scholarly journals Usability and Acceptability of Two Smartphone Apps for Smoking Cessation Among Young Adults With Serious Mental Illness: Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Minda A Gowarty ◽  
Meghan R Longacre ◽  
Roger Vilardaga ◽  
Nathan J Kung ◽  
Ashley E Gaughan-Maher ◽  
...  
Keyword(s):  
Mental Illness ◽  
Young Adults ◽  
Young Adult ◽  
Serious Mental Illness ◽  
Mental Health Treatment ◽  
Psychotic Disorders ◽  
Task Completion ◽  
Smartphone Apps ◽  
System Usability Scale ◽  
The Mean

BACKGROUND Young adults with serious mental illness (SMI) have higher smoking rates and lower cessation rates than young adults without SMI. Scalable interventions such as smartphone apps with evidence-based content (eg, the National Cancer Institute’s [NCI’s] QuitGuide and quitSTART) could increase access to potentially appealing and effective treatment for this group but have yet to be tested in this population. OBJECTIVE The goal of this user-centered design study is to determine the user experience (including usability and acceptability) of 2 widely available apps developed by the NCI—QuitGuide and quitSTART—among young adult tobacco users with SMI. METHODS We conducted usability and acceptability testing of QuitGuide and quitSTART among participants with SMI aged between 18 and 35 years who were stable in community mental health treatment between 2019 and 2020. Participants were randomly assigned to use QuitGuide or quitSTART on their smartphones. App usability was evaluated at baseline and following a 2-week field test of independent use via a video-recorded task completion protocol. Using a mixed method approach, we triangulated 4 data sources: nonparticipant observation, open-ended interviews, structured interviews (including the System Usability Scale [SUS]), and backend app use data obtained from the NCI. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using thematic analysis. RESULTS Participants were 17 smokers who were not interested in quitting, with a mean age of 29 (SD 4) years; 41% (n=7) presented with psychotic disorders. Participants smoked an average of 15 (SD 7) cigarettes per day. The mean SUS scores for QuitGuide were similar at visits one and two (mean 64, SD 18 and mean 66, SD 18, respectively). The mean SUS scores for quitSTART numerically increased from visit one (mean 55, SD 20) to visit two (mean 64, SD 16). Acceptability scores followed the same pattern. Observed task completion rates were at least 75% (7/9 for QuitGuide, 6/8 for quitSTART) for both apps at both visits for all but 2 tasks. During the 13-day trial period, QuitGuide and quitSTART users interacted with their assigned app on an average of 4.6 (SD 2.8) days versus 10.8 (SD 3.5) days, for a mean total of 5.6 (SD 3.8) interactions versus 41 (SD 26) interactions, and responded to a median of 1 notification (range 0-8) versus 18.5 notifications (range 0-37), respectively. Qualitative comments indicated moderate to high satisfaction overall but also included concerns about the accuracy of the apps’ feedback. CONCLUSIONS Both QuitGuide and quitSTART had acceptable levels of usability and mixed levels of acceptability among young adults with SMI. The higher level of engagement with quitSTART suggests that quitSTART may be a favorable tool for young adult smokers with SMI. However, clinical support or coaching may be needed to overcome initial usability issues.

scholarly journals Acceptability and Usability of Mobile Apps for Smoking Cessation Among Young Adults With Psychotic Disorders and Other Serious Mental Illness

2021 ◽  
Vol 12 ◽  
Author(s):  
Minda A. Gowarty ◽  
Kelly A. Aschbrenner ◽  
Mary F. Brunette
Keyword(s):  
Mental Illness ◽  
Young Adults ◽  
Young Adult ◽  
Serious Mental Illness ◽  
Psychotic Disorders ◽  
Mobile Apps ◽  
Initial Study ◽  
Task Completion ◽  
Post Traumatic Stress ◽  
Structured Interviews

Background: Young adults with serious mental illness (SMI) are over twice as likely to smoke cigarettes than those in the general population, but little research has evaluated the efficacy of interventions for this group. While smartphone apps are a promising tool to address this need, their usability should be evaluated among young adults with psychotic disorders, whose symptoms and cognitive impairments may be a barrier to app use.Methods: We compared usability and acceptability of National Cancer Institute apps (QuitGuide and quitSTART) between young adult smokers with SMI psychotic disorders and other SMI diagnoses. We evaluated objective app usability at the initial study visit and following 2 weeks of independent use via a video-recorded task-completion protocol. Perceptions of usability and acceptability were assessed with semi-structured interviews. Engagement was assessed with backend app use data.Results: Participants had a mean age of 29 years old (SD = 4). Of the participants without psychotic disorders (n = 10), all were diagnosed with SMI post-traumatic stress disorder (SMI-PTSD). QuitGuide objective task completion rates were high and similar between diagnosis groups, whereas quitSTART task completion was initially lower among users with psychotic disorder compared to users with SMI-PTSD at Visit 1, and improved by Visit 2. Mean app interactions, mean days of use, and median completed notifications were dramatically higher among quitSTART users compared to QuitGuide users. Compared to quitSTART users with SMI-PTSD, quitSTART users with psychotic disorders had similar daily app interactions over the first week of use (mean 3.8 ± 2.4 interactions), and numerically lower mean daily app interactions during the second week (1.9 ± 1.5 vs. 3.4 ± 2.5), whereas completed notifications remained stable among quitSTART users in both diagnosis groups over time. Qualitative comments indicated general acceptability of both apps among both diagnosis groups.Conclusions: Both QuitGuide and quitSTART were usable and appealing among young adult smokers with psychotic disorders and SMI-PTSD, although quitSTART engendered a dramatically greater level of engagement compared to QuitGuide. Initial coaching to support initiation and app notifications to promote prolonged engagement may be important for young adult smokers with psychotic disorders. Replication and efficacy testing for quitSTART is warranted.

