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.