Video-Based Mobile Health Interventions for People With Schizophrenia: Bringing the 'Pocket Therapist' to Life

摘要

Objective: To examine whether video-based mobile health (mHealth) interventions are feasible, acceptable, understandable, and engaging to people with schizophrenia. Method: This study used a mixed-methods design. Ten individuals with schizophrenia spectrum disorders were recruited for a month-long trial in which they used FOCUS-Audio/Video (FOCUS-AV), a smartphone system that offers video and written intervention options. Participants completed posttrial measures and engaged in semistructured interviews. Findings: One participant dropped out. The remaining 9 participants used intervention videos successfully. Participants responded to 67% of system-delivered prompts to engage FOCUS-AV, and 52% of FOCUS-AV use was initiated by the users. On average, participants used interventions 6 days a week, 4 times daily. Participants used video functions an average of 28 times. They chose video over written interventions on 67% of the times they used on-demand functions but opted for written content 78% of the times they responded to prescheduled prompts. Clinician videos were rated as more personal, engaging, and helpful than written interventions. Video and written interventions were rated as equally usable and understandable. Written interventions were rated as more favorable in letting users proceed at their own pace. Similarly to what is seen in live therapy, the communication style and demeanor of clinicians depicted in intervention videos reportedly affected participants' experience with treatment. Conclusions and Implications for Practice: Video-based mHealth may be a feasible, usable, acceptable, and highly engaging method for flexible delivery of interventions to people with schizophrenia using mobile technology. Producing intervention videos is more time-, labor-, and cost-intensive than generating written content, but participant feedback suggests that there may be added value in this approach. Additional research will determine whether video-based mHealth interventions lead to better, faster, or more sustainable clinical gains.