Search:
Scroll to top
Tag: mhealth
09/05/2023

Preventing mental illness in children that experienced maltreatment the efficacy of REThink online therapeutic game

David OA & Fodor LA. Preventing mental illness in children that experienced maltreatment the efficacy of REThink online therapeutic game. npj Digit. Med. 6, 106 (2023). https://doi.org/10.1038/s41746-023-00849-0

This article reports on a randomized controlled trial to test the efficacy of REThink, an online therapeutic game, compared to usual care in preventing mental illness in children who have experienced maltreatment. REThink was developed based on a transdiagnostic cognitive-behavioral therapy and has an action and adventure approach to learning and practicing therapeutic tasks. Each REThink level/session is completed weekly using a mobile device under the supervision of study staff. Children aged 8-12 years with self-reported maltreatment history (N=294) were recruited from schools. Participants completed pre- and post-intervention assessments measuring mental health, emotion regulation, and irrational cognitions. In the REThink group, 65% of the children completed all of the levels/sessions of the game and 18% dropped out from treatment. The REThink intervention arm was found to have a significantly lower level of emotional problems (d=0.42, p=0.001), mental health problems (d=0.35, p=0.007), maladaptive emotion regulation strategies (catastrophizing: d=0.41, p=0.002; self-blame: d=0.26, p=0.017) and irrational cognitions (d=0.54, p<0.001) compared to the control arm post-intervention. Additionally, children with higher maltreatment severity benefitted the most from the REThink game and children with lower parent attachment security benefited the least. Future research is needed to test the long-term efficacy of the REThink game.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ;
08/07/2023

Identifying Desired Features That Would Be Acceptable and Helpful in a Wrist-Worn Biosensor–Based Alcohol Intervention: Interview Study Among Adults Who Drink Heavily

Richards VL, Rajendran S, Cook RL, Leeman RF, Wang Y, Prins C, Cook C. Identifying Desired Features That Would Be Acceptable and Helpful in a Wrist-Worn Biosensor–Based Alcohol Intervention: Interview Study Among Adults Who Drink Heavily. J Med Internet Res 2023;25:e38713. doi: 10.2196/38713

Researchers identified desired features that could help people reduce their drinking in a wrist-worn biosensor-based alcohol intervention for adults who drink heavily. Wearable alcohol biosensors can passively and continuously measure ethanol excreted through the skin. Participants were at least 40 years old, drank at least twice per week, and were interested in reducing their drinking, and were recruited via an alcohol contingency study, a contact registry, and referrals. In-depth qualitative interviews were conducted on Zoom with 20 participants. Interviews included questions about participants’ thoughts about a wrist-worn biosensor, potential helpfulness to reduce drinking, and what information they would want to receive from the biosensor. Participants reported five major desired feature themes: 1) comfort and look of the biosensor, 2) personalized prompts and feedback, 3) time wearing the biosensor, 4) sharing data with friends, family, and providers, and 5) incorporation of mental health support. In general, participants were open to wearing the biosensor, but were only inclined to engage with the biosensor content if had they were motivation to reduce drinking. Findings also indicated that a mobile app that stores and interprets sensor data for participants to track drinking patterns could be beneficial. Engaging potential end-users to identify desire intervention features can inform and optimize development of interventions that use wrist-worn biosensors to reduce alcohol use.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
05/30/2023

Predicting symptom response and engagement in a digital intervention among individuals with schizophrenia and related psychoses

Price GD, Heinz MV, Nemesure MD, McFadden J, Jacobson NC. Predicting symptom response and engagement in a digital intervention among individuals with schizophrenia and related psychoses. Front Psychiatry. 2022;13:807116. doi:10.3389/fpsyt.2022.807116

