scholarly journals Usability Evaluations of Mobile Mental Health Technologies: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Yavuz Inal ◽  
Jo Dugstad Wake ◽  
Frode Guribye ◽  
Tine Nordgreen

BACKGROUND Many mobile health (mHealth) apps for mental health have been made available in recent years. Although there is reason to be optimistic about their effect on improving health and increasing access to care, there is a call for more knowledge concerning how mHealth apps are used in practice. OBJECTIVE This study aimed to review the literature on how usability is being addressed and measured in mHealth interventions for mental health problems. METHODS We conducted a systematic literature review through a search for peer-reviewed studies published between 2001 and 2018 in the following electronic databases: EMBASE, CINAHL, PsycINFO, PubMed, and Web of Science. Two reviewers independently assessed all abstracts against the inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. RESULTS A total of 299 studies were initially identified based on the inclusion keywords. Following a review of the title, abstract, and full text, 42 studies were found that fulfilled the criteria, most of which evaluated usability with patients (n=29) and health care providers (n=11) as opposed to healthy users (n=8) and were directed at a wide variety of mental health problems (n=24). Half of the studies set out to evaluate usability (n=21), and the remainder focused on feasibility (n=10) or acceptability (n=10). Regarding the maturity of the evaluated systems, most were either prototypes or previously tested versions of the technology, and the studies included few accounts of sketching and participatory design processes. The most common reason referred to for developing mobile mental health apps was the availability of mobile devices to users, their popularity, and how people in general became accustomed to using them for various purposes. CONCLUSIONS This study provides a detailed account of how evidence of usability of mHealth apps is gathered in the form of usability evaluations from the perspective of computer science and human-computer interaction, including how users feature in the evaluation, how the study objectives and outcomes are stated, which research methods and techniques are used, and what the notion of mobility features is for mHealth apps. Most studies described their methods as trials, gathered data from a small sample size, and carried out a summative evaluation using a single questionnaire, which indicates that usability evaluation was not the main focus. As many studies described using an adapted version of a standard usability questionnaire, there may be a need for developing a standardized mHealth usability questionnaire.

10.2196/15337 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e15337 ◽  
Author(s):  
Yavuz Inal ◽  
Jo Dugstad Wake ◽  
Frode Guribye ◽  
Tine Nordgreen

Background Many mobile health (mHealth) apps for mental health have been made available in recent years. Although there is reason to be optimistic about their effect on improving health and increasing access to care, there is a call for more knowledge concerning how mHealth apps are used in practice. Objective This study aimed to review the literature on how usability is being addressed and measured in mHealth interventions for mental health problems. Methods We conducted a systematic literature review through a search for peer-reviewed studies published between 2001 and 2018 in the following electronic databases: EMBASE, CINAHL, PsycINFO, PubMed, and Web of Science. Two reviewers independently assessed all abstracts against the inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Results A total of 299 studies were initially identified based on the inclusion keywords. Following a review of the title, abstract, and full text, 42 studies were found that fulfilled the criteria, most of which evaluated usability with patients (n=29) and health care providers (n=11) as opposed to healthy users (n=8) and were directed at a wide variety of mental health problems (n=24). Half of the studies set out to evaluate usability (n=21), and the remainder focused on feasibility (n=10) or acceptability (n=10). Regarding the maturity of the evaluated systems, most were either prototypes or previously tested versions of the technology, and the studies included few accounts of sketching and participatory design processes. The most common reason referred to for developing mobile mental health apps was the availability of mobile devices to users, their popularity, and how people in general became accustomed to using them for various purposes. Conclusions This study provides a detailed account of how evidence of usability of mHealth apps is gathered in the form of usability evaluations from the perspective of computer science and human-computer interaction, including how users feature in the evaluation, how the study objectives and outcomes are stated, which research methods and techniques are used, and what the notion of mobility features is for mHealth apps. Most studies described their methods as trials, gathered data from a small sample size, and carried out a summative evaluation using a single questionnaire, which indicates that usability evaluation was not the main focus. As many studies described using an adapted version of a standard usability questionnaire, there may be a need for developing a standardized mHealth usability questionnaire.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.


