Barriers to and Facilitators of Engagement With mHealth Technology for Remote Measurement and Management of Depression: Qualitative Analysis.

Sara Simblett,Josep Maria Haro,Matthew Hotopf,Sara Siddi,Giovanni De Girolamo,Chiara Barattieri Di San Pietro,Peter Gamble,Viola Bulgari,Til Wykes,Hans Eriksson,José Ferrão,Jorge Hortas López,Ashley Polhemus,Faith Matcham

doi:10.2196/11325

Abstract

BackgroundMobile technology has the potential to provide accurate, impactful data on the symptoms of depression, which could improve health management or assist in early detection of relapse. However, for this potential to be achieved, it is essential that patients engage with the technology. Although many barriers to and facilitators of the use of this technology are common across therapeutic areas and technology types, many may be specific to cultural and health contexts.ObjectiveThis study aimed to determine the potential barriers to and facilitators of engagement with mobile health (mHealth) technology for remote measurement and management of depression across three Western European countries.MethodsParticipants (N=25; 4:1 ratio of women to men; age range, 25-73 years) who experienced depression participated in five focus groups held in three countries (two in the United Kingdom, two in Spain, and one in Italy). The focus groups investigated the potential barriers to and facilitators of the use of mHealth technology. A systematic thematic analysis was used to extract themes and subthemes.ResultsFacilitators and barriers were categorized as health-related factors, user-related factors, and technology-related factors. A total of 58 subthemes of specific barriers and facilitators or moderators emerged. A core group of themes including motivation, potential impact on mood and anxiety, aspects of inconvenience, and ease of use was noted across all countries.ConclusionsSimilarities in the barriers to and facilitators of the use of mHealth technology have been observed across Spain, Italy, and the United Kingdom. These themes provide guidance on ways to promote the design of feasible and acceptable cross-cultural mHealth tools.

Highlights

Depression is a major cause of disability in Europe and worldwide
Facilitators and barriers were categorized as health-related factors, user-related factors, and technology-related factors
Similarities in the barriers to and facilitators of the use of mobile health (mHealth) technology have been observed across Spain, Italy, and the United Kingdom

Summary

Introduction

Depression is a major cause of disability in Europe and worldwide. It is associated with a range of negative outcomes including premature mortality [1], reduced quality of life [2], loss of occupational function [3], poor social integration and loneliness [4], and increased risk of other psychiatric problems such as comorbid anxiety disorders [5] and alcohol dependence [6]. With the global increase in availability of mobile phones and wearable devices [8,9], there is potential for more frequent health assessment that might help identify signals indicative of relapse, such as changes in behaviors, circadian rhythms, stresses, or symptoms [10] Identification of such indicators might lead to fast treatment, possibly preventing relapse through early interventions [10]. Mobile technology has the potential to provide accurate, impactful data on the symptoms of depression, which could improve health management or assist in early detection of relapse. For this potential to be achieved, it is essential that patients engage with the technology. Many barriers to and facilitators of the use of this technology are common across therapeutic areas and technology types, many may be specific to cultural and health contexts

Methods

Results

Discussion

Conclusion