Previously submitted to: JMIR Mental Health (no longer under consideration since Jan 27, 2023)
Date Submitted: Jan 12, 2023
Open Peer Review Period: Jan 9, 2023 - Jan 27, 2023
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Exploring the use of digital interventions by people with Severe Mental Illness to support their physical health: A mixed methods study.
ABSTRACT
Background:
People with severe mental illness (SMI) are more likely to suffer from physical health conditions than the general population, with a lower life expectancy of up to 18 years. Little is known about the experience of people with SMI using digital health interventions (DHIs) to support their physical health, and whether they perceive such interventions as beneficial.
Objective:
We explored how people with SMI use DHIs to support their physical health, the acceptability, factors effecting use and any perceived impact on physical health.
Methods:
A mixed methods approach was used, delivered in three stages. Stage 1 online survey of people with SMI; Stage 2 interviews with a sub-sample of participants from Stage 1; Stage 3 stakeholder workshops with people with SMI, clinical staff, carers, voluntary sector staff and commissioners. Study design, data collection and analyses were co-produced with two Experts by Experience with lived experience of SMI.
Results:
Stage 1 results revealed that participants were generally satisfied with the quality of DHIs available to them. The most popular DHIs were targeted at diet, exercise, and weight management. Stage 2 results suggested participants experienced a number of barriers and facilitators to use of DHIs. Factors that encouraged use included simplicity, passivity, and data-linkage. Concerns included costs, data security and reliability of information. Positive impacts included accountability, encouragement, and tangible physical health benefits. Self-awareness and autonomy of care were also perceived to increase. Mental health impacted engagement with DHIs: low mood often hindered motivation to engage with devices, and information produced by these devices could be perceived as triggering. Findings of stage 2 were corroborated in stage 3: workshop participants reported that DHIs could be a useful tool to monitor physical health but could not replace contact with clinical services. The two could be used in conjunction, to expand the benefit of clinical appointments and encourage service user autonomy. Participants appreciated being able to share physical health data in appointments and suggested that data sharing between service user and care team could be a positive feature. Participants sought clinical guidance and recommendations for which devices they could use to monitor or support their physical health.
Conclusions:
Popular DHIs for supporting physical health were considered useful and acceptable by people with SMI and may be used as an extension of clinical care, giving people with SMI a sense of control and involvement in their own health. The specific needs and priorities of people with SMI should be considered both in developing and recommending interventions.
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