Abstract
BackgroundThe increase in availability of patient data through consumer health wearable devices and mobile phone sensors provides opportunities for mental health treatment beyond traditional self-report measurements. Previous studies have suggested that wearables can be effectively used to benefit the physical health of people with mental health issues, but little research has explored the integration of wearable devices into mental health care. As such, early research is still necessary to address factors that might impact integration including patients' motivations to use wearables and their subsequent data.ObjectiveThe aim of this study was to gain an understanding of patients’ motivations to use or not to use wearables devices during an intensive treatment program for post-traumatic stress disorder (PTSD). During this treatment, they received a complementary Fitbit. We investigated the following research questions: How did the veterans in the intensive treatment program use their Fitbit? What are contributing motivators for the use and nonuse of the Fitbit?MethodsWe conducted semistructured interviews with 13 veterans who completed an intensive treatment program for PTSD. We transcribed and analyzed interviews using thematic analysis.ResultsWe identified three major motivations for veterans to use the Fitbit during their time in the program: increase self-awareness, support social interactions, and give back to other veterans. We also identified three major reasons certain features of the Fitbit were not used: lack of clarity around the purpose of the Fitbit, lack of meaning in the Fitbit data, and challenges in the veteran-provider relationship.ConclusionsTo integrate wearable data into mental health treatment programs, it is important to understand the patient’s perspectives and motivations in using wearables. We also discuss how the military culture and PTSD may have contributed to our participants' behaviors and attitudes toward Fitbit usage. We conclude with possible approaches for integrating patient-generated data into mental health treatment settings that may address the challenges we identified.
Highlights
Study MotivationApproximately one in five adults in the United States will experience a mental health disorder each year amounting to 43.4 million adults with a diagnosable mental illness [1]
We found that the participants of our study were motivated to use the Fitbit to increase their self-awareness, interact with fellow veterans and health care providers (HCPs), and as a means of giving back to other veterans
We found that participants of the study stopped using the Fitbit for reasons including lack of clarity of the purpose of tracking, the inability to track behaviors of interest, and challenges in the veteran-provider relationship
Summary
Study MotivationApproximately one in five adults in the United States will experience a mental health disorder each year amounting to 43.4 million adults with a diagnosable mental illness [1]. New avenues for collecting data are becoming available through wearable devices such as Fitbits [3] and mobile phone sensors These devices could contribute to an understanding of a patient’s daily experience and provide some indication of their behavioral and mental health [4,5]. Wearable consumer health tracking devices that record PGD are designed with the user as the primary stakeholder; yet increasingly, data from these devices are finding its way into clinical settings in multiple ways [6,7] Such data might enter the clinical setting indirectly through the patient introducing it himself or herself to a provider or directly through application programming interfaces that could integrate the data into traditional clinical practices. Some of these barriers include a lack of time to review or discuss the data, few HCPs who are qualified to engage with the data, and insufficient mechanisms with which to transfer the data [16]
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