Attributes of Provider Referrals for Digital Mental Health Applications in an Integrated Health System, 2019–2021

Eberhart, Lindsay; Seegan, Paige L.; McGuire, Joseph F.; Tripuraneni, Bhaskara Rao; Miller, Michael J.

doi:10.1176/appi.ps.20220401

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…For example, many healthcare systems allow for providers within different departments (e.g., behavioral health, primary care, speciality clinics) to refer patients to mTDIs as a means of addressing lower severity symptoms, supplementing pre-existing mental health services, or bridging the patient to other levels of care, such as while they are on a waitlist. [67] Similarly, many employers now offer mental health mTDIs as part of their health insurance package, [68] and there is emerging research on integrating mental health care into routine curricular and extracurricular settings on college campuses. [69][70][71] While mTDIs are increasingly incorporated into non-traditional settings, the typical approach is simply to provide individuals with access to the mTDI, leaving users to download and engage with the program on their own.…”

Section: Clinical Applications and Research Implicationsmentioning

confidence: 99%

Boosting the Benefits of Mobile Technology-Delivered Interventions: A Randomized Controlled Trial Examining Human Support to Enhance Engagement, Skill Integration, and Learning (Preprint)

Conley,

DeLorenzo,

Gonzales

et al. 2024

Preprint

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BACKGROUND Mobile technology-delivered interventions (TDIs), or mTDIs, have great promise for maximizing reach, but struggle with low rates of uptake and engagement. Among other evidence-based mTDIs, mindfulness apps such as Headspace have demonstrated numerous benefits for both community and clinical samples. People with depression or other mental health problems can experience many benefits from mTDIs, yet also may face even greater challenges in engaging with app-based interventions. Although users usually value the self-guided nature of mTDIs, they also might benefit from social connection with peers, and instructional guidance from a knowledgeable source, around mTDI use. College students are often studied as mTDI users given their high level of engagement with technology. Students also benefit from ample opportunities for social connection with peers, and instructional settings. OBJECTIVE This randomized controlled trial evaluated the impact of two human support enhancements – a one-time interactive orientation, with or without placement into a peer supportive accountability group – on mTDI engagement, skill integration, and learning among a sample of 123 depressed college students. METHODS Participants authorized access to their recorded app use data, provided by Headspace. Additionally, at midpoint (1 month), post (2 months) and follow-up (3 months) assessments, participants reported on the extent to which they had been using the intervention’s skills outside of the app, how likely they were to continue using the app and related skills in the future, and the extent to which they learned from the intervention. RESULTS As compared to those who were simply given access to the app without these enhancements, participants who were randomized to attended orientation, regardless of additional randomization to the peer support group, demonstrated significantly greater mTDI engagement (e.g., more minutes meditated, F=11.20, p<.001) and rated multiple aspects of skill integration and learning more favorably (e.g., increased awareness of thoughts and feelings, F=6.05, p=.004), indicating potential implications for amplifying the benefits of mTDIs through increased user engagement. CONCLUSIONS The results of this study illustrate that an initial face-to-face orientation boosts mTDI engagement, enhances integration of intervention skills in everyday life, and increases learning. Future work is needed to determine the active ingredients of the orientation that might drive increased levels of engagement and the associated positive intervention benefits. CLINICALTRIAL Open Science Framework (OSF): https://osf.io/3trzk

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Section: Clinical Applications and Research Implicationsmentioning

confidence: 99%

Boosting the Benefits of Mobile Technology-Delivered Interventions: A Randomized Controlled Trial Examining Human Support to Enhance Engagement, Skill Integration, and Learning (Preprint)

Conley,

DeLorenzo,

Gonzales

et al. 2024

Preprint

View full text Add to dashboard Cite

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Clinical Considerations for an Evidence-Based Assessment of Anxiety Disorders in Adults

Steuber,

Miller,

McGuire

2024

Psychiatric Clinics of North America

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Patient and Health Care Professional Perspectives About Referral, Self-Reported Use, and Perceived Importance of Digital Mental Health App Attributes in a Diverse Integrated Health System: Cross-Sectional Survey Study

Miller,

Eberhart,

Heliste

et al. 2024

JMIR Form Res

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Background Digital mental health applications (DMHAs) are emerging, novel solutions to address gaps in behavioral health care. Accordingly, Kaiser Permanente Mid-Atlantic States (KPMAS) integrated referrals for 6 unique DMHAs into clinical care in 2019. Objective This study investigated patient and health care professional (HCP) experiences with DMHA referral; DMHA use; and perceived importance of engagement, functionality, design, and information attributes in real-world practice. Methods Separate cross-sectional surveys were developed and tested for patients and HCPs. Surveys were administered to KPMAS participants through REDCap (Research Electronic Data Capture), and completed between March 2022 and June 2022. Samples included randomly selected patients who were previously referred to at least 1 DMHA between April 2021 and December 2021 and behavioral health and primary care providers who referred DMHAs between December 2019 and December 2021. Results Of the 119 patients e-mailed a survey link, 58 (48.7%) completed the survey and 44 (37%) confirmed receiving a DMHA referral. The mean age of the sample was 42.21 (SD 14.08) years (29/44, 66%); 73% (32/44) of the respondents were female, 73% (32/44) of the respondents had at least a 4-year college degree, 41% (18/44) of the respondents were Black or African American, and 39% (17/44) of the respondents were White. Moreover, 27% (12/44) of the respondents screened positive for anxiety symptoms, and 23% (10/44) of the respondents screened positive for depression. Overall, 61% (27/44) of the respondents reported DMHA use for ≤6 months since referral, 36% (16/44) reported use within the past 30 days, and 43% (19/44) of the respondents reported that DMHAs were very or extremely helpful for improving mental and emotional health. The most important patient-reported DMHA attributes by domain were being fun and interesting to use (engagement); ease in learning how to use (functionality); visual appeal (design); and having well-written, goal- and topic-relevant content (information). Of the 60 sampled HCPs, 12 (20%) completed the survey. Mean HCP respondent age was 46 (SD 7.75) years, and 92% (11/12) of the respondents were female. Mean number of years since completing training was 14.3 (SD 9.94) years (10/12, 83%). Of the 12 HCPs, 7 (58%) were physicians and 5 (42%) were nonphysicians. The most important HCP-reported DMHA attributes by domain were personalized settings and content (engagement); ease in learning how to use (functionality); arrangement and size of screen content (design); and having well-written, goal- and topic-relevant content (information). HCPs described “typical patients” referred to DMHAs based on perceived need, technical capability, and common medical conditions, and they provided guidance for successful use. Conclusions Individual patient needs and preferences should match the most appropriate DMHA. With many DMHA choices, decision support systems are essential to assist patients and HCPs with selecting appropriate DMHAs to optimize uptake and sustained use.

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Attributes of Provider Referrals for Digital Mental Health Applications in an Integrated Health System, 2019–2021

Cited by 4 publications

References 31 publications

Boosting the Benefits of Mobile Technology-Delivered Interventions: A Randomized Controlled Trial Examining Human Support to Enhance Engagement, Skill Integration, and Learning (Preprint)

Boosting the Benefits of Mobile Technology-Delivered Interventions: A Randomized Controlled Trial Examining Human Support to Enhance Engagement, Skill Integration, and Learning (Preprint)

Clinical Considerations for an Evidence-Based Assessment of Anxiety Disorders in Adults

Patient and Health Care Professional Perspectives About Referral, Self-Reported Use, and Perceived Importance of Digital Mental Health App Attributes in a Diverse Integrated Health System: Cross-Sectional Survey Study

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