Understanding the Subjective Experience of Long-term Remote Measurement Technology Use for Symptom Tracking in People With Depression: Multisite Longitudinal Qualitative Analysis

White, Katie M; Dawe-Lane, Erin; Siddi, Sara; Lamers, Femke; Simblett, Sara; Alacid, Gemma Riquelme; Ivan, Alina; Myin-Germeys, Inez; Haro, Josep María; Oetzmann, Carolin; Popat, Priya; Rintala, Aki; Rubio‐Abadal, Elena; Wykes, Til; Henderson, Claire; Hotopf, Matthew; Matcham, Faith

doi:10.2196/39479

Cited by 3 publications

(7 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This meant that they had prior experience of and interest in symptom monitoring. Previous work has also highlighted the impact of the academic setting on engagement through altruistic motivations [41]. It is possible that our results reflect a ceiling effect, whereby participants in both groups were motivated to participate in the research and complete symptom monitoring regardless of the changes to the app.…”

Section: Implications and Links With Previous Workmentioning

confidence: 79%

“…The design of the additional in-app components was grounded in behavioral theory and user research on the barriers to and facilitators of RMT use in patients with MDD [11,13,16]. The COM-B [31] framework of behavior change highlighted education, incentivization, and enablement as the most suitable forms of intervention function.…”

Section: Intervention Armmentioning

confidence: 99%

“…Third, with regard to subjective engagement, the measures used in this study might not have reflected the experience of self-monitoring in the most nuanced manner. We used previous findings [6,41] to inform our operationalization of subjective engagement with RMTs as usability (UES), emotional self-awareness (ESQ), and utility (MAUQ). Our qualitative evaluation suggested that participants generally saw the in-app components as helpful in increasing task completion, which, in turn, might have promoted the feelings of emotional self-awareness they gained from monitoring their symptoms.…”

Section: Implications and Links With Previous Workmentioning

confidence: 99%

“…The study has recently reported data availability metrics; 55.4% (345/623) of the sample completed >50% of the self-reported mood questionnaires expected to be completed, and 70.1% (437/623) had wearable heart rate data for >50% of the study days. Qualitative analyses from RADAR-MDD have revealed that the presence of a physical research team providing technological support and planned task reminders was a fundamental facilitator of long-term engagement in the study [13]. To ensure the scalability and real-world implementation of RMT systems, it is important to investigate methods that maximize engagement with RMTs while minimizing the human resources needed.…”

Section: Introductionmentioning

confidence: 99%

“…In the case of RMTs, the target behavior can be defined as objective engagement with symptom monitoring tasks. A series of published studies have evaluated both perceived [11,16] and experienced [13] barriers to RMT use in MDD research. Factors such as the knowledge of the utility of the research (capability), motivation linked to mood (motivation), and confirmation of logged data (opportunity) have been suggested to be prominent.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Engagement With a Remote Symptom-Tracking Platform Among Participants With Major Depressive Disorder: Randomized Controlled Trial

White¹,

Carr²,

Leightley³

et al. 2024

JMIR Mhealth Uhealth

Self Cite

View full text Add to dashboard Cite

Background Multiparametric remote measurement technologies (RMTs), which comprise smartphones and wearable devices, have the potential to revolutionize understanding of the etiology and trajectory of major depressive disorder (MDD). Engagement with RMTs in MDD research is of the utmost importance for the validity of predictive analytical methods and long-term use and can be conceptualized as both objective engagement (data availability) and subjective engagement (system usability and experiential factors). Positioning the design of user interfaces within the theoretical framework of the Behavior Change Wheel can help maximize effectiveness. In-app components containing information from credible sources, visual feedback, and access to support provide an opportunity to promote engagement with RMTs while minimizing team resources. Randomized controlled trials are the gold standard in quantifying the effects of in-app components on engagement with RMTs in patients with MDD. Objective This study aims to evaluate whether a multiparametric RMT system with theoretically informed notifications, visual progress tracking, and access to research team contact details could promote engagement with remote symptom tracking over and above the system as usual. We hypothesized that participants using the adapted app (intervention group) would have higher engagement in symptom monitoring, as measured by objective and subjective engagement. Methods A 2-arm, parallel-group randomized controlled trial (participant-blinded) with 1:1 randomization was conducted with 100 participants with MDD over 12 weeks. Participants in both arms used the RADAR-base system, comprising a smartphone app for weekly symptom assessments and a wearable Fitbit device for continuous passive tracking. Participants in the intervention arm (n=50, 50%) also had access to additional in-app components. The primary outcome was objective engagement, measured as the percentage of weekly questionnaires completed during follow-up. The secondary outcomes measured subjective engagement (system engagement, system usability, and emotional self-awareness). Results The levels of completion of the Patient Health Questionnaire-8 (PHQ-8) were similar between the control (67/97, 69%) and intervention (66/97, 68%) arms (P value for the difference between the arms=.83, 95% CI −9.32 to 11.65). The intervention group participants reported slightly higher user engagement (1.93, 95% CI −1.91 to 5.78), emotional self-awareness (1.13, 95% CI −2.93 to 5.19), and system usability (2.29, 95% CI −5.93 to 10.52) scores than the control group participants at follow-up; however, all CIs were wide and included 0. Process evaluation suggested that participants saw the in-app components as helpful in increasing task completion. Conclusions The adapted system did not increase objective or subjective engagement in remote symptom tracking in our research cohort. This study provides an important foundation for understanding engagement with RMTs for research and the methodologies by which this work can be replicated in both community and clinical settings. Trial Registration ClinicalTrials.gov NCT04972474; https://clinicaltrials.gov/ct2/show/NCT04972474 International Registered Report Identifier (IRRID) RR2-10.2196/32653

