Browsing by Author "Schueller, Stephen M"
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- ItemThe behavioral intervention technology model: an integrated conceptual and technological framework for eHealth and mHealth interventions.(2014-06-09) Mohr, David C; Schueller, Stephen M; Montague, Enid; Burns, Michelle Nicole; Rashidi, ParisaA growing number of investigators have commented on the lack of models to inform the design of behavioral intervention technologies BITs BITs which include a subset of mHealth and eHealth interventions employ a broad range of technologies such as mobile phones the Web and sensors to support users in changing behaviors and cognitions related to health mental health and wellness We propose a model that conceptually defines BITs from the clinical aim to the technological delivery framework The BIT model defines both the conceptual and technological architecture of a BIT Conceptually a BIT model should answer the questions why what how conceptual and technical and when While BITs generally have a larger treatment goal such goals generally consist of smaller intervention aims the why such as promotion or reduction of specific behaviors and behavior change strategies the conceptual how such as education goal setting and monitoring Behavior change strategies are instantiated with specific intervention components or elements the what The characteristics of intervention elements may be further defined or modified the technical how to meet the needs capabilities and preferences of a user Finally many BITs require specification of a workflow that defines when an intervention component will be delivered The BIT model includes a technological framework BIT Tech that can integrate and implement the intervention elements characteristics and workflow to deliver the entire BIT to users over time This implementation may be either predefined or include adaptive systems that can tailor the intervention based on data from the user and the user s environment The BIT model provides a step towards formalizing the translation of developer aims into intervention components larger treatments and methods of delivery in a manner that supports research and communication between investigators on how to design develop and deploy BITs
- ItemDigital apothecaries: a vision for making health care interventions accessible worldwide.(0000-00-00) Muñoz, Ricardo F; Chavira, Denise A; Himle, Joseph A; Koerner, Kelly; Muroff, Jordana; Reynolds, Julia; Rose, Raphael D; Ruzek, Josef I; Teachman, Bethany A; Schueller, Stephen MEvidence based psychological interventions are growing in number but are not within reach of many individuals who could benefit from them The recent revolution in digital technologies now makes it possible to reach people around the globe with digital interventions in the form of web sites mobile applications wearable devices and so on Although a plethora of digital interventions are available online few are evidence based and individuals have little guidance to decide among the multitude of options We propose the development of digital apothecaries that is online repositories of evidence based digital interventions As portals to effective interventions digital apothecaries would be useful to individuals who could access evidence based interventions directly to health care providers who could identify specific digital tools to suggest to or use with their patients and to researchers who could study a range of tools with large samples enabling comparative tests and evaluation of moderators of effects We present a taxonomy of types of in person and digital interventions ranging from traditional therapy without the use of digital tools to totally automated self help interventions This taxonomy highlights the potential of blending digital tools into health care systems to expand their reach Digital apothecaries would provide access to evidence based digital interventions both free and paid versions provide data on effectiveness including effectiveness for diverse populations and encourage the development and testing of more such tools Other issues discussed include criteria for inclusion of interventions into digital apothecaries how digital tools could enhance health care for diverse populations and cautionary notes regarding potential negative unintended consequences of the adoption of digital interventions into the health care system In particular we warn about the potential misuse of evidence based digital interventions to justify reducing access to live providers Digital apothecaries bring with them the promise of reducing health disparities by reaching large numbers of individuals across the world who need health interventions but are not currently receiving them The health care field is encouraged to mindfully develop this promise while being alert not to cause inadvertent harm
- ItemDiscovery of and Interest in Health Apps Among Those With Mental Health Needs: Survey and Focus Group Study.(0000-00-00) Schueller, Stephen M; Neary, Martha; O'Loughlin, Kristen; Adkins, Elizabeth CBACKGROUND A large number of health apps are available directly to consumers through app marketplaces Little information is known however about how consumers search for these apps and which factors influence their uptake adoption and long term use OBJECTIVE The aim of this study was to understand what people look for when they search for health apps and the aspects and features of those apps that consumers find appealing METHODS Participants were recruited from Northwestern University s Center for Behavioral Intervention Technologies research registry of individuals with mental health needs Most participants n 811 completed a survey asking about their use and interest in health and mental health apps Local participants were also invited to participate in focus groups A total of 7 focus groups were conducted with 30 participants that collected more detailed information about their use and interest in health and mental health apps RESULTS Survey participants commonly found health apps through social media 45 1 366 811 personal searches 42 7 346 811 or word of mouth 36 9 299 811 as opposed to professional sources such as medical providers 24 6 200 811 From the focus groups common themes related to uptake and use of health apps included the importance of personal use before adoption specific features that users found desirable and trusted sources either developing or promoting the apps CONCLUSIONS As the number of mental health and health apps continue to increase it is imperative to better understand the factors that impact people s adoption and use of such technologies Our findings indicated that a number of factors ease of use aesthetics and individual experience drove adoption and use and highlighted areas of focus for app developers and disseminators
