Care Managers and Role Ambiguity: The Challenges of Supporting the Mental Health Needs of Patients with Chronic Conditions

Lattie, Emily G.; Burgess, Eleanor R.; Mohr, David C.; Reddy, Madhu

doi:10.1007/s10606-020-09391-z

Cited by 12 publications

(12 citation statements)

References 100 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…but "What coaching content and models of coaching delivery are most feasible and effective?" (Lattie et al, 2021). For instance, two different deployment models for coaching may be considered: a "centralized" model where coaches spend most of their effort making virtual coaching contacts from a centralized location and are provided more extensive training; and a "diffused" model where coaching activities are only one part of an individual's duties and multiple coaches are trained, similar to the model used in this trial.…”

Section: Discussionmentioning

confidence: 99%

The Implementation and Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia in Primary Care: A Pilot Study

Hermes

Rosenheck

Burrone

et al. 2021

Implementation Research and Practice

View full text Add to dashboard Cite

Background Digital interventions delivering Cognitive Behavioral Therapy for insomnia (Digital CBTi) may increase utilization of effective care for a common and serious condition. A low-intensity implementation strategy may facilitate digital CBTi use in healthcare settings. This pilot study assessed the feasibility of implementing a digital CBTi in Veterans Health Administration (VA) primary care through iterative modifications to a low-intensity implementation strategy, while evaluating clinical outcomes of a specific digital CBTi program. Methods A self-directed digital CBTi was implemented in the primary care clinics of a single VA facility using a cohort trial design that iteratively modified an implementation strategy over three 8-month phases. The phase 1 implementation strategy included (1) provider education; (2) point-of-care information via pamphlets; and (3) provider referral to digital CBTi through phone calls or messages. Phases 2 and 3 maintained these activities, while (1) adding a clinic-based coach who performed initial patient education and follow-up support contacts, (2) providing additional recruitment pathways, and (3) integrating the referral mechanism into provider workflow. Implementation outcomes included provider adoption, patient adoption, and acceptability. Clinical outcomes (insomnia severity, depression severity, and sedative hypnotic use) were compared among enrollees at baseline and 10 weeks. Results Across all phases 66 providers (48.9%) made 153 referrals, representing 0.38% of unique clinic patients. Of referrals, 77 (50.3%) enrolled in the study, 45 (29.4%) engaged in the program, and 24 (15.7%) completed it. Provider and patient adoption did not differ meaningfully across phases. Among enrollees, digital CBTi was acceptable and the Insomnia Severity Index decreased by 4.3 points (t = 6.41, p < 0.001) and 13 (18.6%) reached remission. The mean number of weakly sedative-hypnotic doses decreased by 2.2 (35.5%) (t = 2.39, p < 0.02). Conclusions Digital CBTi implementation in VA primary care is feasible using low-intensity implementation strategy, resulting in improved clinical outcomes for users. However, iterative implementation strategy modifications did not improve adoption. The trial was registered at clinicaltrials.gov (NCT03151083).

show abstract

Section: Discussionmentioning

confidence: 99%

The Implementation and Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia in Primary Care: A Pilot Study

Hermes

Rosenheck

Burrone

et al. 2021

Implementation Research and Practice

View full text Add to dashboard Cite

show abstract

“…Although chatbots leverage GIFs, emojis, or hilarious responses as a means of showing empathetic behavior and to keep the conversation more humanlike [ 29 ], our findings suggest that they are not always well received by adult users. Most commercial apps are downloadable by everyone beyond the set age limit (which in most cases is ≥17 years); thus, designers must carefully consider the media types and content of the conversation.…”

Section: Discussionmentioning

confidence: 99%

An Overview of Chatbot-Based Mobile Mental Health Apps: Insights From App Description and User Reviews