This study utilized data from a trial delivering a psychosocial smartphone app designed for patients with psychosis (App4Independence or A4i) to better understand personalized markers of digital intervention engagement and response. Machine learning models were applied to baseline data, app use data, and semi-structured interview data to predict response to change in symptoms, level of engagement, and qualitative impressions of the A4i app. Thirty-eight participants received the A4i app intervention for one month. Machine learning models were capable of moderately predicting participant engagement and experience with the app (r=0.39) as well as changes in psychosis symptom severity (r=0.32). Participants with high baseline interpersonal sensitivity, versus low, benefitted more from the A4i intervention in reducing symptom severity. Additionally, participants with lower baseline psychotic and obsessive-compulsive traits were predicted to benefit more. Higher baseline depression predicted both higher engagement and satisfaction with the app. These findings demonstrate the potential of predicting response to a digital intervention for psychosis using unique patient factors. This study further highlights the need to investigate individual response to and engagement with digital-based mental health interventions. Future research should consider how individual demographic characteristics influence engagement with a digital intervention.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
05/02/2023

Text Messages Exchanged Between Individuals With Opioid Use Disorder and Their mHealth e-Coaches: Content Analysis Study

Ranjit Y, Davis W, Fentem A, Riordan R, Roscoe R, Cavazos-Rehg P. Text Messages Exchanged Between Individuals With Opioid Use Disorder and Their mHealth e-Coaches: Content Analysis Study. JMIR Hum Factors 2023;10:e37351 DOI: 10.2196/37351

The aim of this study was to understand the text messaging communication between persons undergoing opioid use disorder (OUD) recovery and their e-coaches. The study was part of a larger mHealth intervention study called “uMAT-R”, which is a support mobile app to improve OUD treatment adherence and recovery. The uMAT-R app provides instant in-app messaging with a recovery support e-coach. Participants were recruited from various OUD recovery programs in St. Louis and were eligible if they had a formal OUD diagnosis and were currently receiving treatment. For this content analysis, messages from 70 participants were coded for emotional support, informational support, and material support (services and resources that help solve practical issues). Messages were also coded for treatment and recovery domains and problems related to mobile app usage. On average, the number of messages exchanged between participants and e-coaches was 17 (SD=16.05) and 90% of conversations were initiated by e-coaches. Emotional support was most commonly identified in conversations (196 occurrences), followed by material support (110 occurrences). For OUD treatment content, messages about OUD recovery and opioid use risk factors occurred the most (N=72), followed by motivation to avoid drug use (N=47). Depression was significantly associated with social support related messages (r=0.27, p=0.02). Overall, findings demonstrate that people in OUD recovery seek social support and relapse prevention support when provided online communication with their health care providers. Due to the need for continuous interpersonal support as part of addiction care, instant two-way text messaging could be a cost-effective and sustainable tool to support OUD recovery.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
01/03/2023

Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials

Qin M, Chen B, Sun S, Liu X.Effect of Mobile Phone App–Based Interventions on Quality of Life and Psychological Symptoms Among Adult Cancer Survivors: Systematic Review and Meta-analysis of Randomized Controlled Trials. J Med Internet Res 2022;24(12):e39799 DOI: 10.2196/39799

A systematic review and meta-analysis was conducted to investigate the effectiveness of mobile phone app interventions on quality of life (QOL) and psychological outcomes in adult cancer patients. Researchers identified randomized controlled trial studies evaluating apps that targeted adults with cancer and QOL or psychological symptoms. In total, 30 randomized controlled trials with a total of 5,353 patients were included in the meta-analysis. App interventions included health education, physician-patient communication, or data management regarding patient self-monitoring behaviors. On average, interventions were conducted over 2.8 months. Compared with standard care, app interventions significantly improved QOL (Standardized Mean Difference (SMD)=0.39, p<.001) and self-efficacy (SMD=0.15, p=.03) and reduced anxiety (SMD=0.64, p<.001), depression (SMD=-0.33, p=.009), and distress (SMD=-0.34, p=.01) symptoms. Subgroup analyses were also conducted for intervention duration, type of cancer, theoretical approach, treatment category, and intervention delivery (interactive 2-way communication format versus 1-way communication format). Short-term (<3 months) interventions were found to have higher effectiveness compared to longer term interventions for QOL, anxiety and depression. However, given that only 9 studies were longer than 3 months, there is a need for further research on the long-term effects of these app interventions. Apps that included physician-patient communication and that were based on cognitive behavioral therapy were most effective for improving QOL and psychological outcomes. Overall, results provide evidence for the effectiveness of mobile phone app interventions on QOL and psychological outcomes, however caution is needed in the over-interpretation of findings due to high heterogeneity across the studies.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
12/05/2022