2021 ◽  
Author(s):  
Nancy Lau ◽  
Susannah F Colt ◽  
Shayna Waldbaum ◽  
Alison O'Daffer ◽  
Kaitlyn Fladeboe ◽  
...  

BACKGROUND Children, adolescents, and young adults with chronic conditions experience difficulties coping with disease-related stressors, comorbid mental health problems, and decreased quality of life. The COVID-19 pandemic has led to a global mental health crisis, and telemental health has necessarily displaced in-person care. However, it remains unknown whether such remote interventions are feasible or efficacious. We aimed to fill this research-practice gap. OBJECTIVE In this systematic review, we present a synthesis of studies examining the feasibility and efficacy of telemental health interventions for youth aged ≤25 years with chronic illnesses. METHODS PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched from 2008 to 2020. We included experimental, quasiexperimental, and observational studies of telemental health interventions designed for children, adolescents, and young adults aged ≤25 years with chronic illnesses, in which feasibility or efficacy outcomes were measured. Only English-language publications in peer-reviewed journals were included. We excluded studies of interventions for caregivers or health care providers, mental health problems not in the context of a chronic illness, disease and medication management, and prevention programs for healthy individuals. RESULTS We screened 2154 unique study records and 109 relevant full-text articles. Twelve studies met the inclusion criteria, and they represented seven unique telemental health interventions. Five of the studies included feasibility outcomes and seven included efficacy outcomes. All but two studies were pilot studies with relatively small sample sizes. Most interventions were based on cognitive behavioral therapy and problem-solving therapy. The subset of studies examining intervention feasibility concluded that telemental health interventions were appropriate, acceptable, and satisfactory to patients and their parents. Technology did not create barriers in access to care. For the subset of efficacy studies, evidence in support of the efficacy of telemental health was mixed. Significant heterogeneity in treatment type, medical diagnoses, and outcomes precluded a meta-analysis. CONCLUSIONS The state of the science for telemental health interventions designed for youth with chronic illnesses is in a nascent stage. Early evidence supports the feasibility of telehealth-based delivery of traditional in-person interventions. Few studies have assessed efficacy, and current findings are mixed. Future research should continue to evaluate whether telemental health may serve as a sustainable alternative to in-person care after the COVID pandemic.


2019 ◽  
Vol 55 (7) ◽  
pp. 839-876 ◽  
Author(s):  
Ruimin Ma ◽  
Farhana Mann ◽  
Jingyi Wang ◽  
Brynmor Lloyd-Evans ◽  
James Terhune ◽  
...  

Abstract Purpose Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. Methods Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. Results In total, 30 RCTs met the review’s inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants’ characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. Conclusion The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. We highlight the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.


Author(s):  
Mercy Ngosa Mumba ◽  
Alexandria Nancarrow ◽  
Jessica L. Jaiswal ◽  
Erika Hocchaus ◽  
Madelyn H. Campbell ◽  
...  

BACKGROUND: Each year about one in five adults experiences mental illness. Although the independent physical and mental health consequences of alcohol misuse and cigarette smoking are well documented, little is known on how substance use moderates the relationship between physical and mental well-being. OBJECTIVE: The purpose of this study was to examine whether substance use moderates the relationship between physical activity and mental health in adults. METHODS: This was a secondary analysis of data provided by the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS: Participants ( N = 450,016) were adults who completed the BRFSS in 2017. Those who did not drink alcohol had fewer mental health problems when they indicated greater amounts of time spent doing physical activities each week. Last, smokers’ number of mental health problems decreased as they engaged in more physical activity, whereas nonsmokers’ number of mental health problems increased as they engaged in more physical activity. CONCLUSIONS: The relationship between physical activity and mental health outcomes is well established and cannot be overemphasized. Nonetheless, substance abuse can moderate this relationship and should be routinely screened for by health care providers regardless of treatment setting.


