Perspectives on Mobile Health Versus Clinic-Based Group Interventions for People With Serious Mental Illnesses: A Qualitative Study.

Abstract

This study built on research comparing a mobile health intervention (FOCUS) and a clinic-based intervention (Wellness Recovery Action Planning [WRAP]) for self-management of serious mental illnesses. Qualitative interviews were conducted to provide additional insight into engagement and satisfaction and augment understanding of clinical outcomes. Individuals (N=31) with serious mental illness participating in a comparative effectiveness trial were interviewed. Interviewees were sampled purposively for a range of engagement with the interventions. Interviews inquired into experiences with the interventions and were 45-60 minutes long, audio recorded, and transcribed. Researchers developed qualitative codes based on the research aims, interview domains, and inductively derived categories, aggregating data by code and producing analytic memos to distill main findings. Both FOCUS and WRAP participants described gaining new information about mental illness and new skills for managing symptoms. FOCUS participants emphasized the intervention's accessibility, and WRAP participants highlighted the importance of community and shared experiences. FOCUS participants commenced treatment at higher rates, compared with WRAP participants, which may have been related to the strongly negative views of group interventions expressed by some WRAP participants. FOCUS was generally enthusiastically received. The comparable clinical outcomes of the interventions were reflected in narratives detailing the positive impact of the interventions. Interviews provided evidence that mobile health and clinic-based illness self-management interventions were well received and offered opportunities to learn new illness management skills. Findings support expanding the range of services and supports for persons with serious mental illness to include traditional and technology-based approaches.