- ItemMeasuring the Implementation of Behavioral Intervention Technologies: Recharacterization of Established Outcomes.(0000-00-00) Hermes, Eric DA; Lyon, Aaron R; Schueller, Stephen M; Glass, Joseph EBehavioral intervention technologies BITs are websites software mobile apps and sensors designed to help users address or change behaviors cognitions and emotional states BITs have the potential to transform health care delivery and early research has produced promising findings of efficacy BITs also favor new models of health care delivery and provide novel data sources for measurement However there are few examples of successful BIT implementation and a lack of consensus on as well as inadequate descriptions of BIT implementation measurement The aim of this viewpoint paper is to provide an overview and characterization of implementation outcomes for the study of BIT use in routine practice settings Eight outcomes for the evaluation of implementation have been previously described acceptability adoption appropriateness feasibility fidelity implementation cost penetration and sustainability In a proposed recharacterization of these outcomes with respect to BIT implementation definitions are clarified expansions to the level of analysis are identified and unique measurement characteristics are discussed Differences between BIT development and implementation an increased focus on consumer level outcomes the expansion of providers who support BIT use and the blending of BITs with traditional health care services are specifically discussed BITs have the potential to transform health care delivery Realizing this potential however will hinge on high quality research that consistently and accurately measures how well such technologies have been integrated into health services This overview and characterization of implementation outcomes support BIT research by identifying and proposing solutions for key theoretical and practical measurement challenges
- ItemPurple: a modular system for developing and deploying behavioral intervention technologies.(2014-08-01) Schueller, Stephen M; Begale, Mark; Penedo, Frank J; Mohr, David CThe creation deployment and evaluation of Web based and mobile based applications for health mental health and wellness within research settings has tended to be siloed with each research group developing their own systems and features This has led to technological features and products that are not sharable across research teams thereby limiting collaboration reducing the speed of dissemination and raising the bar for entry into this area of research This paper provides an overview of Purple an extensible modular and repurposable system created for the development of Web based and mobile based applications for health behavior change Purple contains features required to construct applications and to manage and evaluate research trials using these applications Core functionality of Purple includes elements that support user management content authorship content delivery and data management We discuss the history and development of the Purple system guided by the rationale of producing a system that allows greater collaboration and understanding across research teams interested in investigating similar questions and using similar methods Purple provides a useful tool to meet the needs of stakeholders involved in the creation provision and usage of eHealth and mHealth applications Housed in a non profit academic institution Purple also offers the potential to facilitate the diffusion of knowledge across the research community and improve our capacity to deliver useful and usable applications that support the behavior change of end users
- ItemStrategies for mHealth research: lessons from 3 mobile intervention studies.(2015-02-25) Ben-Zeev, Dror; Schueller, Stephen M; Begale, Mark; Duffecy, Jennifer; Kane, John M; Mohr, David CThe capacity of Mobile Health mHealth technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research mHealth research entails several unique characteristics including collaboration with technologists at all phases of a project reliance on regional telecommunication infrastructure and commercial mobile service providers and deployment and evaluation of interventions in the wild with participants using mobile tools in uncontrolled environments In the current paper we summarize the lessons our multi institutional multi disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations First we describe three ongoing projects that we draw from to illustrate throughout the paper We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful Finally we discuss mHealth research challenges i e evolving technology mobile phone selection user characteristics the deployment environment and mHealth system bugs and glitches and provide recommendations for identifying and resolving barriers or preventing their occurrence altogether
- ItemVeterans' Perspectives on Fitbit Use in Treatment for Post-Traumatic Stress Disorder: An Interview Study.(0000-00-00) Ng, Ada; Reddy, Madhu; Zalta, Alyson K; Schueller, Stephen MBACKGROUND The 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 OBJECTIVE The 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 METHODS We conducted semistructured interviews with 13 veterans who completed an intensive treatment program for PTSD We transcribed and analyzed interviews using thematic analysis RESULTS We 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 CONCLUSIONS To 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