King Sayde Leya, Lebert Jana, Karpisek Lacey Anne, Phillips Amelia, Neal Tempestt, Kosyluk Kristin
Department of Computer Science and Engineering, College of Engineering, University of South Florida, Tampa, FL, United States.
Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, United States.
JMIR Form Res. 2022 May 3;6(5):e35699. doi: 10.2196/35699.
Limited access to mental health care services due to provider shortages, geographic limitations, and cost has driven the area of mobile health (mHealth) care to address these access gaps. Reports from the Cohen Veterans Network and National Council for Behavioral Health show that in states where mental health care is more accessible, 38% of people still do not receive the care they need. mHealth strategies help to provide care to individuals experiencing these barriers at lower cost and greater convenience, making mHealth a great resource to bridge the gaps.
We present a mixed methods study to evaluate user experiences with the mental mHealth service, Cope Notes. Specifically, we aimed to investigate the following research questions: How do users perceive the service in relation to stigma, impact of the intervention, and perceived usefulness? How do users rate the Cope Notes service and SMS text messaging along various dimensions of acceptability? What is the relationship between Cope Notes SMS text message ratings, user personality, and coping strategies? What are user perspectives of leveraging ubiquitous sensing technologies to improve delivery and provide tailored content?
We performed qualitative interviews with Cope Notes users (N=14) who have used the service for at least 30 days to evaluate their experiences and usefulness of the service. These interviews were coded by 2 raters (SLK and JL), and the interrater reliability was calculated with SPSS (IBM Corp) at 61.8%. In addition, participants completed quantitative measures, including a user experiences survey, personality inventory (Big Five Inventory-10), and coping assessment (Brief Coping Orientation to Problems Experienced).
We derived 7 themes from our qualitative interviews: Likes or Perceived Benefits, Dislikes or Limitations, Suggested Changes, Stigma or Help Seeking, Perceptions of Ubiquitous Sensing, Cultural Sensitivity, and Alternative mHealth Resources. Exploratory analyses between acceptability ratings of Cope Notes and personality factors showed statistically significant positive relationships between seeing oneself as someone who is generally trusting and acceptability items, the most significant being item 7 (I fully understood the sentiment behind Cope Notes Messages) with (r=0.82, P=.001). We also found statistically significant relationships between acceptability and Brief Coping Orientation to Problems Experienced items, with the strongest positive correlation between participants strongly endorsing coping by accepting the reality that an event has happened and acceptability item 7 (r=0.86, P=.001).
Our study found that Cope Notes subscribers appreciate the service for reframing their mental wellness with statistically significant correlations between personality and acceptability of the service. We found that some users prefer a more personalized experience with neutral to positive reactions to a potential companion app that continuously monitors user behavior via smartphone sensors to provide just-in-time interventions when users need it most.
由于提供者短缺、地理限制和成本问题，获得心理健康护理服务的机会有限，这推动了移动健康（mHealth）护理领域来解决这些获取差距。科恩退伍军人网络和国家行为健康委员会的报告显示，在心理健康护理更容易获得的州，仍有38%的人没有得到他们需要的护理。移动健康策略有助于以更低的成本和更大的便利性为面临这些障碍的个人提供护理，使移动健康成为弥合差距的重要资源。
我们进行了一项混合方法研究，以评估用户对心理健康移动健康服务Cope Notes的体验。具体而言，我们旨在调查以下研究问题：用户如何看待该服务在耻辱感、干预影响和感知有用性方面的情况？用户如何在可接受性的各个维度上对Cope Notes服务和短信进行评分？Cope Notes短信评分、用户个性和应对策略之间的关系是什么？用户对于利用无处不在的传感技术来改善服务提供和提供量身定制的内容有何看法？
我们对使用Cope Notes服务至少30天的用户（N = 14）进行了定性访谈，以评估他们对该服务的体验和有用性。这些访谈由两名评分者（SLK和JL）进行编码，使用SPSS（IBM公司）计算评分者间信度为61.8%。此外，参与者完成了定量测量，包括用户体验调查、个性量表（大五人格量表 - 10）和应对评估（经历问题的简短应对取向）。
我们从定性访谈中得出了7个主题：喜欢或感知到的益处、不喜欢或限制、建议的改变、耻辱感或寻求帮助、对无处不在传感的看法、文化敏感性以及替代性移动健康资源。Cope Notes可接受性评分与个性因素之间的探索性分析表明，将自己视为通常值得信任的人与可接受性项目之间存在统计学上显著的正相关关系，最显著的是项目7（我完全理解Cope Notes消息背后的情感），相关系数为（r = 0.82，P = 0.001）。我们还发现可接受性与经历问题的简短应对取向项目之间存在统计学上显著的关系，参与者强烈认可通过接受事件已经发生的现实来应对与可接受性项目7之间的正相关最强（r = 0.86，P = 0.001）。
我们的研究发现，Cope Notes的订阅者赞赏该服务以重新构建他们的心理健康，并且该服务的个性与可接受性之间存在统计学上显著的相关性。我们发现一些用户更喜欢更个性化的体验，对一款潜在的伴侣应用程序持中性到积极的反应，该应用程序通过智能手机传感器持续监测用户行为，以便在用户最需要时提供及时干预。
