Stiles-Shields Colleen, Montague Enid, Lattie Emily G, Schueller Stephen M, Kwasny Mary J, Mohr David C
Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, IL, United States.
JMIR Hum Factors. 2017 Aug 11;4(3):e18. doi: 10.2196/humanfactors.7951.
Mental health apps tend to be narrow in their functioning, with their focus mostly being on tracking, management, or psychoeducation. It is unclear what capability such apps have to facilitate a change in users, particularly in terms of learning key constructs relating to behavioral interventions. Thought Challenger (CBITs, Chicago) is a skill-building app that engages users in cognitive restructuring, a core component of cognitive therapy (CT) for depression.
The purpose of this study was to evaluate the learnability and learning performance of users following initial use of Thought Challenger.
Twenty adults completed in-lab usability testing of Thought Challenger, which comprised two interactions with the app. Learnability was measured via completion times, error rates, and psychologist ratings of user entries in the app; learning performance was measured via a test of CT knowledge and skills. Nonparametric tests were conducted to evaluate the difference between individuals with no or mild depression to those with moderate to severe depression, as well as differences in completion times and pre- and posttests.
Across the two interactions, the majority of completion times were found to be acceptable (5 min or less), with minimal errors (1.2%, 10/840) and successful completion of CT thought records. Furthermore, CT knowledge and skills significantly improved after the initial use of Thought Challenger (P=.009).
The learning objectives for Thought Challenger during initial uses were successfully met in an evaluation with likely end users. The findings therefore suggest that apps are capable of providing users with opportunities for learning of intervention skills.
心理健康应用程序的功能往往较为有限，主要侧重于跟踪、管理或心理教育。目前尚不清楚这类应用程序在促进用户改变方面有何能力，特别是在学习与行为干预相关的关键概念方面。Thought Challenger（芝加哥CBITs）是一款技能培养应用程序，可让用户参与认知重构，这是抑郁症认知疗法（CT）的核心组成部分。
本研究的目的是评估用户初次使用Thought Challenger后的可学习性和学习表现。
20名成年人完成了Thought Challenger的实验室可用性测试，该测试包括与该应用程序的两次交互。通过完成时间、错误率以及心理学家对应用程序中用户条目评分来衡量可学习性；通过CT知识和技能测试来衡量学习表现。进行非参数测试以评估无抑郁症或轻度抑郁症个体与中度至重度抑郁症个体之间的差异，以及完成时间和测试前后的差异。
在两次交互过程中，发现大多数完成时间是可接受的（5分钟或更短），错误极少（1.2%，10/840），并且成功完成了CT思维记录。此外，初次使用Thought Challenger后，CT知识和技能有显著提高（P = .009）。
在与潜在最终用户的评估中，Thought Challenger初次使用时的学习目标得以成功实现。因此，研究结果表明应用程序有能力为用户提供学习干预技能的机会。
