Abstract
BackgroundDigital technology has the potential to improve outcomes for people with psychosis. However, to date, research has largely ignored service user views on digital health interventions (DHIs).ObjectiveThe objective of our study was to explore early psychosis service users’ subjective views on DHIs.MethodsFramework analysis was undertaken with data obtained from 21 semistructured interviews with people registered with early intervention for psychosis services. Robust measures were used to develop a stable framework, including member checking, triangulation, independent verification of themes, and consensus meetings.ResultsThe following 4 themes were established a priori: acceptability of technology in psychosis and mental health; technology increasing access to and augmenting mental health support; barriers to adopting DHIs; and concerns about management of data protection, privacy, risk, and security of information. The following 2 themes were generated a posteriori: blending DHIs with face-to-face treatment and empowerment, control, and choice. DHIs were also viewed as potentially destigmatizing, overcoming barriers faced in traditional service settings, facilitating communication, and empowering service users to take active control of their health care.ConclusionsIn the first study of its kind, early psychosis service users’ were largely positive about the potential use of DHIs supporting and managing mental health. Overall, service users felt that DHIs were a progressive, modern, and relevant platform for health care delivery. Concerns were expressed around privacy and data security and practical barriers inherent within DHIs, all of which require further attention. Future research should explore whether findings transfer to other service user groups, other technology delivery formats, and across a range of treatment modalities.
Highlights
Integration of technology into health services is becoming commonplace, primarily owing to recent developments in hardware and connectivity
Nonlinear and often condensed, data analysis involved the following key stages: (1) familiarization with the data: listening to recordings, reading and rereading transcripts and making analytical notes; (2) coding the data: combination of deductive and inductive approaches; and (3) developing a thematic framework: we developed an initial framework by comparing codes assigned to the data after independently coding several transcripts before agreeing on the set of codes to be assigned to subsequent transcripts
Participants had a mean age of 26 years (SD 5.14, range 16-34) and a mean length of 22 months of early intervention for psychosis service GP (EIS) involvement
Summary
Integration of technology into health services is becoming commonplace, primarily owing to recent developments in hardware and connectivity. The following 3 key themes were identified: usability and familiarity with the technology, acceptability and integration of technology into daily life, and perceived impact of technology on health care Another qualitative study with individuals experiencing psychosis reported that using Web-based resources to access mental health-related information was commonplace with many participants expressing positive attitudes toward the potential of mental health apps for self-care [19]. Evidence suggests that involving service users in intervention development is associated with high levels of engagement with DHIs more generally [21], highlighting the need to examine service users’ perspectives on DHIs. This study aimed to engage with early psychosis service users to gain an in-depth understanding of their perspectives and attitudes toward DHIs. The study is part of a larger program of work to codevelop and test a DHI for early psychosis [22]. This is the first study to examine qualitatively early psychosis service users’ views about a DHI delivered via a smartphone app
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