Accepted for/Published in: JMIR Human Factors
Date Submitted: Apr 2, 2025
Date Accepted: Nov 20, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Optimising SloMo, a digitally supported therapy targeting paranoia, for implementation using inclusive, human-centred design
ABSTRACT
Background:
Despite the promise of digital therapeutics in providing scalable interventions for psychosis, translating them from clinical trials to routine care is challenging. SloMo is an evidence-based, digitally supported cognitive behavioural therapy for psychosis comprising an online therapy platform and mobile app. The therapy encourages individuals to slow down for a moment, to address fast-thinking habits fuelling paranoia. SloMo has received a NICE Early Value Assessment recommendation for National Health Service use to address evidence gaps related to its use in the real world, and an implementation study is underway.
Objective:
This study optimised the SloMo software for this implementation work, with the aim of reducing technology complexity and improving user experience, to increase equitable outcomes.
Methods:
An inclusive, human-centred design methodology was used to optimise SloMo. Guided by the Non-adoption, Abandonment, Scale-up, Spread, Sustainability framework, the redesign sought to reduce the technology’s complexity, and improve the user experience for diverse patients and therapists. The double diamond framework structured the iterative redesign, integrating insights from PPI consultants, therapists, and a transdisciplinary codesign team. Key stages were identifying implementation barriers, redefining user needs, iteratively developing solutions, and delivering a validated minimum viable product. Methods included co-design workshops, 1:1 interaction testing, and think-aloud sessions.
Results:
Users wanted a form of CBTp that was usable, trustworthy, enjoyable, personalised, normalising, and memorable. The redesign therefore included a minimalist user interface, more diverse lived experience vignette content, enhanced agency over data, greater representation of protected characteristics and their intersectionality, and intuitive navigation. Feedback from a purposively sampled patient and therapist sample validated the redesign as it was associated with strong user experience, particularly in relation to usability and usefulness.
Conclusions:
The study produced a redesign of the SloMo software optimised for real-world use, whilst retaining fidelity to the therapeutic content of the previous version. Through an inclusive, human centred approach, the optimised design of SloMo addresses barriers to adoption by reducing complexity and fostering accessibility. This study underscores the value of integrating lived experience involvement into digital therapeutics to support scalable, equitable, and sustainable mental health care solutions. Clinical Trial: N/A
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