Developing a mHealth Routine Outcome Monitoring and Feedback App (“SMART Track”) to Support Self-Management of Addictive Behaviours

Abstract

Background: Routine outcome monitoring (ROM) has been implemented across a range of addiction treatment services, settings and organisations. Mutual support groups are a notable exception. Innovative solutions are needed. SMART Track is a purpose built smartphone app designed to capture ROM data and provide tailored feedback to adults attending Australian SMART Recovery groups for addictive behaviour(s).Objective: Details regarding the formative stage of app development is essential, but often neglected. Improved consideration of the end-user is vital for curtailing app attrition and enhancing engagement. This paper provides a pragmatic example of how principles embedded in published frameworks can be operationalised to address these priorities during the design and development of the SMART Track app.Methods: Three published frameworks for creating digital health technologies (“Person-Based Approach,” “BIT” Model and IDEAS framework) were integrated and applied across two stages of research to inform the development, design and content of SMART Track. These frameworks were chosen to ensure that SMART Track was informed by the needs and preferences of the end-user (“Person-Based”); best practise recommendations for mHealth development (“BIT” Model) and a collaborative, iterative development process between the multi-disciplinary research team, app developers and end-users (IDEAS framework).Results: Stage one of the research process generated in-depth knowledge to inform app development, including a comprehensive set of aims (clinical, research/organisation, and usage); clear articulation of the target behaviour (self-monitoring of recovery related behaviours and experiences); relevant theory (self-determination and social control); appropriate behavioural strategies (e.g., behaviour change taxonomy and process motivators) and key factors that may influence engagement (e.g., transparency, relevance and trust). These findings were synthesised into guiding principles that were applied during stage two in an iterative approach to app design, content and development.Conclusions: This paper contributes new knowledge on important person-centred and theoretical considerations that underpin a novel ROM and feedback app for people with addictive behaviour(s). Although person-centred design and best-practise recommendations were employed, further research is needed to determine whether this leads to improved usage outcomes.Clinical Trial Registration: Pilot Trial: http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336.

I Need to Know: Using the CeHRes Roadmap to Develop a Treatment Feedback Tool for Youngsters with Mental Health Problems

“…According to the youngsters in the panel, feedback is most useful when it involves insight into changes over time, is provided by multiple informants, includes additional information on questionnaires, scales or items and is comprehensive and well-organized. The importance of this value is in line with previous studies [ 12 , 26 , 27 , 28 , 29 ]. Feedback becomes more valuable for youngsters when it provides them with sufficient information to accurately interpret their PROM results.…”

“…Particularly in light of the new opportunities that digital technologies provide. E-mental health applications have the flexibility to tailor content in a personalized way [ 10 , 11 ] and engage users in real-time [ 12 ]. Both personalisation and real-time engagement have been found to improve responsiveness and patient motivation [ 13 ].…”

Feasibility of a Mobile Health App for Routine Outcome Monitoring and Feedback in SMART Recovery Mutual Support Groups: Stage 1 Mixed Methods Pilot Study

“…The preparatory qualitative work [ 63 ] and development process [ 64 ] have been reported separately, and further details are available in the published protocol [ 59 ]. Briefly, three frameworks [ 56 , 65 , 66 ] informed the design, development, and content of SMART Track .…”

Lessons for Uptake and Engagement of a Smartphone App (SURE Recovery) for People in Recovery From Alcohol and Other Drug Problems: Interview Study of App Users

“…This finding differs from the conclusion of a systematic review of health and well-being smartphone app uptake and engagement conducted by Szinay et al [ 11 ] that reported that study participants who discussed a hypothetical app did not always agree with those who gave their views after actually using an app. Such inconsistency with our findings merits further investigation because the good concordance we identified clearly suggests that soliciting and incorporating end-user views into app design can improve uptake and engagement later [ 30 ].…”

“…Taken together, our findings and reflections have potential relevance for other researchers and app developers. For example, we believe that our co-design process was critical in ensuring that SURE Recovery is user friendly, easy to understand, motivating, and trustworthy, and we recommend this collaborative way of working to others [ 8 , 30 ]. Nonetheless, we developed SURE Recovery in response to user demand with limited consideration of our precise target audience and whether we should be including empirically based behavior change techniques [ 2 , 9 , 15 , 16 ].…”