Hatch Ainslie, Hoffman Julia E, Ross Ruth, Docherty John P
Otsuka America Pharmaceutical, Inc, Princeton, NJ, United States.
Behavior Dx, San Jose, CA, United States.
JMIR Ment Health. 2018 Jun 12;5(2):e46. doi: 10.2196/mental.9777.
Digital technology is increasingly being used to enhance health care in various areas of medicine. In the area of serious mental illness, it is important to understand the special characteristics of target users that may influence motivation and competence to use digital health tools, as well as the resources and training necessary for these patients to facilitate the use of this technology.
The aim of this study was to conduct a quantitative expert consensus survey to identify key characteristics of target users (patients and health care professionals), barriers and facilitators for appropriate use, and resources needed to optimize the use of digital health tools in patients with serious mental illness.
A panel of 40 experts in digital behavioral health who met the participation criteria completed a 19-question survey, rating predefined responses on a 9-point Likert scale. Consensus was determined using a chi-square test of score distributions across three ranges (1-3, 4-6, 7-9). Categorical ratings of first, second, or third line were designated based on the lowest category into which the CI of the mean ratings fell, with a boundary >6.5 for first line. Here, we report experts' responses to nine questions (265 options) that focused on (1) user characteristics that would promote or hinder the use of digital health tools, (2) potential benefits or motivators and barriers or unintended consequences of digital health tool use, and (3) support and training for patients and health care professionals.
Among patient characteristics most likely to promote use of digital health tools, experts endorsed interest in using state-of-the-art technology, availability of necessary resources, good occupational functioning, and perception of the tool as beneficial. Certain disease-associated signs and symptoms (eg, more severe symptoms, substance abuse problems, and a chaotic living situation) were considered likely to make it difficult for patients to use digital health tools. Enthusiasm among health care professionals for digital health tools and availability of staff and equipment to support their use were identified as variables to enable health care professionals to successfully incorporate digital health tools into their practices. The experts identified a number of potential benefits of and barriers to use of digital health tools by patients and health care professionals. Experts agreed that both health care professionals and patients would need to be trained in the use of these new technologies.
These results provide guidance to the mental health field on how to optimize the development and deployment of digital health tools for patients with serious mental illness.
数字技术越来越多地被用于改善医学各个领域的医疗保健。在严重精神疾病领域，了解可能影响使用数字健康工具的动机和能力的目标用户的特殊特征，以及这些患者使用该技术所需的资源和培训非常重要。
本研究的目的是进行一项定量专家共识调查，以确定目标用户（患者和医疗保健专业人员）的关键特征、适当使用的障碍和促进因素，以及优化严重精神疾病患者使用数字健康工具所需的资源。
一个由40名符合参与标准的数字行为健康专家组成的小组完成了一项包含19个问题的调查，在9点李克特量表上对预定义的回答进行评分。使用卡方检验对三个范围（1-3、4-6、7-9）的得分分布来确定共识。根据平均评分的置信区间落入的最低类别指定一线、二线或三线的分类评级，一线的边界>6.5。在此，我们报告专家对九个问题（265个选项）的回答，这些问题集中在（1）会促进或阻碍数字健康工具使用的用户特征，（2）数字健康工具使用的潜在益处或动机以及障碍或意外后果，以及（3）对患者和医疗保健专业人员的支持和培训。
在最有可能促进数字健康工具使用的患者特征中，专家认可对使用先进技术的兴趣、必要资源的可用性、良好的职业功能以及对工具有益的认知。某些与疾病相关的体征和症状（例如，更严重的症状、药物滥用问题和混乱的生活状况）被认为可能使患者难以使用数字健康工具。医疗保健专业人员对数字健康工具的热情以及支持其使用的人员和设备的可用性被确定为使医疗保健专业人员能够成功将数字健康工具纳入其实践的变量。专家们确定了患者和医疗保健专业人员使用数字健康工具的一些潜在益处和障碍。专家们一致认为，医疗保健专业人员和患者都需要接受这些新技术使用方面的培训。
这些结果为心理健康领域提供了有关如何优化严重精神疾病患者数字健康工具的开发和部署的指导。
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