Accepted for/Published in: JMIR Human Factors
Date Submitted: Nov 4, 2024
Date Accepted: Mar 12, 2025
Co-Designing a Web-based and Tablet Application to Evaluate Clinical Outcomes of Early Psychosis Service Users in a Learning Health Care Network: Workshop and Pilot Study
ABSTRACT
Background:
The EPI-CAL project, a learning health care network (LHCN) of California early psychosis intervention (EPI) programs, prioritized incorporation of community partner feedback while designing its eHealth application, Beehive. Though eHealth applications can support LHCN data collection aims, low user acceptance or adoption can pose barriers to successful implementation. Adopting user-centered design approaches, such as incorporation of user feedback and continuous evaluation, can mitigate these potential barriers.
Objective:
We employed user-centered design during development of a data-collection and data-visualization eHealth application, Beehive, to promote engagement with Beehive as part of standard EPI care across a diverse user-base.
Methods:
We conducted user-centered design workshops with service users, their support persons, and EPI providers during Beehive storyboarding and alpha testing. We incorporated feedback from these workshopsinto the beta version of the application. Then, after receiving training, four EPI programs piloted Beehive’s beta version. During piloting, service users and their primary support persons (PSPs) completed Beehive surveys at enrollment and every 6 months after treatment initiation. To examine preliminary user acceptance and adoption during the piloting phase, we assessed rates of participant enrollment and survey completion, with a particular focus on the Modified Colorado Symptom Index (MCSI).
Results:
User-centered design workshop feedback resulted in the creation of new workflows and interface changes in Beehive to improve the user experience. During piloting, 48 service users, 42 PSPs, and 72 EPI program providers enrolled in Beehive. Data is available for 88% (n=42) of service users, including self-reported data for 79% (n=38), collateral-reported data for 42% (n=20), and clinician-entered data for 17% (n=8). The MCSI was completed by 54% (n=26) of service users (total score: M=24.16, SD=16.81 and 56% (n=19) of support persons (M=26.71, SD=14.43).
Conclusions:
Implementing user-centered designed while developing the Beehive application resulted in early development workflow changes and produced an application that was acceptable and feasible for collection of self-reported clinical outcomes data from service users. Additional support is needed to increase collateral-reported and clinician-entered data. Clinical Trial: NCT04007510
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