OpenSIMPLe: A real-world implementation feasibility study of a smartphone-based psychoeducation programme for bipolar disorder

Hidalgo‐Mazzei, Diego; Reinares, María; Mateu, Ainoa; Nikolova, Viktoriya L; Bonnín, Caterina del Mar; Samalin, Ludovic; García-Estela, Aitana; Pérez‐Solà, Víctor; Young, Allan H.; Strejilevich, Sergio; Vieta, Eduard; Colom, Francesc

doi:10.1016/j.jad.2018.08.048

Cited by 81 publications

(104 citation statements)

References 62 publications

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“…Several studies have demonstrated high rates of user acceptance and satisfaction when using properly tested mental health apps in research studies [8,20,21]. Therefore, there is a need to develop guidelines and frameworks to validate mental health apps in order to make them available to those who might benefit from them [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have already demonstrated the potential for diagnosing and capturing illness activity in BD based on smartphones use patterns [6]. Additionally, these technologies open a two-way avenue to collect a novel type of comprehensive illness-relevant data while simultaneously delivering personalized mental health interventions remotely, at a low cost and on a large scale [7] (Figure 1). Several apps and IBPs have now been developed to deliver psychological interventions.…”

Section: Introductionmentioning

confidence: 99%

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Internet-connected devices ownership, use and interests in bipolar disorder: from desktop to mobile mental health

Hidalgo‐Mazzei

Nikolova

Kitchen³

et al. 2019

Digital Psychiatry

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Advances in communication technologies have led to a new era of ubiquitous accessibility to Internet-based platforms (IBPs) and devices with an unprecedented potential for mental health. However, it is rarely explored if potential user groups own devices from which they can access these or whether they are interested in the development of new platforms. Two anonymous surveys were circulated to 20,000 subscribers of the Bipolar UK e-newsletter. A total of 570 people responded to the first survey and 286 responded to the second. The first contained five questions regarding participants' interest in a smartphone IBP to support their illness while the second consisted in 27 questions exploring devices ownership and use as well as their potential interest in emerging new IBPs: 97.6% of respondents were diagnosed with bipolar disorder (BD) by a healthcare professional and 92.8% of them owned a smartphone. The most frequent purposes for daily smartphone use were text messaging (73.4%), e-mail (71.3%) and social networks (53.8%). About 77% of respondents expressed willingness to receive self-management strategies through a smartphone app. The pattern of widespread and growing ownership and use of devices with access to IBPs among people with BD is similar to that of the general population. Combined with the expressed interest in novel technological developments for disorder self-management, this represents a great opportunity to establish a two-way avenue to collect and deliver novel type of interventions offering personalized material to people with BD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Internet-connected devices ownership, use and interests in bipolar disorder: from desktop to mobile mental health

Hidalgo‐Mazzei

Nikolova

Kitchen³

et al. 2019

Digital Psychiatry

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“…For example, researchers have found correlations between assessments of psychotic and mood symptoms delivered via smartphone apps and in traditional gold-standard formats [16][17][18]. Additionally, preliminary evidence suggests small improvements in: quality of life and recovery [19]; community functioning [20]; negative symptoms, general psychotic symptoms and mood [21]; positive symptoms, excitement, general psychopathology and disorganisation [22]; and wellbeing [23] after the delivery of DHIs. However, further large-scale studies exploring the specific mechanisms that may elicit change are warranted [20].…”

Section: Introductionmentioning

confidence: 99%

A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems

2019

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BackgroundThe development of digital health interventions (DHIs) for severe mental health problems is fast-paced. Researchers are beginning to consult service users to inform DHIs; however, much of this involvement has been limited to feedback on specific interventions post-DHI development. This study had two aims: 1. explore service user views towards DHIs for severe mental health problems; and 2. make recommendations for specific content within DHIs based on service user needs and suggestions.MethodsQualitative interviews with eighteen people with severe mental health problems focussed on two domains: 1) views about DHIs for severe mental health problems; and 2) ideas for future DHI content and design features. Data were analysed thematically.ResultsParticipants responses were captured in five key themes: 1) DHIs could be empowering tools that instigate reflection and change; 2) society is already divided; DHIs will further increase this divide; 3) considerations must be made about who has access to DHI data and how this data may be used; 4) DHIs should not be delivered without other support options; and 5) DHIs should provide a positive, fun, practical and interactive method for self-management.ConclusionsParticipants found DHIs acceptable due to the empowering nature of self-management and ability to take ownership of their own healthcare needs. However, concerns included the potential for digital exclusion, privacy and confidentiality and fears about DHIs being used to replace other mental health services. Service users want tools to help them self-manage their mental health, but also provide positive and recovery-focussed content that can be used in conjunction with other support options.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1979-1) contains supplementary material, which is available to authorized users.

