Development and Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

Abstract

BackgroundChildren need access to high quality mental health care. Effective treatments now exist for a wide range of mental health conditions. However, these interventions are delivered with variable effectiveness in traditional mental health service settings. Innovative solutions are needed to improve treatment delivery quality and effectiveness.ObjectiveThe aim of this study was to develop a scalable, sustainable technology-based approach to improve the quality of care in child mental health treatment.MethodsA tablet-based resource was developed with input from mental health training experts, mental health providers, and patients. A series of qualitative data collection phases (ie, expert interviews, patient and provider focus groups, usability testing) guided the initial concept and design of the resource, and then its refinement. The result was an iPad-based “e-workbook” designed to improve child engagement and provider fidelity in implementation of a best-practice treatment. We are currently conducting a small scale randomized controlled trial to evaluate the feasibility of e-workbook facilitated child mental health treatment with 10 providers and 20 families recruited from 4 local community-based mental health clinics.ResultsUsability and focus group testing yielded a number of strong, favorable reactions from providers and families. Recommendations for refining the e-workbook also were provided, and these guided several improvements to the resource prior to initiating the feasibility trial, which is currently underway.ConclusionsThis study aimed to develop and preliminarily evaluate a tablet-based application to improve provider fidelity and child engagement in child mental health treatment. If successful, this approach may serve as a key step toward making best-practice treatment more accessible to children and families. As various technologies continue to increase in popularity worldwide and within the health care field more specifically, it is essential to rigorously test the usability, feasibility, acceptability, and effectiveness of novel health technology solutions. It is also essential to ensure that patients and providers drive decision making that supports the development of these resources to ensure that they can be seamlessly integrated into practice.Trial RegistrationClinicaltrials.gov NCT01915160; https://clinicaltrials.gov/ct2/show/NCT01915160 (Archived by WebCite at http://www.webcitation.org/6cPIiQDpu)

The EMPOWER-SUSTAIN e-Health Intervention to improve patient activation and self-management behaviours among individuals with Metabolic Syndrome in primary care: study protocol for a pilot randomised controlled trial

“…Delivery system design Delivery system design through the EMPOWER-SUSTAIN clinic to improve continuity of care and patient-physician relationship [55][56][57] The EMPOWER-SUSTAIN Self-Management e-Health Intervention will be delivered by PCP at baseline and 3-month and 6-month follow-up visits in the EMPOWER-SUSTAIN clinic to ensure continuity of care and sustainability CPG Clinical practice guidelines, PCP Primary care physician the clinic. This prototype is currently undergoing alpha (utility) testing by medical experts [61,62] and beta (usability) testing by patients with MetS [63]. Data which are entered by the PCPs and patients into the app will be stored in a secure server.…”

The EMPOWER-SUSTAIN e-Health Intervention to improve patient activation and self-management behaviours among individuals with Metabolic Syndrome in primary care: study protocol for a pilot randomised controlled trial

“…A complementary desktop application is also being developed for the PCP and nurse to use in the clinic. This prototype is currently undergoing the alpha (utility) testing by medical experts [51,52] and beta (usability) testing by patients with MetS [53]. Data which are entered by the PCP and patients into the app will be stored in a secure server.…”

Fulfilling the promise of mental health technology to reduce public health disparities: Review and research agenda.

“…Low fidelity in turn reduces treatment effectiveness (Miller & Rollnick, 2014). As one example, Ruggiero et al (2015) developed an interactive, tablet-based clinician guide for trauma-focused cognitive-behavioral therapy, an evidence-based intervention for treating child and adolescent posttraumatic stress disorder. While outcome data for the application are pending, initial results from usability, acceptability, and feasibility demonstrated positive results.…”