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Examining Potential Barriers to mHealth Implementation and Engagement in Schizophrenia: Phone Ownership and Symptom Severity

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Abstract

Implementation of mobile health (mHealth) interventions remains limited among those with schizophrenia. This study examined several logistical barriers to the implementation of mHealth interventions, particularly text message interventions, for people with schizophrenia. This study examined the feasibility of leveraging personal mobile phones to deliver mHealth interventions by using data from a pilot randomized controlled trial (RCT) of a text message intervention delivered on personal mobile phones to 56 people with schizophrenia with motivation reductions. Among those screened for the RCT (n = 100), 91% had a mobile phone. For randomized participants (n = 56), 82.1% had a smartphone, with almost all (93.5%) having an Android processing system. Most randomized participants had unlimited text messages (96.4%) or voice calls (76.8%) with their mobile service plan, with 32.1% having unlimited data each month. At baseline, most used text messages (85.2%) and the internet (59.3%), while fewer participants used mobile applications (35.2%) at least once a week. Finally, there were no significant associations between engagement in the text message intervention and participant demographics, symptoms (positive, mood, negative), neurocognition, or mobile phone or plan characteristics, or phone changes made during the 8-week intervention. Even those with schizophrenia with perceived symptom barriers to mHealth engagement (i.e., motivation reductions) may have access to mobile phones and plans and familiarity with mobile features to engage meaningfully with a text message intervention. These results help to support future implementations of text message interventions, which may enhance the provision of care for those with schizophrenia.

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Funding

This work was supported by the William and Dorothy Bevan Scholarship from the American Psychological Foundation, the Indiana Clinical and Translational Sciences Institute (ICTSI), the ICTSI Clinical Research Center (UL1TR001108), the Indiana University-Purdue University Indianapolis Undergraduate Research Opportunities Program, and the National Institutes of Mental Health (T32MH016259). In addition, Dr. Buck is supported by a NARSAD Young Investigator Award from the Brain and Behavior Foundation and a Mentored Patient-Oriented Research Career Development Award from the National Institutes of Mental Health (K23MH122504).

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Room 2603, Charlestown, MA, 02129, USA

    Lauren Luther

  2. Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA

    Lauren Luther

  3. Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA

    Lauren Luther, Melanie A. Fischer, Annalee V. Johnson-Kwochka, George Coffin & Michelle P. Salyers

  4. Behavioral Research in Technology and Engineering (BRiTE) Center, Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA

    Benjamin E. Buck

  5. College of Applied Behavioral Sciences, University of Indianapolis, 1400 East Hanna Avenue, Indianapolis, IN, 46227, USA

    George Coffin

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  1. Lauren Luther
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  2. Benjamin E. Buck
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  3. Melanie A. Fischer
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  4. Annalee V. Johnson-Kwochka
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  6. Michelle P. Salyers
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Correspondence to Lauren Luther.

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The study procedures were approved by the Indiana University-Purdue University Indianapolis Institutional Review Board.

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Luther, L., Buck, B.E., Fischer, M.A. et al. Examining Potential Barriers to mHealth Implementation and Engagement in Schizophrenia: Phone Ownership and Symptom Severity. J. technol. behav. sci. 7, 13–22 (2022). https://doi.org/10.1007/s41347-020-00162-7

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  • DOI: https://doi.org/10.1007/s41347-020-00162-7

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