Haque¹,

Rubya²

2023

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

Background Chatbots are an emerging technology that show potential for mental health care apps to enable effective and practical evidence-based therapies. As this technology is still relatively new, little is known about recently developed apps and their characteristics and effectiveness. Objective In this study, we aimed to provide an overview of the commercially available popular mental health chatbots and how they are perceived by users. Methods We conducted an exploratory observation of 10 apps that offer support and treatment for a variety of mental health concerns with a built-in chatbot feature and qualitatively analyzed 3621 consumer reviews from the Google Play Store and 2624 consumer reviews from the Apple App Store. Results We found that although chatbots’ personalized, humanlike interactions were positively received by users, improper responses and assumptions about the personalities of users led to a loss of interest. As chatbots are always accessible and convenient, users can become overly attached to them and prefer them over interacting with friends and family. Furthermore, a chatbot may offer crisis care whenever the user needs it because of its 24/7 availability, but even recently developed chatbots lack the understanding of properly identifying a crisis. Chatbots considered in this study fostered a judgment-free environment and helped users feel more comfortable sharing sensitive information. Conclusions Our findings suggest that chatbots have great potential to offer social and psychological support in situations where real-world human interaction, such as connecting to friends or family members or seeking professional support, is not preferred or possible to achieve. However, there are several restrictions and limitations that these chatbots must establish according to the level of service they offer. Too much reliance on technology can pose risks, such as isolation and insufficient assistance during times of crisis. Recommendations for customization and balanced persuasion to inform the design of effective chatbots for mental health support have been outlined based on the insights of our findings.

show abstract

“… What are the determinants that may affect implementation of the DMHI and strategies that address those determinants? Community Engagement/Relationship Building ( Hayes, 2014 ; Le Dantec and Fox, 2015 ; Stiles-Shields et al, 2022 ) Volunteering Community meetings ( Harrington et al, 2019 ; Lu et al, 2023 ) Needs Elicitation Focus Groups ( Knapp et al, 2021 ; Kruzan et al, 2022a ; Lattie et al, 2020b ; Makosky Daley et al, 2010 ; Powell et al, 1996 ) Co-Design Workshops Interviews ( Berry et al, 2019 ; Muller and Kogan, 2010 ; Ryu et al, 2023 ) Observations ( Berry et al, 2017 ; Millen, 2000 ) Crowdsourcing ( Kornfield et al, 2022b ) Workflow design sessions ( Knapp et al, 2022 ; Lattie et al, 2021 ) Persona development ( Faily and Flechais, 2011 ; LeRouge et al, 2013 ) Resource and environment evaluation Interviews and/or surveys with service organizations Prototyping the product or service ( ideate , prototype , evaluate , and refine & develop ) What is the ideal format of, or platform for, the DMHI? What kinds of use pathways exist when using the DMHI?…”

Section: Discussionmentioning

confidence: 99%

“…Needs Elicitation Focus Groups ( Knapp et al, 2021 ; Kruzan et al, 2022a ; Lattie et al, 2020b ; Makosky Daley et al, 2010 ; Powell et al, 1996 ) Co-Design Workshops Interviews ( Berry et al, 2019 ; Muller and Kogan, 2010 ; Ryu et al, 2023 ) Observations ( Berry et al, 2017 ; Millen, 2000 ) Crowdsourcing ( Kornfield et al, 2022b ) Workflow design sessions ( Knapp et al, 2022 ; Lattie et al, 2021 ) …”

Section: Discussionmentioning

confidence: 99%

From formative design to service-ready therapeutic: A pragmatic approach to designing digital mental health interventions across domains

Meyerhoff,

Kornfield,

Lattie

et al. 2023

Internet Interventions

Self Cite

View full text Add to dashboard Cite

Care Managers and Role Ambiguity: The Challenges of Supporting the Mental Health Needs of Patients with Chronic Conditions

Cited by 12 publications

References 100 publications

The Implementation and Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia in Primary Care: A Pilot Study

The Implementation and Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia in Primary Care: A Pilot Study

An Overview of Chatbot-Based Mobile Mental Health Apps: Insights From App Description and User Reviews

From formative design to service-ready therapeutic: A pragmatic approach to designing digital mental health interventions across domains

Contact Info

Product

Resources

About