This research project aims to evaluate the feasibility and effectiveness of a new approach to tailored mobile applications using the Chorus Participatory Mobile Framework. PHP and IOP program participants-patients and therapists--will be consented and enrolled by study staff. Study participants will be invited to workgroups specific to their program to discuss the usability of Chorus and be asked to complete surveys on demographics, satisfaction, self-efficacy, and involvement with Chorus and usability of the tool.
The Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) in the Neuropsychatric Hospital at UCLA provide psychiatric services for adults and children with acute mental illness. These include voluntary programs that support individuals in their recovery with the goal to assist patients in achieving the highest level of independence. Most programs operate Monday through Friday between four to eight hours a day. Recently, the PHP and IOP programs have decided to start including mobile messaging as a part of care, helping patients to feel supported even after they have left the hospital for the day. The purpose of this study is to evaluate the feasibility and effectiveness of their ongoing use of the Chorus Participatory Mobile Framework to support clinical care. Chorus is a framework and web application that allows users to rapidly create a broad range of automated text messaging (SMS), interactive voice (IVR), or mobile web applications using a simple and accessible visual interface without requiring any server programming. There will be two broad populations using Chorus: (1) programs (e.g. OCD Intensive Treatment Program) in which all participants will receive participatory mobile messaging and (2) programs (e.g. Adult Acute PHP) in which patients will be randomized to receive either participatory mobile messaging or no mobile messaging. Across all programs, Kandace Whiting and Armen Arevian will train PHP and IOP therapists starting with creating simple, basic, useful messaging content in Chorus to support patients in achieving program goals. Examples of messages include Cognitive Behavioral Therapy (CBT), symptom management, and stress management cues to patients in the Obsessive Compulsive Disorder Clinic, patients in the Adult Eating Disorder Clinic, and parents from The Achievement, Behavior, Cognition (ABC) Child Programs. All participating patients receiving participatory mobile messaging will work with program staff one-on-one to tailor SMS and IVR content and design based on their own preferences. By being able to personalize the messaging, the Chorus Participatory Mobile Framework meets the capacities and preferences of the users rather than a "one-size" approach requiring adaptation of the users to the technology. Both therapists and patients will be invited to up to bi-weekly, in-person workshops specific to their program to provide feedback and input. The goal of these workshops is to further develop and refine the novel mobile interventions based on stakeholder input. The Chorus Participatory Framework will be used during the workshops to develop and test the application in real-time. Workshops will be audio and/or video recorded to document the process.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
150
Creating mobile support tools by patients and their therapists
Usual care as part of the UCLA PHP and IOP programs
UCLA Partial Hospitalization and Intensive Outpatient Programs
Los Angeles, California, United States
Change in homework completion rate
the change in the degree to which patients complete tasks assigned to them by their provider as part of their treatment
Time frame: Collected on each program attendance day (up to daily), through discharge from program, an average of 12 weeks
length of stay
length of stay (in terms of days and hours/day of program attendance)
Time frame: At discharge from program, an average of 12 weeks
time to discharge
time to step down from partial hospitalization program to intensive outpatient program and time to discharge from program
Time frame: From admission to program until discharge from program, assessed up to 20 weeks
Number of patient visits to health care organizations outside of clinic
the number of services that patients utilize outside of the clinic, including ED visits and inpatient hospitalizations.
Time frame: at patient disenrollment from study, approximately 3 months after discharge from program, up to 40 weeks
Types of health care services patients utilize outside of clinic
the types of services that patients utilize outside of the clinic, including ED visits and inpatient hospitalizations.
Time frame: at patient disenrollment from study, approximately 3 months after discharge from program, up to 40 weeks
change in depression symptoms
PHQ-9 to measure changes in depression symptoms
Time frame: Upon admission to program, at mid-point of stay in program, at discharge from program (may also be up to weekly during stay), an average of 12 weeks; and 3 months after discharge from programa
Change in Patient Treatment Self-Efficacy
change patient treatment self-efficacy from week-to-week during program
Time frame: weekly during stay in program, through discharge from program, an average of 12 weeks
Difference in Patient Satisfaction with Program between Intervention vs Control groups
comparing patient satisfaction with services and support between the intervention and control groups
Time frame: at discharge from program, an average of 12 weeks
Messaging Application Usability
Weekly survey of patients in the intervention arm and all providers to assess the usability of the messaging application
Time frame: weekly during stay in program, through discharge from program, an average of 12 weeks
Patient Involvement in Message Development
Completed by patients in the intervention arm and by provider for each patient in intervention arm to assess the extent of patient involvement in the development of message content and schedule, and use of messaging application
Time frame: weekly during stay in program, through discharge from program, an average of 12 weeks
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