scholarly journals Therapeutic Social Control of People with Serious Mental Illness: An Empirical Verification and Extension of Theory

2017 ◽  
Vol 8 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Brea L. Perry ◽  
Emma Frieh ◽  
Eric R. Wright
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Social Control ◽  
Serious Mental Illness ◽  
Mental Health Treatment ◽  
Structured Interview ◽  
Ethical Challenges ◽  
Therapeutic Goals ◽  
Contraception Use ◽  
Client Behavior

Mental health services and psychiatric professional values have shifted in the past several decades toward a model of client autonomy and informed consent, at least in principle. However, it is unclear how much has changed in practice, particularly in cases where client behavior poses ethical challenges for clinicians. Drawing on the case of clients’ sexual behavior and contraception use, we examine whether sociological theories of “soft” coercion remain relevant (e.g., therapeutic social control; Horwitz 1982) in contemporary mental health treatment settings. Using structured interview data from 98 men and women with serious mental illness (SMI), we explore client experiences of choice, coercion, and the spaces that lie in between. Patterns in our data confirm Horwitz’s (1982) theory of therapeutic social control but also suggest directions for updating and extending it. Specifically, we identify four strategies used to influence client behavior: coercion, enabling, education, and conciliation. We find that most clients’ experiences reflect elements of ambiguous or limited autonomy, wherein compliance is achieved by invoking therapeutic goals. However, women with SMI disproportionately report experiencing intense persuasion and direct use or threat of force. We argue that it is critical to consider how ostensibly noncoercive and value-free interventions nonetheless reflect the goals and norms of dominant groups.

scholarly journals Barriers and facilitators to employment for young adults with mental illness: a scoping review

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024487 ◽  
Author(s):  
Taryn Gmitroski ◽  
Christl Bradley ◽  
Lyn Heinemann ◽  
Grace Liu ◽  
Paige Blanchard ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Young Adults ◽  
Social Services ◽  
Scoping Review ◽  
Mental Health Treatment ◽  
Adult Population ◽  
Barriers And Facilitators ◽  
Self Awareness ◽  
Adults With Mental Illness

ObjectivesThe issue of gaining employment for those with mental illness is a growing global concern. For many in the young adult population, who are at a transitional age, employment is a central goal. In response, we conducted a scoping review to answer the question, ‘What are the barriers and facilitators to employment for young adults with mental illness?’DesignWe conducted a scoping review in accordance to the Arksey and O’Malley framework. We performed a thorough search of Medline, EMBASE, CINAHL, ABI/INFORM, PsycINFO and Cochrane. We included studies that considered young adults aged 15–29 years of age with a mental health diagnosis, who were seeking employment or were included in an employment intervention.ResultsOur search resulted in 24 research articles that focused on employment for young adults with mental illness. Four main themes were extracted from the literature: (1) integrated health and social services, (2) age-exposure to employment supports, (3) self-awareness and autonomy and (4) sustained support over the career trajectory.ConclusionsOur review suggests that consistent youth-centred employment interventions, in addition to usual mental health treatment, can facilitate young adults with mental illness to achieve their employment goals. Aligning the mental health and employment priorities of young adults may result in improved health and social outcomes for this population while promoting greater engagement of young adults in care.

scholarly journals Engagement intervention versus treatment as usual for young adults with serious mental illness: a randomized pilot trial

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Michelle R. Munson ◽  
James J. Jaccard ◽  
Lionel D. Scott ◽  
Sarah C. Narendorf ◽  
Kiara L. Moore ◽  
...  
Keyword(s):  
Mental Illness ◽  
Young Adults ◽  
Serious Mental Illness ◽  
Pilot Trial ◽  
Treatment As Usual ◽  
Versus Treatment ◽  
Engagement Intervention

Psychotic Disorders and Serious Mental Illness

2017 ◽  
Author(s):  
Alexander Thompson ◽  
Daniel Williams ◽  
Oliver Freudenreich ◽  
Andrew Angelino ◽  
Glenn Treisman
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Psychotic Disorders ◽  
Public Health Problem ◽  
Cost Effective ◽  
Models Of Care ◽  
Major Public Health Problem ◽  
Effective Care ◽  
Psychiatric Conditions ◽  
Hiv Aids

The major public health problem that is HIV/AIDS in persons with a serious mental illness is aptly described a “syndemic.” Having HIV/AIDS puts one at much greater risk for developing a serious mental illness. Conversely, having a serious mental illness, such as schizophrenia, bipolar disorder, major depressive disorder, substance use disorder, is associated with many factors that place one at greater risk for contracting and transmitting HIV. And, in both cases of serious mental illness and HIV/AIDS, each disorder creates many new challenges in the management of the other disorder. This chapter addresses these challenges, which center around being able to participate actively and adhere to medication regimens needed to manage both medical and psychiatric conditions. Fortunately, specialized models of care like comprehensive, integrated clinics and nurse care managers are ways to provide effective, satisfying, and cost-effective care to this most vulnerable population.

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