Life with FOCUS: A qualitative evaluation of the impact of a smartphone intervention on people with serious mental illness.
Open accessAbstract
OBJECTIVE: A growing body of literature indicates that mobile health (mHealth) interventions that utilize smartphones for illness management are feasible, acceptable, and clinically promising. In this study, we examine how individuals with serious mental illness use a mHealth intervention-FOCUS-to self-manage their illnesses. Additionally, we explored participant perceptions of the intervention's impact on their subjective illness experience. METHOD: We analyzed qualitative data from 30 individuals with serious mental illness who participated in 1 of 2 community-based, 3-month trials of FOCUS. In Study 1, weekly calls were conducted by a mHealth specialist to facilitate and enhance intervention use. In Study 2, researchers conducted qualitative interviews to gather detailed perspectives of intervention use. Data were sampled from the weekly call notes and qualitative interviews and analyzed using a thematic and collaborative approach. RESULTS: Thematic analyses revealed 6 recurring themes. Three themes emerged in regard to participants' ongoing daily use of FOCUS: "back-up" support, symptom management, and self-awareness. Another 3 themes emerged related to the intervention's impact on participants' recovery processes: acceptance of symptoms, motivation and supporting positive outlook. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This qualitative study offers insight into how individuals with serious mental illness made use of a mHealth intervention designed to support illness self-management. Our findings suggest that individuals may benefit differently from mHealth interventions depending on where they are in the recovery process. As mHealth interventions become increasingly popular in clinical settings, it is important to understand consumers' short-term and long-term benefits from these interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Participants expressed a need for more structured use of DMHIs (e.g., app reminders or a human coach checking on them regularly).
“Participants expressed a need to receive more structured use, for example, through app reminders or a human coach checking on them on a regular basis [49,50,113,122,133,137,139,148,150,163,175-182].”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [139]
The Methods section (page unavailable) says FOCUS prompted daily use through notifications and that an mHealth specialist called participants weekly. The Discussion describes participants wanting tailored content and fresh material, but does not report that they expressed a need for more structured use, reminders, or regular coach check-ins. (LLM, conf=0.78)
Experimental — accuracy not yet measuredIn 6 studies, users stated a preference for DMHI as a complement to existing in-person therapy rather than a replacement for in-person therapy.
“In 6 studies, users stated that they would prefer if an intervention served as a complement to existing, in-person therapy rather than a replacement for in-person therapy [30,122,134,139,166,183].”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [139]
Increased insight into users' health could facilitate engagement.
“Additional positive effects that could facilitate engagement were an increased insight into users’ health [79,84,114,124,134,138-140,158,176,202-205]”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [139]
Intervention normalizing people's experiences (e.g., by providing examples of other people with similar experiences) is a facilitating factor.
“Another facilitating factor was whether the intervention normalized people’s experiences [79,139,157,190,201], for instance, by providing examples of other people with similar experiences.”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [139]
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- Authors
- Jonathan, G., Carpenter-Song, E. A., Brian, R. M., & Ben-Zeev, D.
- Venue
- Psychiatric Rehabilitation Journal
- Published
- 2019-06
- Volume
- 42
- Issue
- 2
- Pages
- 182-189
- ISSN
- 1095-158X (ISSN-L)
- 1559-3126
- PMC
- PMC10438016
- OpenAlex
- W2907972569
- Cited by
- 45
- References
- 32
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 6 · 2023: 7 · 2022: 4 · 2021: 10 · 2020: 4 · 2019: 2
- FWCI
- 5.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychiatric Rehabilitation Journal (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Patient Centered Outcomes Research Institute (CER-1403–11403)
- National Institute of Mental Health (R34MH100195)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- severe mental illness, mobile health, smartphone-based intervention, illness self-management, recovery process, self-awareness, symptom management, participant perceptions, community-based intervention
- MeSH terms
- Smartphone, Self-Management, Adult, Mental Disorders, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Satisfaction, Telemedicine, Qualitative Research, Mobile Applications
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