A Feasibility Trial of Power Up: Smartphone App to Support Patient Activation and Shared Decision Making for Mental Health in Young People
A Feasibility Trial of Power Up: Smartphone App to Support Patient Activation and Shared Decision Making for Mental Health in Young People
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DOI：
10.2196/11677
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发表时间：
2019-06-04
影响因子：
5
通讯作者：
Wolpert, Miranda
中科院分区：
文献类型：
--
作者：
Edbrooke-Childs, Julian;Edridge, Chloe;Wolpert, Miranda
背景：面对年轻人日益严重的心理健康问题，数字工具具有支持患者激活和共享决策的潜力。需要对数字干预措施进行可行性试验，以确定干预措施的使用情况和可接受性。此外，还需要确定招募和留住研究参与者的能力，以计划严格的有效性试验，从而制定基于证据的建议。目的：本研究旨在确定进行整群随机对照试验的可行性，以测试与年轻人共同设计的智能手机应用Power Up的有效性，以支持患者的激活和共同的心理健康决策。方法：总体而言，270名年轻人被筛选参与，52.5%(142/270)的人被招募并完成了8个专科儿童心理健康服务(n=62，平均年龄14.66(SD 1.99)岁)的基线测量；52%[32/62]女生)和2所主流中学(n=80；平均年龄16.88[SD 0.68]岁；46%[37/80]女生)。年轻人除了照常接受管理外，还接受了加电，或者只接受了照常管理。对11名来自干预部队(专科6人，学校5人)的青少年进行了试验后访谈。结果：使用数据显示，在干预部队中，估计有50名(来自)的Power Up用户。采访结果表明，年轻人认为Power Up是可以接受的。年轻人报告了(1)他们使用Power Up的动机，(2)使用的影响，(3)使用的障碍。在招募的142名参与者中，45.0%(/142)完成了随访措施，并讨论了指导小组同意的增加保留率的方法。结论：本研究结果表明APP是可以接受的，在前瞻性随机对照试验中检验Power Up的有效性是可行的。
Background: Digital tools have the potential to support patient activation and shared decision making in the face of increasing levels of mental health problems in young people. There is a need for feasibility trials of digital interventions to determine the usage and acceptability of interventions. In addition, there is a need to determine the ability to recruit and retain research participants to plan rigorous effectiveness trials and, therefore, develop evidence-based recommendations for practice.Objective: This study aimed to determine the feasibility of undertaking a cluster randomized controlled trial to test the effectiveness of a smartphone app, Power Up, co-designed with young people to support patient activation and shared decision making for mental health.Methods: Overall, 270 young people were screened for participation and 52.5% (142/270) were recruited and completed baseline measures across 8 specialist child mental health services (n=62, mean age 14.66 (SD 1.99) year; 52% [32/62] female) and 2 mainstream secondary schools (n=80; mean age 16.88 [SD 0.68] years; 46% [37/80] female). Young people received Power Up in addition to management as usual or received management as usual only. Posttrial interviews were conducted with 11 young people from the intervention arms (specialist services n=6; schools n=5).Results: Usage data showed that there were an estimated 50 (out of 64) users of Power Up in the intervention arms. Findings from the interviews indicated that young people found Power Up to be acceptable. Young people reported (1) their motivation for use of Power Up, (2) the impact of use, and (3) barriers to use. Out of the 142 recruited participants, 45.0% (64/142) completed follow-up measures, and the approaches to increase retention agreed by the steering group are discussed.Conclusions: The findings of this study indicate that the app is acceptable, and it is feasible to examine the effectiveness of Power Up in a prospective cluster randomized controlled trial.