Adapting and Implementing Apps for Mental Healthcare

Zielasek, Jürgen; Reinhardt, Isabelle; Schmidt, Laura A.

doi:10.1007/s11920-022-01350-3

Cited by 12 publications

(9 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients are offered the use of the “blended ALMAMAR” app during their inpatient stay in addition to routine care. The app (named ALMAMAR, Arabic for “path”) is based on CETA (Common Elements Treatment Approach) [ 19 ], a transdiagnostic therapeutic intervention that has already been evaluated in different settings and groups [e.g. 22 – 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…Guided support by health professionals leading to patient recruitment and stabilizing program adherence as well as professional qualification, training and supervision of practitioners seem to be crucial. The process of adapting and implementing apps for inpatient mental healthcare needs to address clinicians, patients and administrative staff [ 19 ]. To date, many clinical practitioners in inpatient settings still lack practical experience with e-mental health care [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Blended-ALMAMAR app for inpatient mental health care for refugees: study protocol for a multicenter implementation study within the I-REACH consortium (Internet based REfugee mentAl healtH Care)

Reinhardt,

Schmidt,

Reske

et al. 2023

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background Refugees are at high risk for developing mental illnesses. Due to language and cultural barriers, there is need for specifically adapted therapeutic procedures for refugees in inpatient mental health care settings. Internet-based applications in refugee mother tongues have the potential to improve the outcomes of mental health care for this vulnerable population. The key research question of the present implementation study is whether the newly developed “blended ALMAMAR” app for Arabic and Farsi speaking refugees in Germany is used and accepted by patients and professionals in routine inpatient mental health care (blended care). Methods We present the design of an observational, prospective multicenter implementation study in eight psychiatric hospitals. We plan to recruit 100 Farsi or Arabic speaking refugees receiving in-patient treatment due to depression, anxiety disorder, posttraumatic stress disorder or substance use disorders. These patients will get access to the “blended ALMAMAR” app during their inpatient stay in a blended-care approach. We will assess the usage (e.g., duration and frequency of use of the app) as well as subjective acceptability and usability of the intervention. To identify sociodemographic and clinical factors associated with “blended ALMAMAR” usage, we will also perform clinical and questionnaire assessments. Discussion The newly developed “blended ALMAMAR” app may help to close communication gaps for the hard-to reach and vulnerable group of refugees in inpatient mental health care. It is the first blended-care intervention that addresses severely mentally ill refugees in an inpatient psychiatric setting in Germany. Trial registration The trial was registered in the German Clinical Trials Register on November 11, 2021 (DRKS00025972) and adapted on November 14, 2023.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blended-ALMAMAR app for inpatient mental health care for refugees: study protocol for a multicenter implementation study within the I-REACH consortium (Internet based REfugee mentAl healtH Care)

Reinhardt,

Schmidt,

Reske

et al. 2023

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Medical care through smartphone apps and associated sensors is at the cusp of moving from being a topic of research to being implemented in outpatient care. Some apps already exist, that help patients track their symptoms, review and apply content from psychotherapy and perform cognitive training and also support patients in adhering to their medication [41, 42].…”

Section: Elements Enabling a Radical Change In Psychiatrymentioning

confidence: 99%

“…Health apps can improve the diagnosis and prevention of diseases, provide patients with psychoeducation in the face of a shortage of therapists and monitor progress during therapy [41, 43]. Patients may share very sensitive data via apps, which may also be connected to other sensors such as a smartwatch, so strict data protection and data security rules are needed to reduce the risk of data violations [44].…”

Section: Elements Enabling a Radical Change In Psychiatrymentioning

confidence: 99%

Improving mental health care in depression: A call for action

Eder,

Dom,

Gorwood

et al. 2023

Eur. Psychiatr.

View full text Add to dashboard Cite

Depressive disorders have one of the highest disability-adjusted life years (DALYs) of all medical conditions, which led the European Psychiatric Association to propose a policy paper, pinpointing their unmet health care and research needs. The first part focuses on what can be currently done to improve the care of patients with depression, and then discuss future trends for research and healthcare. Through the narration of clinical cases, the different points are illustrated. The necessary political framework is formulated, to implement such changes to fundamentally improve psychiatric care. The group of European Psychiatrist Association (EPA) experts insist on the need for (1) increased awareness of mental illness in primary care settings, (2) the development of novel (biological) markers, (3) the rapid implementation of machine learning (supporting diagnostics, prognostics, and therapeutics), ( 4) the generalized use of electronic devices and apps into everyday treatment, (5) the development of the new generation of treatment options, such as plasticity-promoting agents, and (6) the importance of comprehensive recovery approach. At a political level, the group also proposed four priorities, the need to (1) increase the use of open science, (2) implement reasonable data protection laws, (3) establish ethical electronic health records, and (4) enable better healthcare research and saving resources. Treatment of depression today The reality of diagnosing and treating depressionIn Europe, almost one citizen in five is diagnosed with depression. The 12-month prevalence of depression varies between different regions but is approximately 6% across all countries. The first depressive episode typically occurs in a period between adolescence and the mid-40s [1]. The European Study of the Epidemiology of Mental Disorders showed that only 36.8% of participants with an affective disorder and 20.6% with an anxiety disorder reached out to health services for help. Of the participants who sought help, 20.7% received no therapy to alleviate their mental health problems [2]. Depressive disorders have a peak prevalence between the ages of 25 to 35. They are referred to as complex disorders because their etiology involves an interaction of genetic and environmental risk factors. Despite the availability of evidence-based treatments, only 45% of patients with depression recover permanently [3]; According to the World Health Organization, unipolar depression and other mental disorders on average lead to a significant functional impairment more debilitating than chronic diseases like diabetes [2]. Compared with the general population, people with mental illnesses such as depression are in poorer health and their life expectancy is lower [3], showing a need for improvement of diagnostic capabilities, as well as expansion of care for the affected.The associated reasons are outlined in the first part of this policy paper below and are used as the basis for European Psychiatric Association (EPA) action points which aim to ensure that pr...