show abstract

Section: Implications and Links With Previous Workmentioning

confidence: 79%

Section: Intervention Armmentioning

confidence: 99%

Section: Implications and Links With Previous Workmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Engagement With a Remote Symptom-Tracking Platform Among Participants With Major Depressive Disorder: Randomized Controlled Trial

White¹,

Carr²,

Leightley³

et al. 2024

JMIR Mhealth Uhealth

Self Cite

View full text Add to dashboard Cite

show abstract

Barriers to and Facilitators of Using Remote Measurement Technology in the Long-Term Monitoring of Individuals With ADHD: Interview Study

Denyer¹,

Deng²,

Adanijo³

et al. 2023

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

Background Remote measurement technology (RMT) has the potential to address current research and clinical challenges of attention-deficit/hyperactivity disorder (ADHD) symptoms and its co-occurring mental health problems. Despite research using RMT already being successfully applied to other populations, adherence and attrition are potential obstacles when applying RMT to a disorder such as ADHD. Hypothetical views and attitudes toward using RMT in a population with ADHD have previously been explored; however, to our knowledge, there is no previous research that has used qualitative methods to understand the barriers to and facilitators of using RMT in individuals with ADHD following participation in a remote monitoring period. Objective We aimed to evaluate the barriers to and facilitators of using RMT in individuals with ADHD compared with a group of people who did not have a diagnosis of ADHD. We also aimed to explore participants’ views on using RMT for 1 or 2 years in future studies. Methods In total, 20 individuals with ADHD and 20 individuals without ADHD were followed up for 10 weeks using RMT that involved active (questionnaires and cognitive tasks) and passive (smartphone sensors and wearable devices) monitoring; 10 adolescents and adults with ADHD and 12 individuals in a comparison group completed semistructured qualitative interviews at the end of the study period. The interviews focused on potential barriers to and facilitators of using RMT in adults with ADHD. A framework methodology was used to explore the data qualitatively. Results Barriers to and facilitators of using RMT were categorized as health-related, user-related, and technology-related factors across both participant groups. When comparing themes that emerged across the participant groups, both individuals with and without ADHD experienced similar barriers and facilitators in using RMT. The participants agreed that RMT can provide useful objective data. However, slight differences between the participant groups were identified as barriers to RMT across all major themes. Individuals with ADHD described the impact that their ADHD symptoms had on participating (health-related theme), commented on the perceived cost of completing the cognitive tasks (user-related theme), and described more technical challenges (technology-related theme) than individuals without ADHD. Hypothetical views on future studies using RMT in individuals with ADHD for 1 or 2 years were positive. Conclusions Individuals with ADHD agreed that RMT, which uses repeated measurements with ongoing active and passive monitoring, can provide useful objective data. Although themes overlapped with previous research on barriers to and facilitators of engagement with RMT (eg, depression and epilepsy) and with a comparison group, there are unique considerations for people with ADHD, for example, understanding the impact that ADHD symptoms may have on engaging with RMT. Researchers need to continue working with people with ADHD to develop future RMT studies for longer periods.

show abstract

Adherence to wearables by people with severe mental illness in Switzerland: Time-use study

Richter,

Hasler,

Kurpicz-Briki

2024

Preprint

View full text Add to dashboard Cite

Wearables will play a central role in the digital support of people with severe mental disorders. So far, there are only a few studies that have investigated the temporal usage behaviour of wearables among this service user group. We equipped 10 service users of a Swiss psychiatric rehabilitation institution with wearables and used a survey to investigate whether and how often the devices were worn. The results showed a relatively high level of use overall. On average, the participants wore the wearable for 20 hours per day. However, we also found considerable variability. Wearables must fulfil high requirements for widespread implementation in practice.

show abstract

Understanding the Subjective Experience of Long-term Remote Measurement Technology Use for Symptom Tracking in People With Depression: Multisite Longitudinal Qualitative Analysis

Cited by 3 publications

References 37 publications

Engagement With a Remote Symptom-Tracking Platform Among Participants With Major Depressive Disorder: Randomized Controlled Trial

Engagement With a Remote Symptom-Tracking Platform Among Participants With Major Depressive Disorder: Randomized Controlled Trial

Barriers to and Facilitators of Using Remote Measurement Technology in the Long-Term Monitoring of Individuals With ADHD: Interview Study

Adherence to wearables by people with severe mental illness in Switzerland: Time-use study

Contact Info

Product

Resources

About