Kidd Sean A, D'Arcey Jessica, Tackaberry-Giddens Leah, Asuncion Toni-Rose, Agrawal Sacha, Chen Sheng, Wang Wei, McKenzie Kwame, Zhou Wenjia, Luo Sherry, Feldcamp Laura, Kaleis Linda, Zedan Saleena, Foussias George, Kozloff Nicole, Voineskos Aristotle
Centre for Addiction and Mental Health, University of Toronto Department of Psychiatry, Canada.
Centre for Addiction and Mental Health, Canada.
Schizophr Res. 2025 Jan;275:52-61. doi: 10.1016/j.schres.2024.11.011. Epub 2024 Dec 9.
Given the widespread adoption of smartphone technologies, digital health strategies to address schizophrenia spectrum disorders hold considerable promise. However, there are relatively few trials of digital health interventions for schizophrenia. The App for Independence (A4i) is a multi-function digital platform co-designed by people with schizophrenia, their families, and service providers.
This trial was designed to assess the feasibility of A4i.
The study was a single-blinded randomized trial. This trial was undertaken to generate feasibility data that might inform the design and utility of future effectiveness and implementation trials. The study took place in Toronto, Canada, with 91 participants randomized to 6 months of A4i use or treatment as usual. Feasibility metrics included recruitment, engagement and retention targets, qualitative and satisfaction data, and a secondary assessment of clinical, quality of life, and treatment adherence outcomes.
The COVID-19 pandemic markedly affected the recruitment of both primary participants and clinicians. Feasibility outcomes were difficult to interpret, though they presented some useful information for future trials. Engagement objectives were not achieved. However, A4i-user satisfaction ratings and qualitative feedback were positive, and technology engagement was fairly positive despite implementation challenges.
This study adds to emerging discourse regarding how technologies such as A4i are implemented. It suggests that digital technologies are of interest and are received positively by severe mental illness populations, though more work is needed to understand how they are implemented and the optimal methods for researching them.
鉴于智能手机技术的广泛应用，采用数字健康策略来应对精神分裂症谱系障碍具有很大的前景。然而，针对精神分裂症的数字健康干预试验相对较少。独立应用程序（A4i）是一个由精神分裂症患者及其家属和服务提供者共同设计的多功能数字平台。
本试验旨在评估A4i的可行性。
该研究为单盲随机试验。进行此试验是为了生成可行性数据，为未来的有效性和实施试验的设计及效用提供参考。该研究在加拿大多伦多进行，91名参与者被随机分为两组，一组使用A4i 6个月，另一组接受常规治疗。可行性指标包括招募、参与和留存目标、定性和满意度数据，以及对临床、生活质量和治疗依从性结果的二次评估。
新冠疫情显著影响了主要参与者和临床医生的招募。可行性结果难以解读，不过它们为未来试验提供了一些有用信息。参与目标未达成。然而，A4i用户的满意度评分和定性反馈是积极的，尽管在实施过程中存在挑战，但技术参与度也相当积极。
本研究为有关A4i等技术如何实施的新兴讨论增添了内容。这表明数字技术受到严重精神疾病人群的关注且得到了积极认可，不过仍需要更多工作来了解它们是如何实施的以及研究它们的最佳方法。