A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial

Brody C, Chhoun P, Tuot S, Fehrenbacher A, Moran A, Swendeman D, Yi S. A Mobile Intervention to Link Young Female Entertainment Workers in Cambodia to Health and Gender-Based Violence Services: Randomized Controlled Trial. J Med Internet Res 2022;24(1):e27696 DOI: 10.2196/27696

This study evaluated the efficacy of the Mobile Link intervention to improve female entertainment workers’ (FEW) health through engagement and connection to HIV, sexual and reproductive health, and gender-based violence services. In Cambodia, FEWs are employed at karaoke bars, restaurants, bars, and massage parlors and many exchange sex to supplement their income. Researchers conducted a randomized controlled trial in the capital city and 3 other regions in Cambodia with high numbers of FEWs and HIV prevalence. Eligible participants were aged 18-30 years, working as a FEW, sexually active, and owned a mobile phone. Participants were randomized to the Mobile Link intervention arm (n=218) or to the control arm (standard care; n=170). For 60 weeks, participants in the Mobile Link arm received automated twice-weekly text messages and voice messages with health information and direct links to community outreach workers. Outcomes included self-reported HIV and sexually transmitted infection (STI) testing, condom use, and contraceptive use at baseline and 6- and 12-month follow up. Results showed significant improvements in HIV and STI testing, condom use, and contraceptive use in both arms. The Mobile Link intervention was effective in connecting FEWs with outreach workers – contact increased by 61% in the intervention arm compared to a decrease of 30% in the control arm. Additionally, participants in the intervention arm reported significant reductions in forced drinking behavior at work from supervisors or peers compared to those in the control arm. Although there were no differences in the main outcomes, the Mobile Link intervention may be helpful in linking to outreach workers and could be potentially implemented among other populations in Cambodia, perhaps as an adjunct to standard care. Future research may consider using longer-term messaging to increase access to services and impact health outcomes.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ;
09/19/2022

The Efficacy of “Foundations,” a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial

Catuara-Solarz S, Skorulski B, Estella-Aguerri I, Avella-Garcia C, Shepherd S, Stott E, Hemmings N, Ruiz de Villa A, Schulze L, Dix S. The Efficacy of “Foundations,” a Digital Mental Health App to Improve Mental Well-being During COVID-19: Proof-of-Principle Randomized Controlled Trial. JMIR Mhealth Uhealth 2022;10(7):e30976 DOI: 10.2196/30976

This study aimed to evaluate the efficacy of a mobile app, “Foundations”, to reduce self-reported symptoms of anxiety and stress in a randomized control trial during the COVID-19 pandemic in the United Kingdom. Adults (N=136) with mild to severe anxiety and moderate to high levels of perceived stress were randomly assigned to four weeks of the Foundations app or a waitlist control. The Foundations app includes cognitive behavioral therapy interventions and psychoeducation aimed at reducing stress and promoting mental well-being. Activities consist of reading articles, journaling, meditation, and relaxation. Resilience, anxiety, well-being, and sleep were assessed at baseline, weeks 2 and 4. Perceived stress was assessed weekly. The intervention group (n=62) showed significant improvement in anxiety (p=0.04), resilience (p<0.001), sleep (p=0.01), and mental well-being (p=0.02) compared to the control group (n=74). This improvement was observed within 2 weeks of the intervention and sustained at week 4. There was no significant difference in perceived stress between the intervention and control groups (p=0.20). Overall, this study provides a proof of principle that the Foundations app may improve mental well-being, anxiety, resilience, and sleep. Future research should evaluate the long-term effects of the Foundations app and the scalability and cost-effectiveness of the intervention. The passive nature of the control group in this study does not rule out placebo effects in the digital intervention group and future research would benefit from an active control condition.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ; ;
07/05/2022

