Feasibility and outcomes of a multi-function mobile health approach for the schizophrenia spectrum: App4Independence (A4i)

Abstract

Relative to the large investments in mobile health (mHealth) strategies for mental illnesses such as anxiety and depression, the development of technology to facilitate illness self-management for people with schizophrenia spectrum illnesses is limited. This situation falls out of step with the opportunity mHealth represents for providing inexpensive and accessible self-care resources and the routine use of mobile technologies by people with schizophrenia. Accordingly, the focus of this study was upon the feasibility of a schizophrenia-focused mobile application: App4Independence (A4i). A4i is a multi-feature app that uses feed, scheduling, and text-based functions co-designed with service users to enhance illness self-management. This study was completed in a large urban Canadian centre and employed pre-post assessments over a 1-month period that examined medication adherence, personal recovery, and psychiatric symptomatology. App use metrics were assessed as was qualitative feedback through semi-structured interview. Findings are reported in line with the World Health Organization mHealth Evidence and Assessment (mERA) checklist. Among the 38 individuals with a primary psychosis who participated, there was no research attrition and classic retention on the app was 52.5%. Significant improvement was observed in some psychiatric symptom domains with small-medium effects. Significant change in recovery engagement and medication adherence were not observed after controlling for multiple comparisons. Those who interacted with the app more frequently were more depressed and had higher hostility and interpersonal sensitivity at baseline. Satisfaction with the app was high and qualitative feedback provided insights regarding feature enhancements. This research suggested that A4i is feasible in terms of outcome and process indicators and is a technology that is ready to move on to clinical trial and validation testing. This study contributes to the small but emergent body of work investigating digital health approaches in severe mental illness populations.

WeChat-based mHealth intention and preferences among people living with schizophrenia

“…The finding that 43% of participants were willing to participate in WeChat-based mHealth programs resonates with a WeChat use rate of 40.75% among PLS in the current study. This rate was higher than that reported in other studies about online mental health program through social medias in and out of China ( Borzekowski et al, 2009 ; Kidd et al, 2019 ; Miller et al, 2015 ). For instance, Borzekowski et al reported only one third of PLS and people with other serious mental illness used internet for health information ( Borzekowski et al, 2009 ).…”

Pencegahan Kekambuhan Klien Skizofrenia Berbasis Mobile Apps dan Mobile Web: Systematic Review

“…No Penulis/negara Metode Kondisi N Nama aplikasi/web Fitur aplikasi/web dan program intervensi 1 Xu D et al (19) Cina Fitur data demografi klien Fitur randomisasi responden berdasarkan data demografi, hasil randomisasi akan dikirimkan via email ke responden Fitur pengisian kuesioner Early Warning Sign (EWS) melalui telepon genggam klien dan keluarga Apabila hasil kuesioner menunjukkan adanya keparahan gejala maka email secara otomatis akan terkirim ke petugas yang merawat Klien dianjurkan mengunjungi pelayanan kesehatan dan akan diberikan tambahan terapi 3 Gottlieb JD et al (21) USA Fitur pengkajian early warning sign pada kekambuhan untuk menilai kekambuhan pada klien yang mendapatkan intervensi 1 tahun pengurangan dosis terapi antipsikotik 9 Kidd SA et al (27) Kanada (31) Cina…”

“…(19,31) Fitur integrasi yang disediakan oleh aplikasi App4Independence hampir sama dengan LEAN dimana data kondisi kesehatan mental klien terintegrasi secara langsung dengan sistem informasi kesehatan sehingga petugas kesehatan dapat memantau keadaan klien dari jarak jauh. (27) M-Resist menggunakan web based platform sebagai alat untuk mengumpulkan data klien, dan melakukan komunikasi dan koordinasi dengan klien dan petugas kesehatan lainnya. (30)…”

Examining a Digital Health Approach for Advancing Schizophrenia Illness Self-Management and Provider Engagement: Protocol for a Feasibility Trial

“…In this initial pilot, we focused on the early-stage testing of a digital health tool, App4Independence (A4i), which was performed in 2 steps. Following a preliminary 1-week beta test by 5 individuals to address technical issues, the qualitative and quantitative A4i outcome data from 38 individuals were analyzed, assessing feasibility over a 1-month period [ 32 ]. The mean number of interactions with the app per day was 4.21 and, by day 20, a 4% churn rate was observed (rates of individuals who ceased app use).…”