular digital intervention was developed to facilitate delivery of evidence-based psychosocial skills by non-mental health clinicians for youth with expressed suicidality. The paper describes pilot mixed method findings on the intervention’s effectiveness, feasibility, acceptability, and appropriateness. The intervention, I-CARE, consisted of seven modules grounded in cognitive behavior therapy and were delivered via a table computer with videos and practice activities. Licensed nursing assistants provided one-on-one supervision and facilitated the intervention. I-CARE was implemented in a pediatric hospital with 24 patients aged 12-17 years hospitalized due to suicidal ideation or attempt. Clinical outcomes were assessed by self-reported surveys at hospital admission and 24 hours before hospital discharge. Emotional distress significantly decreased after participation (6.3 points on 63-point scale). There were no significant changes in engagement readiness and illness severity. Majority of youth, caregivers and clinicians rated I-CARE as feasible (98%, N=39), acceptable (90%, N=36), and appropriate (78%, N=31). Overall, I-CARE was feasible to implement and acceptable to end-users and demonstrated preliminary positive impact on emotional distress for suicidal young people in psychiatric hospitalization.



Supporting people affected by problematic alcohol, substance use and other behaviours under pandemic conditions: A pragmatic evaluation of how SMART recovery Australia responded to COVID-19

Beck AK, Larance B, Baker AL, Deane FP, Manning V, Hides L, & Kelly PJ. (2023). Supporting people affected by problematic alcohol, substance use and other behaviours under pandemic conditions: A pragmatic evaluation of how SMART recovery Australia responded to COVID-19. Addictive Behaviors, 139, 107577–107577.

Researchers conducted a pragmatic evaluation of the scaling up of online, group-based addiction services during the COVID-19 pandemic. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) was applied to analyze the SMART Recovery Australia (SRAU) online program for 12 months and at 2-month follow-up. SRAU is a mutual-help program based on a four-point curriculum (building motivation, coping with urges, problem solving, and lifestyle balance) and led by a trained facilitator via Zoom. Before the pandemic, there were only 6 online groups and SRAU aimed to expand this service during the pandemic by developing 100 groups. Data was collected by online self-report participant surveys, Zoom data analytics on meetings and attendees, and administrative logs of third-party providers. During the 12-month evaluation period, the number of online groups increased from 6 to 132. A total of 2786 meetings were delivered with 41,752 attendees. Participant survey results (N=1052) showed that 91% of participants were highly engaged and 92% had positive experiences with the online group meetings. Further, 91% of participants who had experienced the in-person format rated their online experience as equivalent or better. However, 21% reported technical difficulties. The average number of meetings delivered and number of attendees per month were sustained at the two-month follow-up. Overall, SRAU achieved the goal of establishing at least 100 online mutual-help groups in response to the COVID-19 pandemic. Results support the acceptability and sustainability of delivering groups online for substance use behaviors.


Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain

Anderson Goodell EM, Nordeck C, Finan PH, Vandrey R, Dunn KE, & Thrul J. (2021). Feasibility and acceptability of using smartphone-based EMA to assess patterns of prescription opioid and medical cannabis use among individuals with chronic pain. Internet Interventions: the Application of Information Technology in Mental and Behavioural Health, 26, 100460–100460.

This paper described the feasibility and acceptability of a smartphone-based Ecological Momentary Assessment (EMA) data collection tool among people who use multiple substances and suffer from chronic pain. Forty-six participants were recruited through targeted Facebook and Instagram advertisements and completed screening via the link in the ads. Eligible participants had an opioid medication prescription, current opioid use, a pain disorder, and a referral for medical cannabis. Participants completed prompted EMA surveys on a mobile app for 30 days. Surveys included questions about opioid medication use, medical cannabis use, and pain symptoms. Participants were prompted to respond to four randomly timed surveys (assessing the past hour) and one daily diary per day. A subsample of 10 participants completed qualitative interviews. On average, participants responded to 70% of past-hour surveys and 92% of daily diaries. During qualitative interviews, participants reported an overall positive experience, but identified some issues related to smartphone notifications, redundant questions, or being prompted to complete assessments when they do not feel well. Findings demonstrate the feasibility and general acceptability of using this methodology for examining patterns of medical cannabis and prescription opioid medication use among individuals with chronic pain. Engagement with the digital tool over the 30-day duration was comparable to previous work. This study has implications for informing larger-scale epidemiology studies, interventions, and assessments on a wider geographic scale.


Parent-Based Prevention of Bullying and Cyberbullying During COVID-19 Social Distancing: A Pilot Intervention using the MOST Framework

Doty J, Gabrielli J, Abraczinskas M, Giron K, Yourell J, Stormshak E. Parent-Based Prevention of Bullying and Cyberbullying During COVID-19 Social Distancing: A Pilot Intervention using the MOST Framework. J of Prevention 43, 719–734 (2022).

This pilot study investigated satisfaction and acceptability of an evidence-based parenting intervention enhanced to address bullying and cyberbullying. The Everyday Parenting intervention focuses on content on positive reinforcement, monitoring daily activities, setting limits, negotiation, and positive parenting. This program was enhanced with intensive role playing, social emotional coaching, and media parenting components. The pilot was delivered via video teleconferencing during the COVID-19 pandemic. Thirty-two parents (88% female) with children ages 9-12 years old participated in weekly online 60-minute sessions for 8 weeks. Eligibility for free- or reduced-price lunch was met by 56% of participants. Thirty of the parents completed all the sessions. Researchers examined participant satisfaction and qualitative analyses to explain outcomes and explore participant acceptability. Average satisfaction with individual sessions was high (3.93 on 4-point scale). Qualitative findings reinforced and explained quantitative findings. Participants found the intervention and virtual delivery acceptable and gave feedback to strengthen the focus on bullying and cyberbullying topics. There were non-significant differences in satisfaction and delivery in families eligible for free- or reduced-priced lunch. Overall, parents found the enhancements to Everyday Parenting program acceptable. It was also feasible to deliver the program through video conferencing with parents. The increase in technology engagement due to the COVID-19 pandemic will potentially increase the importance of online safety for children.