Examining Potential Barriers to mHealth Implementation and Engagement in Schizophrenia: Phone Ownership and Symptom Seve
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Examining Potential Barriers to mHealth Implementation and Engagement in Schizophrenia: Phone Ownership and Symptom Severity Lauren Luther 1,2,3 & Benjamin E. Buck 4 & Melanie A. Fischer 3 & Annalee V. Johnson-Kwochka 3 & George Coffin 3,5 & Michelle P. Salyers 3 Received: 11 June 2020 / Revised: 30 July 2020 / Accepted: 20 August 2020 # Springer Nature Switzerland AG 2020
Abstract Implementation of mobile health (mHealth) interventions remains limited among those with schizophrenia. This study examined several logistical barriers to the implementation of mHealth interventions, particularly text message interventions, for people with schizophrenia. This study examined the feasibility of leveraging personal mobile phones to deliver mHealth interventions by using data from a pilot randomized controlled trial (RCT) of a text message intervention delivered on personal mobile phones to 56 people with schizophrenia with motivation reductions. Among those screened for the RCT (n = 100), 91% had a mobile phone. For randomized participants (n = 56), 82.1% had a smartphone, with almost all (93.5%) having an Android processing system. Most randomized participants had unlimited text messages (96.4%) or voice calls (76.8%) with their mobile service plan, with 32.1% having unlimited data each month. At baseline, most used text messages (85.2%) and the internet (59.3%), while fewer participants used mobile applications (35.2%) at least once a week. Finally, there were no significant associations between engagement in the text message intervention and participant demographics, symptoms (positive, mood, negative), neurocognition, or mobile phone or plan characteristics, or phone changes made during the 8-week intervention. Even those with schizophrenia with perceived symptom barriers to mHealth engagement (i.e., motivation reductions) may have access to mobile phones and plans and familiarity with mobile features to engage meaningfully with a text message intervention. These results help to support future implementations of text message interventions, which may enhance the provision of care for those with schizophrenia. Keywords Mobile health (mHealth) . Schizophrenia . Technology-based intervention . Text messages . Motivation
Introduction * Lauren Luther [email protected] 1
Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Room 2603, Charlestown, MA 02129, USA
2
Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
3
Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN 46202, USA
4
Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA
5
College of Applied Behavioral Sciences, University of Indianapolis, 1400 East Hanna Avenue, Indianapolis, IN 46227, USA
Mobile health (mHealth) involves using mobile and wireless technologies (e.g., smartphones, activity tracking devices) to i
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