2017 ◽  
Vol 48 (4) ◽  
pp. 453-464 ◽  
Author(s):  
Vinitha Jithoo

Emerging adults are an important group not only because their opinions and knowledge will determine future attitudes but also because of the emergence of mental health problems during young adulthood. In order to provide relevant support, academics, health care providers as well as policy makers need to be more cognisant of how emerging adults make meaning of their psycho-social developmental context. The objective of the study was to explore how a cohort of 150 university students made meaning of emotional well-being and mental illness, the causes of mental health problems, the negative connotations associated with mental ill health, help-seeking behaviours, and how culture was used as a lens through which mental well-being was understood. The main findings indicate that students struggle to fully understand these concepts mainly because it is shrouded in mystery and complexity and not engaged with freely because of stigma and stereotypical attitudes, and while culture provides a lens to understand the causes and interventions, emerging adults often adopt a level of scepticism and are beginning to vacillate between tradition and modernity. Emerging adults face many barriers to accessing health care services including limited knowledge and stigma related to services, lack of confidentiality, fear of mistreatment, location of facilities, and the high cost of services. Universities and government should actively engage with research evidence to inform policies and programmes to improve the health and well-being of emerging adults.


2021 ◽  
pp. 1-19
Author(s):  
Xiaolong Zhang ◽  
Shôn Lewis ◽  
Joseph Firth ◽  
Xu Chen ◽  
Sandra Bucci

Abstract Mental health problems are highly prevalent in China; however, China's mental health services lack resources to deliver high-quality care to people in need. Digital mental health is a promising solution to this short-fall in view of the population's digital literacy. In this review, we aim to: (i) investigate the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China; (ii) critically appraise the literature; and (iii) make recommendations for future research directions. The databases MEDLINE, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, and VIP were systemically searched for English and Chinese language articles evaluating DHTs for people with mental health problems in mainland China. Eligible studies were systematically reviewed. The heterogeneity of studies included precluded a meta-analysis. In total, 39 articles were retrieved, reporting on 32 DHTs for various mental health problems. Compared with the digital mental health field in the West, the Chinese studies targeted schizophrenia and substance use disorder more often and investigated social anxiety mediated by shame and culturally specific variants, DHTs were rarely developed in a co-production approach, and methodology quality was less rigorous. To our knowledge, this is the first systematic review focused on digital mental health in the Chinese context including studies published in both English and the Chinese language. DHTs were acceptable and usable among Chinese people with mental health problems in general, similar to findings from the West. Due to heterogeneity across studies and a paucity of robust control trial research, conclusions about the efficacy of DHTs are lacking.


1997 ◽  
Vol 42 (9) ◽  
pp. 943-949 ◽  
Author(s):  
MA Craven ◽  
M Cohen ◽  
D Campbell ◽  
J Williams ◽  
Nick Kates

Objective: To obtain descriptions of how family physicians detect and manage mental health problems commonly encountered in their practices and how they function in their role as mental health care providers. Also, to elicit their perceptions of barriers to the delivery of optimal mental health care. Method: Focus groups with standardized questions were used to elicit descriptive data, opinions, attitudes, and terminology. Convenience samples of 10 to 12 physicians were chosen in each of Ontario's 7 health care planning regions, with a mixture of rural, urban, and university settings. Discussions were audiotaped, transcribed, analyzed, and recurring themes were extracted. Results: Family physicians' descriptions of the range of problems commonly encountered and their detection and management highlight the unique nature of mental health care in the primary care setting. The realities of family medicine, the undifferentiated nature of presenting problems, the long-term physician–patient relationship, and the frequent overlap of physical and mental health problems dictate an approach to diagnosis and treatment that differs from mental health care delivery in other settings. Difficulties in the relationship with local psychiatric services—accessing psychiatric care (especially for emergencies), poor communication with mental health care providers, and cumbersome intake procedures of many mental health services—were consistently identified as barriers to the delivery of optimal mental health care. Conclusions: This study confirms the importance of the family physician in the detection and management of mental health problems. It offers insights into how family physicians function in their role as mental health care providers and how they deal with diagnostic and management challenges that are specific to primary care. It also identifies barriers to the optimal delivery of mental health care in the primary care setting, including difficulties at the clinical interface between psychiatry and family medicine. Further studies are needed to explore these issues in greater depth.


