Enhancing Functional Outcomes in Schizophrenia Using a Novel mHealth Approach

描述（由申请人提供）：该项目的目标是完成移动健康应用程序的开发和试点测试，以提高动机，从而改善新近发病（RO）精神分裂症患者的功能结局。动机障碍是精神分裂症的一个核心特征，可以说是决定患者参与并坚持有效治疗能力的最重要因素，也是功能最强的预测因素，占心理社会结果方差的74%。先前改善精神分裂症功能结局的方法在其疗效上是有限的，高辍学率仍然是一个重大问题。鉴于这一紧迫的公共卫生问题，必须采取创新办法。我们建议开发一种新的干预措施，PRIME（动机增强的个性化实时干预），这是一款移动应用程序，它将使用移动软件的最新创新来改善个体在疾病早期的功能结果。PRIME需要较少的动机参与，同时也比传统治疗策略所允许的频率更高(例如：

DESCRIPTION (provided by applicant): The goal of this project is to complete the development and pilot testing of a mobile health app to improve motivation, thereby improving functional outcomes in individuals with recent-onset (RO) schizophrenia. Motivational impairment, a core feature of schizophrenia, is arguably the single most important factor in determining a patient's ability to engage in and adhere to effective treatment, and is the strongest predictor of functioning, accounting for 74% of the variance of psychosocial outcomes. Prior approaches to improve functional outcomes in schizophrenia are limited in their efficacy and high dropout rates remain a significant problem. In light of this pressing public health problem, an innovative approach is necessary. We propose to develop a new intervention, PRIME (Personalized Real-Time Intervention for Motivational Enhancement), a mobile app, which will use the latest innovations in mobile software to improve functional outcomes in individuals early in the course of illness. PRIME will require less motivational engagement while also being available at greater frequency than traditional therapeutic strategies would allow (e.g. psychotherapy). PRIME will be theoretically grounded in an evidence-based model of motivated behavior (Expectancy Value Theory) and target known motivational deficits, such as reward prediction, behavioral activation, and reward learning. This project will use a participatory desig strategy to enhance the likelihood that PRIME will be feasible and well tolerated in the target population. After a series of focus groups and field tests, we will conduct a small, randomized controlled trial to test the extent to which PRIME improves motivated behavior in three key domains: social, role, and health functioning, over a one-month period, relative to RO individuals in a wait-list control condition. This study will result in the first mobile app designed for individuals with schizophrenia, while also holding promise for other health conditions in which motivational impairments impede health outcomes.