Nicholson Joanne, Wright Spenser M, Carlisle Alyssa M, Sweeney Mary Ann, McHugo Gregory J
Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States.
Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States.
JMIR Ment Health. 2018 Oct 25;5(4):e11383. doi: 10.2196/11383.
BACKGROUND: The disparities in employment for individuals with serious mental illnesses have been well documented, as have the benefits of work. Mobile technology can provide accessible in-the-moment support for these individuals. The WorkingWell mobile app was developed to meet the need for accessible follow-along supports for individuals with serious mental illnesses in the workplace. OBJECTIVE: We explore the usability, usage, usefulness, and overall feasibility of the WorkingWell mobile app with individuals with serious mental illnesses who are actively employed and receiving community-based services. METHODS: In this proof-of-concept, mixed-methods, 2-month feasibility study (N=40), employed individuals with serious mental illnesses were recruited in mental health agencies. Participants completed surveys regarding background characteristics and cellphone use at enrollment and responded to interview items regarding app usability, usage, and usefulness in technical assistance calls at 1, 2, 4, and 6 weeks of participation and in the exit interview at 8 weeks. Data on the frequency of app usage were downloaded on a daily basis. A version of the System Usability Scale (SUS) was administered in the exit interview. Overall feasibility was determined by the percent of users completing the study, responses to an interview item regarding continued use, and findings on usability, usage, and usefulness. General impressions were obtained from users regarding user support materials, technical assistance, and study procedures. RESULTS: Most participants were male (60%, 24/40), aged 55 or younger (70%, 28/40), white (80%, 32/40), had less than a 4-year college education (78%, 31/40), were employed part-time (98%, 39/40), had been working more than 6 months (60%, 24/40), and indicated a diagnosis of bipolar, schizoaffective, or depressive disorder (84%, 16/25). The majority of participants owned cellphones (95%, 38/40) and used them multiple times per day (83%, 33/40). Their average rating on SUS usability items was 3.93 (SD 0.77, range 1.57-5.00), reflecting positive responses. In general, participants indicated WorkingWell was "very easy," "straightforward," "simple," and "user friendly." Usability challenges were related to personal issues (eg, memory) or to difficulties with the phone or app. Data on app usage varied considerably. The most frequent navigations were to the home screen, followed by Rate My Day and My Progress, and then by Manage the Moment and Remind Me. The app was described as useful by most participants; 86% (30/35) agreed the app would help them manage better on the job. Of the 40 original participants, 35 (87%) completed the study. CONCLUSIONS: The WorkingWell app is a feasible approach to providing accessible, as-needed employment support for individuals with serious mental illnesses. The app would benefit from modifications to address recommendations from feasibility testing. Controlled research with larger samples, more diverse in individual characteristics and workplace settings, is essential to demonstrating the effectiveness of the app.
背景:严重精神疾病患者在就业方面的差距已有充分记录,工作的益处也同样如此。移动技术可为这些人提供便捷的即时支持。开发了“工作顺利”移动应用程序,以满足为职场中患有严重精神疾病的人提供便捷的跟进支持的需求。 目的:我们探讨“工作顺利”移动应用程序对积极就业且接受社区服务的严重精神疾病患者的可用性、使用情况、有用性及总体可行性。 方法:在这项为期2个月的概念验证性混合方法可行性研究(N = 40)中,从心理健康机构招募了患有严重精神疾病的在职人员。参与者在入组时完成了关于背景特征和手机使用情况的调查,并在参与的第1、2、4和6周以及第8周的退出访谈中,就应用程序的可用性、使用情况和有用性在技术援助电话中回答了访谈问题。每天下载应用程序使用频率的数据。在退出访谈中使用了系统可用性量表(SUS)的一个版本。总体可行性由完成研究的用户百分比、对关于继续使用的访谈问题的回答以及关于可用性、使用情况和有用性的研究结果来确定。从用户那里获得了关于用户支持材料、技术援助和研究程序的总体印象。 结果:大多数参与者为男性(60%,24/40),年龄在55岁及以下(70%,28/40),白人(80%,32/40),大学教育年限不足4年(78%,31/40),兼职工作(98%,39/40),工作超过6个月(60%,24/40),并表示被诊断为双相情感障碍、精神分裂情感障碍或抑郁症(84%,16/25)。大多数参与者拥有手机(95%,38/40),并且每天多次使用手机(83%,33/40)。他们在SUS可用性项目上的平均评分为3.93(标准差0.77,范围1.57 - 5.00),反映出积极的回应。总体而言,参与者表示“工作顺利”“非常容易”“简单明了”“简单”且“用户友好”。可用性挑战与个人问题(如记忆力)或手机或应用程序的困难有关。应用程序使用数据差异很大。最常访问的是主屏幕,其次是“评价我的一天”和“我的进度”,然后是“掌控当下”和“提醒我”。大多数参与者认为该应用程序有用;86%(30/35)的人同意该应用程序会帮助他们在工作中更好地应对。在40名最初的参与者中,35名(87%)完成了研究。 结论:“工作顺利”应用程序是为患有严重精神疾病的人提供便捷的按需就业支持的可行方法。该应用程序将受益于根据可行性测试的建议进行调整。对样本量更大、个体特征和工作场所设置更多样化的对照研究对于证明该应用程序的有效性至关重要。
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