Feasibility, Acceptability, and Preliminary Effectiveness of a Peer-Delivered and Technology Supported Self-Management Intervention for Older Adults with Serious Mental Illness

Abstract

To assess the feasibility, acceptability, and preliminary effectiveness of a peer-delivered and technology supported integrated medical and psychiatric self-management intervention for older adults with serious mental illness. Ten older adults with serious mental illness (i.e., schizophrenia, schizoaffective disorder, bipolar disorder, or major depressive disorder) and medical comorbidity (i.e., cardiovascular disease, obesity, diabetes, chronic obstructive pulmonary disease, hypertension, and/or high cholesterol) aged 60 years and older received the PeerTECH intervention in their homes. Three certified peer specialists were trained to deliver PeerTECH. Data were collected at baseline, one-month, and three-month. The pilot study demonstrated that a three-month, peer-delivered and technology-supported integrated medical and psychiatric self-management intervention ("PeerTECH") was experienced by peer specialists and participants as feasible and acceptable. PeerTECH was associated with statistically significant improvements in psychiatric self-management. In addition, pre/post, non-statistically significant improvements were observed in self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment. This pre/post pilot study demonstrated it is possible to train peers to use technology to deliver an integrated psychiatric and medical self-management intervention in a home-based setting to older adults with serious mental illness with fidelity. These findings provide preliminary evidence that a peer-delivered and technology-supported intervention designed to improve medical and psychiatric self-management is feasible, acceptable, and is potentially associated with improvements in psychiatric self-management, self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment with older adults with serious mental illness and chronic health conditions.

Smartphone Ownership, Use, and Willingness to Use Smartphones to Provide Peer-Delivered Services: Results from a National Online Survey

“…Promising evidence indicates that a smartphone-based intervention appears to be an increasingly useful device for fidelity-adherent peer-delivered care. For example, a pilot study, N =8, found that certified peer specialists are providing evidence-based integrated self-management training with the assistive use of guided eModules (i.e., guided web-based curriculum) augmented by a smartphone application (PeerTECH) [15]. Emerging data from pilot studies and the findings in this report indicate support for further research on the effectiveness and implementation of peer evidence-based illness self-management interventions.…”

“…A pilot study found that the combination of peers and mobile health (mHealth) was feasible and acceptable [15]. This pilot led to improvements in psychiatric self-management, self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment [15].…”

“…A pilot study found that the combination of peers and mobile health (mHealth) was feasible and acceptable [15]. This pilot led to improvements in psychiatric self-management, self-efficacy for managing chronic health conditions, hope, quality of life, medical self-management skills, and empowerment [15]. Promising evidence suggests incorporating mHealth technologies with peer services delivery may offset the substantial organizational and financial resources needed to implement existing self-management interventions.…”

“…Promising evidence suggests incorporating mHealth technologies with peer services delivery may offset the substantial organizational and financial resources needed to implement existing self-management interventions. For example, existing interventions commonly take 1–2 years to deliver [7]; however, the combination of peers and mHealth reduces intervention duration, yet increases intervention dose through using smartphone app features to reinforce self-management skill development outside of the clinical environment [15, 16]. Smartphone-supported interventions may also have a higher potential for cost effectiveness than in-person only interventions [17].…”

Differential Influences of Social Support on App Use for Diabetes Self-Management – a Mixed Methods Approach

“…Bene cial effects of technology use on self-management and health outcomes were typically reported in studies that addressed non-professional social support by the patient's personal networks (37,38). The use of social media, online communities, or mobile health (mHealth) has enhanced or improved psychological empowerment (39,40), self-care information and knowledge (38,41), blood glucose levels (HbA1c), as well as glucose self-monitoring and physical activity (3,42), and other health topics (43)(44)(45). The inclusion of family members or spouses in technological diabetes management systems was found to improve their understanding of self-management requirements and affected the communication about diabetes and the support of the patient positively (46).…”