Fortuna Karen L, Cui Sunny, Lebby Stephanie, Xie Haiyi, Bruce Martha L, Bartels Stephen J
Community and Family Medicine and of Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Mhealth. 2025 Jun 30;11:28. doi: 10.21037/mhealth-24-64. eCollection 2025.
Certified peer support specialists (CPSs) can empower individuals with serious mental illness (SMI) to engage with mobile health interventions designed to improve medical and psychiatric self-management. This study pilot-tested PeerTECH, a digital, 12-session intervention adapted from Integrated Illness Management and Recovery and delivered by CPSs, to assess its feasibility, acceptability, and preliminary effectiveness in enhancing self-management among individuals with SMI compared to peer support as usual (PSAU).
A two-arm pilot randomized controlled trial was conducted with individuals diagnosed with SMI and at least one medical comorbidity. Participants were randomly assigned to either PeerTECH, a 12-week structured mobile health intervention delivered by CPSs, or PSAU (peer support without mobile technology). Outcome measures related to medical and psychiatric self-management were assessed at baseline and 12 weeks. Data was analysed using linear mixed-effects regression models to compare outcomes between groups. Feasibility and acceptability were evaluated by participant retention rates, intervention adherence, and participant-reported satisfaction.
The study demonstrated that the randomized control trial design was feasible and acceptable, with 72.73% of approached patients consenting to participate. PeerTECH delivery was engaging, with 90% of participants initiating the intervention, approximately 80% completing it, and participants engaging in text exchanges on 70% of possible days, averaging 10 text exchanges. The intervention was found to be acceptable, with 100% of participants reporting satisfaction, and safe, with no adverse events. Statistically significant improvements were observed in PeerTECH compared to PSAU in physical health outcomes, as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 Physical Health scores (P=0.023). Clinically meaningful improvements in the Integrated Management and Recovery Scale and PROMIS-derived utility scores (EuroQol 5-Dimension Scale, Health Utilities Index) were also observed.
The Peer-Led Mobile Health Intervention demonstrated feasibility and effectiveness in enhancing self-management among individuals with SMI and chronic comorbidities.
This trial was registered at ClinicalTrials.gov (NCT04481737).
认证同伴支持专家（CPS）可以使患有严重精神疾病（SMI）的个体有能力参与旨在改善医疗和精神自我管理的移动健康干预措施。本研究对PeerTECH进行了试点测试，这是一种从综合疾病管理与康复改编而来的数字化、为期12节的干预措施，由CPS提供，以评估其在增强SMI个体自我管理方面的可行性、可接受性和初步有效性，并与常规同伴支持（PSAU）进行比较。
对诊断为SMI且至少有一种医疗合并症的个体进行双臂试点随机对照试验。参与者被随机分配到PeerTECH组，这是一种由CPS提供的为期12周的结构化移动健康干预措施，或PSAU组（无移动技术的同伴支持）。在基线和12周时评估与医疗和精神自我管理相关的结果指标。使用线性混合效应回归模型分析数据，以比较组间结果。通过参与者保留率、干预依从性和参与者报告的满意度来评估可行性和可接受性。
该研究表明随机对照试验设计是可行且可接受的，72.73%的被邀请患者同意参与。PeerTECH的实施很有吸引力，90%的参与者开始干预，约80%的参与者完成干预，参与者在70%的可能天数进行文本交流，平均进行10次文本交流。发现该干预措施是可接受的，100%的参与者报告满意，且是安全的，没有不良事件。与PSAU相比，通过患者报告结果测量信息系统（PROMIS）全球-10身体健康评分衡量，PeerTECH在身体健康结果方面有统计学显著改善（P=0.023）。在综合管理与康复量表以及PROMIS衍生的效用评分（欧洲五维健康量表、健康效用指数）方面也观察到了具有临床意义的改善。
同伴主导的移动健康干预措施在增强SMI和慢性合并症个体的自我管理方面显示出可行性和有效性。
本试验在ClinicalTrials.gov（NCT04481737）注册。
