Development of a Mobile System for Self-management of Schizophrenia (SOS)

描述(由申请人提供)：精神分裂症与惊人的个人和社会成本有关。抗精神病药物被认为是精神分裂症长期治疗的主要干预措施，但长期治疗结果往往很差。大量研究表明，疾病管理策略可以通过减轻与持续性精神病症状相关的严重程度和痛苦来支持药物治疗，改善疾病不同阶段的社会功能，并提高用药依从性。不幸的是，这些疾病管理干预措施在精神健康中心很少使用。移动技术无处不在，可能极大地有助于增加对精神分裂症的有效心理社会干预的可及性和利用率。已经成功地开发和部署了流动干预措施，以支持对一些慢性健康状况以及若干精神健康状况的自我管理。拟议项目的目标是开发和试验一个用于精神分裂症自我管理(SOS)的移动系统，最终目标是创建一个可由用户根据需要在自己的环境中部署的广泛可用的工具。精神分裂症患者将就计划的干预内容以及拟议系统的结构和风格提供意见。专家顾问将审查并提供反馈，以确保内容以有效的循证方法为基础，技术复杂性适合目标受众。将进行实验室和实地测试，以确定和解决技术问题，并确定SOS系统在实际条件下的可接受性和可行性。经过适当的修改后，将对精神分裂症患者进行SOS与常规治疗的随机试点试验。将检查干预方案的所有方面，包括功能、招募和保留程序，以及移动干预对结果的初步有效性，为随后的更大规模的随机对照试验做准备。拟议的项目将引入一种治疗模式，该模式在任何时间和任何地点提供疾病管理战略，允许持续的和“按需”治疗支持。如果有效，SOS系统可以提高个人在没有接受心理社会服务时有效管理疾病的能力，或者在作为标准治疗的辅助提供时增强护理的效力。该项目的长期目标是创建一个经过验证的应用程序，该应用程序可以轻松下载到移动电话上并供任何人使用，从而促进以证据为基础的工具的广泛和深远的实施和传播。

DESCRIPTION (provided by applicant): Schizophrenia is associated with staggeringly high individual and societal costs. Antipsychotic medications are considered the primary intervention for long-term treatment of schizophrenia, but long-term treatment outcomes are often poor. A large body of research suggests illness-management strategies can support pharmacotherapies by reducing the severity and distress associated with persistent psychotic symptoms, improve social functioning at various stages of the illness, and enhance medication adherence. Unfortunately, these illness-management interventions are rarely available at mental health centers. Mobile technologies are ubiquitous and may be tremendously instrumental in increasing the accessibility and utilization of effective psychosocial interventions for schizophrenia. Mobile interventions have already been successfully developed and deployed to support the self-management of a number of chronic health conditions as well as several mental health conditions. The goal of the proposed project is to develop and pilot a mobile system for Self- Management of Schizophrenia (SOS) with the ultimate objective of creating a widely-available tool that can be deployed by users as needed, in their own environments. Individuals with schizophrenia will provide input on planned intervention content as well as the structure and style of the proposed system. Expert consultants will review and provide feedback to ensure content is grounded in effective evidence-based approaches and the technical complexity is appropriate for the target audience. Laboratory and field tests will be conducted to identify and resolve technical problems, and to determine acceptability and feasibility of the SOS system in real-world conditions. Following appropriate modifications, a randomized pilot trial of SOS compared to treatment as usual will be conducted with individuals with schizophrenia. All aspects of the intervention protocol will be examined, including functionality, recruitment and retention procedures, and preliminary effectiveness of the mobile intervention on outcomes, in preparation for a subsequent larger randomized controlled trial. The proposed project will introduce a model of treatment which offers illness-management strategies at any time and in any location, allowing for ongoing, as well as "on-demand" therapeutic support. If effective, the SOS system could improve individuals' ability to effectively manage their illness when they are not receiving psychosocial services, or enhance the potency of care when offered as adjunct to standard treatments. The long-term goals of the project are to create a validated application that can be easily downloaded onto a mobile phone and used by anyone, facilitating wide-scale and far-reaching implementation and dissemination of evidence-based tools.