User-Centered Development of Bolster, an mHealth Intervention for Early Psychosis Caregivers: Needs Assessment, Prototyping, and Field Trial.
User-Centered Development of Bolster, an mHealth Intervention for Early Psychosis Caregivers: Needs Assessment, Prototyping, and Field Trial.
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DOI：
10.2196/50522
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发表时间：
2023-11-30
影响因子：
5.2
通讯作者：
Ben-Zeev, Dror
中科院分区：
文献类型：
--
作者：
Buck, Benjamin;Wingerson, Mary;Whiting, Erica;Snyder, Jaime;Monroe-DeVita, Maria;Ben-Zeev, Dror
关键词：
照顾者在治疗和恢复有精神病风险的青年和年轻人方面发挥着关键作用。照顾者经常报告感到孤立，不知所措，缺乏资源。移动的健康（mHealth）有可能为护理人员提供可扩展、可访问和即时的支持。到目前为止，很少有专门为这一人群开发的移动健康资源。本研究的目的是进行以用户为中心的设计和测试的mHealth干预，以支持早期精神病照顾者。我们进行了一个多阶段的以用户为中心的开发过程来开发Bolster移动的应用程序。在第一阶段，共招募了21名护理人员参与定性需求评估，并对Bolster平台的初始原型做出响应。内容分析用于确定关键需求和设计目标，指导Bolster移动的应用程序的开发。在第2阶段，共招募了11名护理人员参加为期1周的现场试验，他们提供有关Bolster可用性和可接受性的定性和定量反馈;此外，他们提供了基线和测试后的痛苦，疾病评估和家庭沟通的措施评估。在第一阶段，参与者确定了心理教育，沟通辅导，寻求服务的指南，并支持应对作为解决领域。实时原型交互会话产生了多个设计目标，包括确保来自平台的消息是可操作的，并根据护理人员的体验进行定制，以多种方式（例如，视频和文本）传递消息，并消除消息样式界面。这些结论被用于开发在现场试验中测试的摇枕的最终版本。在第2阶段，11名护理人员中，10名（91%）报告说，如果他们可以使用Bolster，他们会使用它，并会推荐给另一名护理人员。他们还报告了他们对疾病（科恩d=0.55-0.68），痛苦（科恩d=1.77）和表达情绪（科恩d=0.52）的评估的显着变化。据我们所知，这项研究是第一个专门为早期精神病照顾者设计mHealth干预措施的研究。初步数据表明，Bolster是可用的，可接受的，并有希望改善关键目标和结果。未来的一项全面临床试验将有助于确定mHealth是否可以减轻照顾者的负担，并增加受精神病影响的个人对服务的参与。
Caregivers play a critical role in the treatment and recovery of youth and young adults at risk for psychosis. Caregivers often report feeling isolated, overwhelmed, and lacking in resources. Mobile health (mHealth) has the potential to provide scalable, accessible, and in-the-moment support to caregivers. To date, few if any mHealth resources have been developed specifically for this population. The aim of this study was to conduct user-centered design and testing of an mHealth intervention to support early psychosis caregivers. We conducted a multiphase user-centered development process to develop the Bolster mobile app. In phase 1, a total of 21 caregivers were recruited to participate in a qualitative needs assessment and respond to an initial prototype of the Bolster platform. Content analysis was used to identify key needs and design objectives, which guided the development of the Bolster mobile app. In phase 2, a total of 11 caregivers were recruited to participate in a 1-week field trial wherein they provided qualitative and quantitative feedback regarding the usability and acceptability of Bolster; in addition, they provided baseline and posttest assessments of the measures of distress, illness appraisals, and family communication. In phase 1, participants identified psychoeducation, communication coaching, a guide to seeking services, and support for coping as areas to address. Live prototype interaction sessions led to multiple design objectives, including ensuring that messages from the platform were actionable and tailored to the caregiver experience, delivering messages in multiple modalities (eg, video and text), and eliminating a messaging-style interface. These conclusions were used to develop the final version of Bolster tested in the field trial. In phase 2, of the 11 caregivers, 10 (91%) reported that they would use Bolster if they had access to it and would recommend it to another caregiver. They also reported marked changes in their appraisals of illness (Cohen d=0.55-0.68), distress (Cohen d=1.77), and expressed emotion (Cohen d=0.52). To our knowledge, this study is the first to design an mHealth intervention specifically for early psychosis caregivers. Preliminary data suggest that Bolster is usable, acceptable, and promising to improve key targets and outcomes. A future fully powered clinical trial will help determine whether mHealth can reduce caregiver burdens and increase engagement in services among individuals affected by psychosis.
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