Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series

Kellett, Stephen; Easton, Katherine; Cooper, Martin; Millings, Abigail; Simmonds‐Buckley, Melanie; Parry, Glenys

doi:10.2196/19888

Cited by 5 publications

(39 citation statements)

References 56 publications

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“…Furthermore, the objectives of the investigation varied. Of the 29 articles included, 18 (62%) articles focused on 1 app [ 16 , 18 , 19 , 22 , 25 , 26 , 30 , 32 , 33 , 36 - 44 ], 2 (7%) articles focused on multiple apps [ 24 , 35 ], and 9 (31%) articles did not focus on a specific app or device [ 17 , 21 , 23 , 24 , 27 - 29 , 34 , 35 ]; 8 (28%) studies included had a qualitative design [ 16 , 18 , 21 , 32 , 34 , 37 , 39 , 42 ], 5 (17%) studies were quantitative [ 22 , 24 , 27 , 31 , 35 ], 12 (41%) had a mixed methods design (qualitative and quantitative) [ 19 , 20 , 25 , 26 , 30 , 33 , 36 , 38 , 40 , 41 , 43 , 44 ], and 4 (14%) studies were reviews [ 17 , 23 , 28 , 29 ] ( Multimedia Appendix 1 ). Most qualitative studies were based on interviews [ 16 , 26 , 30 , 32 - 34 , 39 - 42 , 44 ], focus group studies [ 18 , 21 ,…”

Section: Resultsmentioning

confidence: 99%

“…Problems with validity were addressed in 16 articles [ 16 , 18 , 21 , 23 - 30 , 33 , 35 , 39 , 40 , 44 ]. Of these, 3 described quantitative studies [ 24 , 27 , 35 ], 4 described qualitative studies [ 16 , 18 , 21 , 39 ], 6 were mixed-design studies [ 25 , 26 , 30 , 33 , 40 , 44 ], and 3 were reviews [ 23 , 28 , 29 ]. Problems addressed in these studies were mainly in the area of contents, outcomes, and user input.…”

Section: Resultsmentioning

confidence: 99%

“…One quantitative study found that a few apps provided details about the underlying formulas used for calculations [ 24 ]. In 2 studies, some users criticized that functions did not meet their needs [ 35 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

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Problems and Barriers Related to the Use of Digital Health Applications: Scoping Review

Giebel¹,

Speckemeier²,

Abels³

et al. 2023

J Med Internet Res

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Background The digitization of health care led to a steady increase in the adoption and use of mobile health (mHealth) apps. Germany is the first country in the world to cover the costs of mHealth apps through statutory health insurance. Although the benefits of mHealth apps are discussed in detail, aspects of problems and barriers are rarely studied. Objective This scoping review aimed to map and categorize the evidence on problems and barriers related to the use of mHealth apps. Methods Systematic searches were conducted in the MEDLINE, Embase, and PsycINFO databases. Additional searches were conducted on JMIR Publications and on websites of relevant international organizations. The inclusion criteria were publications dealing with apps similar to those approved in the German health care system, publications addressing problems and barriers related to the use of mHealth apps, and articles published between January 1, 2015, and June 8, 2021. Study selection was performed by 2 reviewers. The manuscript was drafted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The analysis of the included publications and categorization of problems and hurdles were performed using MAXQDA (VERBI Software GmbH). Results The database search identified 1479 publications. Of the 1479 publications, 21 (1.42%) met the inclusion criteria. A further 8 publications were included from citation searching and searching in JMIR Publications. The identified publications were analyzed for problems and barriers. Problems and barriers were classified into 10 categories (“validity,” “usability,” “technology,” “use and adherence,” “data privacy and security,” “patient-physician relationship,” “knowledge and skills,” “individuality,” “implementation,” and “costs”). The most frequently mentioned categories were use and adherence (eg, incorporating the app into daily life or dropouts from use; n=22) and usability (eg, ease of use and design; n=19). Conclusions The search identified various problems and barriers in the context of mHealth apps. Although problems at the app level (such as usability) are studied frequently, problems at the system level are addressed rather vaguely. To ensure optimal use of and care with mHealth apps, it is essential to consider all types of problems and barriers. Therefore, researchers and policy makers should have a special focus on this issue to identify the needs for quality assurance. International Registered Report Identifier (IRRID) RR2-10.2196/32702

