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Comparing mobile health (mHealth) and clinic-based self-management interventions for serious mental illness: patient engagement, satisfaction, and outcomes
Investigator (PI): Ben-Zeev, Dror
Performing Organization (PO): (Current): University of Washington, School of Medicine, Department of Psychiatry and Behavioral Sciences / (206) 543-3750
(Past): Dartmouth College, Geisel School of Medicine, Department of Psychiatry / (603) 650-1200
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2017
Final Year: 2018
Record Source/Award ID: PCORI/CER-1403-11403-IC ; PCORI/CER-1403-11403
Funding: Total Award Amount: $1,895,479
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: Serious mental illness (SMI), including schizophrenia and bipolar disorder, has profound impact on patients, their family members, and caregivers. Poorly managed, SMI increases patients' risk for homelessness, incarceration, victimization, hospitalization, and suicide. There are several clinic-based illness self-management interventions for SMI, but patients may not fully benefit from them because they are not always accessible, and they are time- and labor-intensive. Recently, mobile health (mHealth) research has produced illness self-management options that are delivered directly to patients using mobile phones. Objectives: We propose to compare two illness self-management interventions for SMI, a widely used clinic-based treatment and a state-of-the-art mHealth intervention. Both interventions target similar outcomes, but differ in how treatment content is delivered, and the burden placed on patients. We aim to 1) evaluate and compare the willingness and ability of individuals with SMI to enroll in the two interventions, 2) examine and compare participant engagement and satisfaction with both treatments, and 3) examine and compare patient outcomes following participation in the interventions. Methods: The study will be conducted in partnership with the patients and practitioners at one of the largest psychiatric rehabilitation agencies in the country. Data will be collected using a mixed-methods approach comprised of patient assessments, qualitative interviews, and focus groups. Study staff will enroll 160 participants with SMI who will receive 12 weeks of clinic-based or mHealth treatment. Patient engagement, satisfaction, and clinical outcomes (i.e., symptoms, quality of life, and recovery) will be compared before and immediately after the intervention period, and at follow-up. Patient outcomes (projected): We anticipate that patients receiving mHealth treatment will be more engaged and satisfied than those receiving clinic-based care. We also anticipate that clinical outcomes will be superior in the mHealth intervention because patients will benefit from the ability to use self-management tools more flexibly. Patient and stakeholder engagement: Several patient and community mental health stakeholders are project co-investigators that are involved in every step of the study. A community mental health advocate is a core member of our team. Current and former patients will meet with the research team twice yearly to maximize the inclusion of patient-stakeholder perspectives. Anticipated impact: Our examination of which intervention patients are more willing and able to use in real-world conditions will inform stakeholders and patients about the utility and limitations of clinic-based vs. mHealth treatment delivery options. Evaluation of which intervention produces better outcomes will provide patients, systems of care, and funding agencies with the information needed to consider treatment options for illness self-management in SMI.
MeSH Terms:
  • Bipolar Disorder /therapy
  • * Cell Phone
  • Community Mental Health Services /*organization & administration
  • Focus Groups
  • Humans
  • Mental Disorders /*therapy
  • Outcome Assessment, Health Care
  • Patient Participation
  • Patient Satisfaction
  • Program Development
  • Program Evaluation
  • Quality of Life
  • Schizophrenia /therapy
  • Self Care /*methods
Country: United States || United States
State: Washington || New Hampshire
Zip Code: 03756 / 98195
UI: 20152198
CTgovId: NCT02421965
Project Status: Completed
Record History: ('2017: Project extended to 2017 and PO changed.',) ('Start date changed to 2017 per PCORI due to institutional change, 2/14/2020',)