show abstract

“…Previous reports have demonstrated that SDM has a positive impact on patient satisfaction, adherence to treatment, quality of life, and empowerment, including among patients with serious mental illness [ 35 - 38 ]. Consistent with this view, Zielesak et al [ 39 ] pointed out that there remains a significant gap in understanding clinician needs for information in mental health care decision-making, as well as ways to better integrate apps into routine clinical care and provider workflow. Furthermore, providers’ lack of engagement with, or buy-in for, patient-reported health data have been noted as a critical barrier to its use in health care generally, making it a priority to elicit adaptations that may facilitate uptake from the provider perspective [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

Development of the First Episode Digital Monitoring mHealth Intervention for People With Early Psychosis: Qualitative Interview Study With Clinicians

Stefancic¹,

Rogers²,

Styke³

et al. 2022

JMIR Ment Health

View full text Add to dashboard Cite

Background Mobile health (mHealth) technologies have been used extensively in psychosis research. In contrast, their integration into real-world clinical care has been limited despite the broad availability of smartphone-based apps targeting mental health care. Most apps developed for treatment of individuals with psychosis have focused primarily on encouraging self-management skills of patients via practicing cognitive behavioral techniques learned during face-to-face clinical sessions (eg, challenging dysfunctional thoughts and relaxation exercises), reminders to engage in health-promoting activities (eg, exercising, sleeping, and socializing), or symptom monitoring. In contrast, few apps have sought to enhance the clinical encounter itself to improve shared decision-making (SDM) and therapeutic relationships with clinicians, which have been linked to positive clinical outcomes. Objective This qualitative study sought clinicians’ input to develop First Episode Digital Monitoring (FREEDoM), an app-based mHealth intervention. FREEDoM was designed to improve the quality, quantity, and timeliness of clinical and functional data available to clinicians treating patients experiencing first-episode psychosis (FEP) to enhance their therapeutic relationship and increase SDM. Methods Following the app’s initial development, semistructured qualitative interviews were conducted with 11 FEP treatment providers at 3 coordinated specialty care clinics to elicit input on the app’s design, the data report for clinicians, and planned usage procedures. We then generated a summary template and conducted matrix analysis to systematically categorize suggested adaptations to the evidence-based intervention using dimensions of the Framework for Reporting Adaptations and Modifications‐Enhanced (FRAME) and documented the rationale for adopting or rejecting suggestions. Results The clinicians provided 31 suggestions (18 adopted and 13 rejected). Suggestions to add or refine the content were most common (eg, adding questions in the app). Adaptations to context were most often related to plans for implementing the intervention, how the reported data were displayed to clinicians, and with whom the reports were shared. Reasons for suggestions primarily included factors related to health narratives and priorities of the patients (eg, focus on the functional impact of symptoms vs their severity), providers’ clinical judgment (eg, need for clinically relevant information), and organizations’ mission and culture. Reasons for rejecting suggestions included requests for data and procedures beyond the intervention’s scope, concerns regarding dilution of the intervention’s core components, and concerns about increasing patient burden while using the app. Conclusions FREEDoM focuses on a novel target for the deployment of mHealth technologies in the treatment of FEP patients—the enhancement of SDM and improvement of therapeutic relationships. This study illustrates the use of the FRAME, along with methods and tools for rapid qualitative analysis, to systematically track adaptations to the app as part of its development process. Such adaptations may contribute to enhanced acceptance of the intervention by clinicians and a higher likelihood of integration into clinical care. Trial Registration ClinicalTrials.gov NCT04248517; https://tinyurl.com/tjuyxvv6

show abstract

Adapting and Implementing Apps for Mental Healthcare

Cited by 12 publications

References 72 publications

Blended-ALMAMAR app for inpatient mental health care for refugees: study protocol for a multicenter implementation study within the I-REACH consortium (Internet based REfugee mentAl healtH Care)

Blended-ALMAMAR app for inpatient mental health care for refugees: study protocol for a multicenter implementation study within the I-REACH consortium (Internet based REfugee mentAl healtH Care)

Improving mental health care in depression: A call for action

Development of the First Episode Digital Monitoring mHealth Intervention for People With Early Psychosis: Qualitative Interview Study With Clinicians

Contact Info

Product

Resources

About