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Problems and Barriers Related to the Use of Digital Health Applications: Scoping Review

Giebel¹,

Speckemeier²,

Abels³

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…There are therefore potential benefits of an app to augment therapy by making the process more accessible both between sessions or after the therapy has finished, by increasing the ways in which a patient can hold the therapy in mind outside the therapy room (ie, an internalization process) [19] and make use of the treatment model [20]. There is evidence of reduced interpersonal problems during the follow-up from CAT [21], and therefore, an app may be particularly important in terms of supporting the durability of relational change through ongoing relational awareness.…”

Section: Cat and Digital Supportmentioning

confidence: 99%

Blending Cognitive Analytic Therapy With a Digital Support Tool: Mixed Methods Study Involving a User-Centered Design of a Prototype App

Easton¹,

Kellett²,

Cooper³

et al. 2021

JMIR Ment Health

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Background Patients can struggle to make good use of psychotherapy owing to deficits in awareness, and digital technologies that support awareness are at a premium. Currently, when patients participate in cognitive analytic therapy (CAT), the technology supporting relational awareness work involves completion of paper-based worksheets as between-session tasks. Objective We aimed to design, with therapists and patients, a prototype digital mobile app. This was to help patients better engage in the “recognition” phase of the CAT treatment model by providing an unobtrusive means for practicing relational awareness with dynamic feedback on progress. Methods A national online survey was conducted with CAT therapists (n=50) to determine readiness for adoption of a mobile app in clinical practice and to identify core content, functionality, and potential barriers to adoption. A prototype mobile app based on data and existing paper-based worksheets was built. Initial face-to-face user testing of the prototype system was completed with three therapists and three CAT expatients. Results Among the therapists surveyed, 72% (36/50) reported not currently using any digital tools during CAT. However, the potential value of a mobile app to support patient awareness was widely endorsed. Areas of therapist concern were data security, data governance, and equality of access. These concerns were mirrored during subsequent user testing by CAT therapists. Expatients generated additional user specifications on the design, functionality, and usability of the app. Results from both streams were integrated to produce five key changes for the reiteration of the app. Conclusions The user-centered design process has enabled a prototype CAT-App to be developed to enhance the relational awareness work of CAT. This means that patients can now practice relational awareness in a much more unobtrusive manner and with ongoing dynamic feedback of progress. Testing the acceptability and feasibility of this technological innovation in clinical practice is the next stage in the research process, which has since been conducted and has been submitted. The important challenges of data protection and governance must be navigated in order to ensure implementation and adoption if the CAT-App is found to be acceptable and clinically effective.

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“…In their evaluation of DHIs, Murray et al (2016) Numerous studies (e.g. Kellett et al, 2020) describe the benefits of specific digital health interventions. There are also a growing number of general literature reviews on this topic (e.g.…”

Section: Benefitsmentioning

confidence: 99%

Digital Health Interventions: New opportunities for health science librarians

Murphy

2021

Health Info Libraries J

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This article acquaints health science librarians with digital health interventions (DHIs) and suggests ways they can become involved with initiatives in their own organisations. Examples of DHIs are provided and the risks and benefits of these applications are examined, including increasing accuracy of diagnosis & treatment, and health care efficiencies within legal and ethical frameworks. The WHO Guideline on digital interventions for health system strengthening is a useful resource which highlights ways that countries can use digital health technology to improve people's health and essential services. JM proposes the creation of a road map to assist health science librarians in becoming involved in digital health, providing practical suggestions to inform the development of action plans within your local service provision. J.M.

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Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series

Cited by 5 publications

References 56 publications

Problems and Barriers Related to the Use of Digital Health Applications: Scoping Review

Problems and Barriers Related to the Use of Digital Health Applications: Scoping Review

Blending Cognitive Analytic Therapy With a Digital Support Tool: Mixed Methods Study Involving a User-Centered Design of a Prototype App

Digital Health Interventions: New opportunities for health science librarians

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