The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomized controlled trial in Scotland and Australia

Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Aucott L, Birchwood M, Briggs A, Bucci S, Cotton SM, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Gleeson J (2022). The EMPOWER blended digital intervention for relapse prevention in schizophrenia: a feasibility cluster randomised controlled trial in Scotland and Australia. The Lancet. Psychiatry, 9(6), 477–486. https://doi.org/10.1016/S2215-0366(22)00103-1

The study used a randomized controlled study design to evaluate feasibility of a digital intervention for relapse prevention in schizophrenia, Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER). Eight community mental health service (CMHS) sites in Glasgow and Melbourne were randomized to EMPOWER or treatment as usual. Participants older than 16 years of age, who had a schizophrenia diagnosis, had contact with CMHS, and had a relapse in the past two years, were recruited (N=73). EMPOWER is a blended peer and clinician support smartphone app that allows people to monitor their wellbeing and warning signs of schizophrenia relapse (i.e., a return to active schizophrenia symptoms) over a maximum of 12 months. The app includes messages to enhance self-management and autonomy and visual charts to observe changes in self-reported well-being over time. Researchers assessed feasibility, acceptability, usability, and safety through in-person interviews at the end of 12-months. Results demonstrated high rates of engagement with the app and participants reported using the app on a weekly to daily basis. Participants reported a moderate willingness (mean of 2.45 on scale of 1-4) to share their data with caregivers and staff. Overall, participants rated the app as interesting to use, easy to learn, and that the content was well written and credible. Fear of relapse was lower in the EMPOWER group than in the treatment as usual group (mean difference of -7.53 points (95% CI: 14.45 to 0.60). Results suggest the promise of EMPOWER and a next step to evaluate its effectiveness and cost-effectiveness in further research.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ;
05/09/2022

FOCUS mHealth Intervention for Veterans with Serious Mental Illness in an Outpatient Department of Veterans Affairs Setting: Feasibility, Acceptability, and Usability Study

Buck B, Nguyen J, Porter S, Ben-Zeev D, Reger GM. FOCUS mHealth Intervention for Veterans With Serious Mental Illness in an Outpatient Department of Veterans Affairs Setting: Feasibility, Acceptability, and Usability Study. JMIR Ment Health 2022;9(1):e26049. doi: 10.2196/26049

This study evaluates the feasibility, acceptability, and preliminary effectiveness of a mobile health intervention for veterans with serious mental illnesses (SMIs) in a VA outpatient care. Seventeen veterans with SMIs participated in a one-month pilot trial of FOCUS. FOCUS consists of a mobile app, a clinician dashboard, and a mHealth support specialist. The app provides brief self-management interventions based on the user’s responses to an ecological momentary assessment (EMA). Interventions include strategies to cope with auditory hallucinations, mood, sleep, social functioning, and medication use. A mHealth support specialist tracks and gives technical support for participants’ use of FOCUS. The specialist also gives weekly updates to the mental health treatment team on each veteran’s use of FOCUS and reported symptoms and functioning. Researchers collected data on mental health symptoms and functional recovery, as well as qualitative feedback on the acceptability of FOCUS. On average, participants completed 85 EMAs and used FOCUS on 19.29 out of 30 access days. Overall, participants reported the intervention as highly acceptable; 94% would recommend FOCUS to a friend, and 88% felt satisfied. Based on qualitative interviews, participants found FOCUS complements their VA services and suggested possible subgroups to target (i.e., combat veterans). During the pilot, participants reported statistically non-significant improvements in recovery, auditory hallucinations, and quality of life. The study administered surveys to clinicians who had patients participating in FOCUS to assess feasibility and acceptability. Based on this data, clinicians found the mHealth updates useful for informing their care. FOCUS appears to be feasible, acceptable, and useful for veterans with SMIs; future research could examine specific implementation strategies in the VA, as well as replicate the effectiveness of FOCUS with a larger sample.

Posted in: Cutting Edge Literature // Tagged: ; ; ; ; ; ; ;