JMIR Publications

ABSTRACT

Background:

Although mental health problems occur in interaction with the natural environment, bringing this contextualized information into the therapy room is challenging. The experience sampling method (ESM) may facilitate this by assessing clients' thoughts, feelings, symptoms, and behavior as they are experienced in everyday life. However, ESM is still primarily used in research settings with little uptake in clinical practice. One aspect that may facilitate clinical implementation concerns the use of 'ESM protocols', which involves providing practitioners with ready-to-use ESM questionnaires, sampling schemes, visualizations, and training.

Objective:

This pilot study's objective was to evaluate the usability of an ESM protocol in clinical practice using a mixed-methods approach.

Methods:

In this pilot study, we created an ESM protocol and tested its usability in clinical practice. The ESM protocol was tailored to the m-Path software platform, consisting of a dashboard for practitioners and an app for clients. The dashboard was used to configure an ESM questionnaire template we designed. Additionally, the dashboard contained custom data visualizations that were made based on end-user feedback. The app was used for completing ESM assessments. A total of 8 practitioners and 17 clients used ESM in practice between December 2020 and July 2021. Usability was assessed using questionnaires, ESM compliance rates, and semi-structured interviews.

Results:

The usability was overall rated reasonable to good by practitioners (Mean scores to usability items ranging from 5.33 [SD = 0.91] to 6.06 [SD = 0.73] on a cale from 1 to 7]). However, practitioners expressed difficulty personalizing the template and reported insufficient guidelines on how to use ESM in clinical practice. On average, clients completed 55% (SD=25%) of the ESM questionnaires. They rated the usability as reasonable to good but slightly lower and more variable than the practitioners (mean scores to usability items ranging from 4.18 [SD = 1.7] to 5.94 [SD = 1.5] on a cale from 1 to 7). Clients also voiced several concerns over the piloted ESM template, with some indicating no interest in the continued use of ESM.

Conclusions:

The findings suggest that using an ESM protocol may facilitate the implementation of ESM as a mobile health assessment tool in psychiatry. However, further adaptions should be made prior to further implementation. Adaptions include training on personalizing questionnaires, adding additional sampling scheme formats, and creating a dynamic data visualization interface. Future studies should also identify factors determining the suitability of ESM for specific treatment goals among different client populations.