10.2196/30098 ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. e30098
Author(s):  
Nancy Lau ◽  
Susannah F Colt ◽  
Shayna Waldbaum ◽  
Alison O'Daffer ◽  
Kaitlyn Fladeboe ◽  
...  

Background Children, adolescents, and young adults with chronic conditions experience difficulties coping with disease-related stressors, comorbid mental health problems, and decreased quality of life. The COVID-19 pandemic has led to a global mental health crisis, and telemental health has necessarily displaced in-person care. However, it remains unknown whether such remote interventions are feasible or efficacious. We aimed to fill this research-practice gap. Objective In this systematic review, we present a synthesis of studies examining the feasibility and efficacy of telemental health interventions for youth aged ≤25 years with chronic illnesses. Methods PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched from 2008 to 2020. We included experimental, quasiexperimental, and observational studies of telemental health interventions designed for children, adolescents, and young adults aged ≤25 years with chronic illnesses, in which feasibility or efficacy outcomes were measured. Only English-language publications in peer-reviewed journals were included. We excluded studies of interventions for caregivers or health care providers, mental health problems not in the context of a chronic illness, disease and medication management, and prevention programs for healthy individuals. Results We screened 2154 unique study records and 109 relevant full-text articles. Twelve studies met the inclusion criteria, and they represented seven unique telemental health interventions. Five of the studies included feasibility outcomes and seven included efficacy outcomes. All but two studies were pilot studies with relatively small sample sizes. Most interventions were based on cognitive behavioral therapy and problem-solving therapy. The subset of studies examining intervention feasibility concluded that telemental health interventions were appropriate, acceptable, and satisfactory to patients and their parents. Technology did not create barriers in access to care. For the subset of efficacy studies, evidence in support of the efficacy of telemental health was mixed. Significant heterogeneity in treatment type, medical diagnoses, and outcomes precluded a meta-analysis. Conclusions The state of the science for telemental health interventions designed for youth with chronic illnesses is in a nascent stage. Early evidence supports the feasibility of telehealth-based delivery of traditional in-person interventions. Few studies have assessed efficacy, and current findings are mixed. Future research should continue to evaluate whether telemental health may serve as a sustainable alternative to in-person care after the COVID pandemic.


2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Fadma Aji Pramudita ◽  
Iman Permana

Mental health is one of the health problems in the world, including in Indonesia, one of which is schizophrenia. Management of schizophrenia not only uses pharmacological therapy but also with non-pharmacological therapy. Spirituality is believed to have a role in the treatment of schizophrenia. Purpose: This article aims to identify and analyze research articles about the spiritual role in healing in schizophrenic patients. This article search uses a literature study approach from several ProQuest, Ebsco ScienceDirect databases, and Google Scholar databases, using the keywords "Spiritual OR Spirituality AND Mental disorder OR Mental Illness OR Schizophrenia". Based on the screening process of 509,589 journals, 9 articles were obtained by selecting inclusion criteria. The results obtained are summarized in 2 theme forms including the spiritual role in mental health problems where the importance of health professionals involves the spiritual dimension in health services as well as the spiritual concepts that play a role in handling mental problems; the second theme is about the spiritual role in schizophrenia healing, which is that spiritual can affect active and adaptive coping in schizophrenia patients. Social support activities, age, service satisfaction, spiritual well-being, and symptom severity are identified as aspirators in the quality of life of patients with schizophrenia. Conclusion: Four things that are felt to have a significant effect on healing schizophrenic patients include interactions or therapeutic relationships with health care providers, increased self-awareness of disease, social support, and the use of psychotropic drugs to reduce symptoms that arise.


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