JMIR Publications

Background:

The COVID-19 pandemic marked an increase in depressive, anxiety, and post-traumatic stress disorder symptoms, more specifically among healthcare workers, teachers, and police officers. These workers face external and occupational factors which had a significant impact on mental health, significant increase in workload and direct exposure to the virus, shortage of personnel protective equipment, and instances of abuse, including discrimination. Mental health care in primary care requires a process of early identification and timely referral of complex cases. . Telehealth emerges as an effective alternative for addressing challenges in mental health care, although its implementation encounters obstacles.

Objective:

Designing a telehealth service that facilitates screening, initial management, and timely referral for mental health diagnoses in workers with a history of SARS-CoV-2 infection, while evaluating its usability, acceptability, and user satisfaction.

Methods:

Mixed-method study with a user-centered design approach involving key external and internal service users in three sequential stages (pre-design, co-design, and post-design). The study phases lasted 6 months, involving a total of 23 participants in the pre-design phase (contextual inquiry and preparation and training), 12 participants in the co-design phase (framing the issue, generative design, and sharing design), and in the post-design phase, 4 participants in service implementation and 81 for efficacy assessment.

Results:

The proposal included the development and evaluation of a service model guide and a telehealth software platform. First, the participants took part in a series of workshops (Pre-design, Co-design) where they provided ideas for meeting the product requirements, based on the Design Thinking methodology framework. The telehealth service model was named TelePsico CENSOPAS. It comprised four processes: a) Service promotion; b) User pre-identification; c) Appointment management; d) Psychoeducation counseling and referral. The Telehealth platform was designed through three cycles of an iterative process and integrated a proprietary development platform with third-party service technologies for communication support and information exchange. During Post-design, the pilot test involved 698 screened patients; 193 were identified with mental health risks, and 134 of them received psychoeducation sessions. In addition to user acceptance, the usability score of the platform was 86.1 ± 16.9 SD, satisfaction dimensions of the service was 45.1 ± 7.2 SD for satisfaction with care processes, and 36.7 ± 5.2 SD satisfaction with psychological care.

Conclusions:

The proposal for telehealth services and its platform in mental health was successfully designed and garnered acceptance among internal and external users, especially in well-structured occupational health services workplaces for vulnerable occupational groups. Additionally, it achieved higher scores in satisfaction and usability compared to Peru's outpatient care services. This proposal demonstrates the replicability of user-centered design frameworks as Design Thinking methodology within the occupational health sphere.

Clinicaltrial: