Moon Khatiya Chelidze, Sobolev Michael, Grella Megan, Alvarado George, Sapra Manish, Ball Trever
Zucker Hillside Hospital, Glen Oaks, NY, United States.
Cornell Tech, New York, NY, United States.
JMIR Form Res. 2022 Jul 1;6(7):e36021. doi: 10.2196/36021.
The collaborative care model is a well-established system of behavioral health care within primary care settings. There is potential for mobile health (mHealth) technology to augment collaborative behavioral health care in primary care settings, thereby improving scalability, efficiency, and clinical outcomes.
We aimed to assess the feasibility of engaging with and the preliminary clinical outcomes of an mHealth platform that was used to augment an existing collaborative care program in primary care settings.
We performed a longitudinal, single-arm feasibility study of an mHealth platform that was used to augment collaborative care. A total of 3 behavioral health care managers, who were responsible for coordinating disease management in 6 primary care practices, encouraged participants to use a mobile app to augment the collaborative model of behavioral health care. The mHealth platform's functions included asynchronous chats with the behavioral health care managers, depression self-report assessments, and psychoeducational content. The primary outcome was the feasibility of engagement, which was based on the number and type of participant-generated actions that were completed in the app. The primary clinical end point was a comparison of the baseline and final assessments of the Patient Health Questionnaire-9.
Of the 245 individuals who were referred by their primary care provider for behavioral health services, 89 (36.3%) consented to app-augmented behavioral health care. Only 12% (11/89) never engaged with the app during the study period. Across all participants, we observed a median engagement of 7 (IQR 12; mean 10.4; range 0-130) actions in the app (participants: n=78). The chat function was the most popular, followed by psychoeducational content and assessments. The subgroup analysis revealed no significant differences in app usage by age (P=.42) or sex (P=.84). The clinical improvement rate in our sample was 73% (32/44), although follow-up assessments were only available for 49% (44/89) of participants.
Our preliminary findings indicate the moderate feasibility of using mHealth technology to augment behavioral health care in primary care settings. The results of this study are applicable to improving the design and implementation of mobile apps in collaborative care.
协作护理模式是基层医疗环境中成熟的行为健康护理系统。移动健康（mHealth）技术有潜力增强基层医疗环境中的协作行为健康护理，从而提高可扩展性、效率和临床结果。
我们旨在评估在基层医疗环境中使用mHealth平台增强现有协作护理项目的可行性及初步临床结果。
我们对用于增强协作护理的mHealth平台进行了一项纵向单臂可行性研究。共有3名负责在6家基层医疗诊所协调疾病管理的行为健康护理经理，鼓励参与者使用移动应用程序来增强行为健康护理的协作模式。mHealth平台的功能包括与行为健康护理经理的异步聊天、抑郁自我报告评估和心理教育内容。主要结果是参与的可行性，这基于应用程序中完成的参与者生成操作的数量和类型。主要临床终点是患者健康问卷-9的基线评估与最终评估的比较。
在其基层医疗服务提供者转介接受行为健康服务的245人中，89人（36.3%）同意接受应用程序增强的行为健康护理。在研究期间，只有12%（11/89）的人从未使用过该应用程序。在所有参与者中，我们观察到应用程序中的操作中位数为7（IQR 12；均值10.4；范围0-130）（参与者：n = 78）。聊天功能最受欢迎，其次是心理教育内容和评估。亚组分析显示，按年龄（P = 0.42）或性别（P = 0.84）划分的应用程序使用情况无显著差异。我们样本中的临床改善率为73%（32/44），尽管只有49%（44/89）的参与者有后续评估。
我们的初步研究结果表明，在基层医疗环境中使用mHealth技术增强行为健康护理具有中等可行性。本研究结果适用于改进协作护理中移动应用程序的设计和实施。
