Behavioral Intervention Technologies: Evidence review and recommendations for future research in mental health

Abstract

This paper reports on the findings of a technical expert panel convened by the Agency for Healthcare Research and Quality and the National Institute of Mental Health, charged with reviewing the state of research on behavioral intervention technologies (BITs) in mental health and identifying the top research priorities. BITs is the comprehensive term used to refer to behavioral and psychological interventions that use information and communication technology features to address behavioral and mental health outcomes. Mental health BITs using videoconferencing and standard telephone technologies to deliver psychotherapy have been wellvalidated. Web-based interventions have shown efficacy across a broad range of mental health outcomes, although outcomes vary widely. Social media such as online support groups have produced generally disappointing outcomes when used alone. Mobile technologies have received limited attention for mental health outcomes, although findings from behavioral health suggest they are promising. Virtual reality has shown good efficacy for anxiety and pediatric disorders. Serious gaming has received relatively little work in mental health. Recommendations for next step research in each of these are made. Research focused on understanding of reach, adherence, barriers and cost is recommended. As BITs can generate large amounts of data, improvements in the collection, storage, analysis, and visualization of big data will be required. Traditional psychological and behavioral theories have proven insufficient to understand how BITs produce behavioral change. Thus new theoretical models, as well as new evaluation strategies, will be required. Finally, for BITs to have a public health impact, research on implementation and application to prevention will be required.

Expert Consensus Survey on Digital Health Tools for Patients With Serious Mental Illness: Optimizing for User Characteristics and User Support (Preprint)

“…DHTs are increasingly being adopted for use independently or in the context of traditional care and have been effective for monitoring and improving physical health in patients with a variety of conditions, including diabetes and cardiovascular disease [6][7][8][9]. Interest in applying digital technologies to psychiatric practice has been increasing since the early 2000s, and recommendations for future research in this area were issued in 2013 by a technical expert panel convened by the Agency for Healthcare Research and Quality and the National Institute of Mental Health [10][11][12]. Examples of interventions that have used DHTs in patients with SMI include ecological momentary assessment and treatment interventions [13], computerized psychotherapies [14], cognitive remediation [15,16], family psychoeducation interventions [17], and interventions specifically targeting medication adherence [18].…”

Measuring the Implementation of Behavioral Intervention Technologies: Recharacterization of Established Outcomes (Preprint)

“…Program development and refinement also occurs with traditional face-to-face psychosocial interventions, but versioning and maintenance may be more applicable to BITs (e.g., version 2.0 of a program). [53] When developed outside of the health system, intervention costs include the price paid by the health system for the BIT to develop initial and subsequent versions of the BIT.…”

Development and Pilot Testing of a Positive Imagery Intervention With Online Support in the Treatment of Fibromyalgia

“…Por ejemplo, los tratamientos basados en la evidencia aplicados a través de Internet, el uso de realidad virtual y de aplicaciones para teléfonos inteligentes en los tratamientos (Keogh, Rosser, y Eccleston, 2010). Estas tecnologías ofrecen múltiples ventajas: reducir barreras para el acceso a servicios de salud, incrementar la eficiencia de los tratamientos y promover el autocuidado (Mohr, Burns, Schueller, Clarke y Klinkman, 2013), un aspecto clave en condiciones crónicas.…”