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“…26 Although we used a relatively short follow-up period (12 weeks), user engagement with apps is typically higher in the short term and tends to wane over time. For example, the average period of app use is 2 months, 28 and only 27% of participants in another study 29 were still using the app at a 14-week follow-up. We therefore reasoned that we were likely to see greater effects over the short term than long term.…”

Section: A B C Dmentioning

confidence: 99%

A co-designed mHealth programme to support healthy lifestyles in Māori and Pasifika peoples in New Zealand (OL@-OR@): a cluster-randomised controlled trial

Mhurchú

Morenga

Firestone

et al. 2019

The Lancet Digital Health

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Background The OL@-OR@ mobile health programme was co-designed with Māori and Pasifika communities in New Zealand, to support healthy lifestyle behaviours. We aimed to determine whether use of the programme improved adherence to health-related guidelines among Māori and Pasifika communities in New Zealand compared with a control group on a waiting list for the programme. Methods The OL@-OR@ trial was a 12-week, two-arm, cluster-randomised controlled trial. A cluster was defined as any distinct location or setting in New Zealand where people with shared interests or contexts congregated, such as churches, sports clubs, and community groups. Members of a cluster were eligible to participate if they were aged 18 years or older, had regular access to a mobile device or computer, and had regular internet access. Clusters of Māori and of Pasifika (separately) were randomly assigned (1:1) to either the intervention or control condition. The intervention group received the OL@-OR@ mHealth programme (smartphone app and website). The control group received a control version of the app that only collected baseline and outcome data. The primary outcome was selfreported adherence to health-related guidelines, which were measured with a composite health behaviour score (of physical activity, smoking, alcohol intake, and fruit and vegetable intake) at 12 weeks. The secondary outcomes were self-reported adherence to health-related behaviour guidelines at 4 weeks; self-reported bodyweight at 12 weeks; and holistic health and wellbeing status at 12 weeks, in all enrolled individuals in eligible clusters; and user engagement with the app, in individuals allocated to the intervention. Adverse events were not collected. This study is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12617001484336. Findings Between Jan 24 and Aug 14, 2018, we enrolled 337 Māori participants from 19 clusters and 389 Pasifika participants from 18 clusters (n=726 participants) in the intervention group and 320 Māori participants from 15 clusters and 405 Pasifika participants from 17 clusters (n=725 participants) in the control group. Of these participants, 227 (67%) Māori participants and 347 (89%) Pasifika participants (n=574 participants) in the intervention group and 281 (88%) Māori participants and 369 (91%) Pasifika participants (n=650 participants) in the control group completed the 12-week follow-up and were included in the final analysis. Relative to baseline, adherence to health-related behaviour guidelines increased at 12 weeks in both groups (315 [43%] of 726 participants at baseline to 329 [57%] of 574 participants in the intervention group; 331 [46%] of 725 participants to 369 [57%] of 650 participants in the control group); however, there was no significant difference between intervention and control groups in adherence at 12 weeks (odds ratio [OR] 1•13; 95% CI 0•84-1•52; p=0•42). Furthermore, the proportion of participants adhering to guidelines on physical activity (351 [61%] of 574 intervention group participants...

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OpenSIMPLe: A real-world implementation feasibility study of a smartphone-based psychoeducation programme for bipolar disorder

Abstract: The 6-month attrition rate of the programme was high. Positive outcomes regarding satisfaction were found predominantly among completers. The optimal dosage and retention of IBP mental health programmes remain challenging issues that need further research.

Cited by 81 publications

References 62 publications

Internet-connected devices ownership, use and interests in bipolar disorder: from desktop to mobile mental health

Internet-connected devices ownership, use and interests in bipolar disorder: from desktop to mobile mental health

A qualitative exploration of service user views about using digital health interventions for self-management in severe mental health problems

A co-designed mHealth programme to support healthy lifestyles in Māori and Pasifika peoples in New Zealand (OL@-OR@): a cluster-randomised controlled trial

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