mHealth for Schizophrenia: Patient Engagement With a Mobile Phone Intervention Following Hospital Discharge
Open accessAbstract
Background: mHealth interventions that use mobile phones as instruments for illness management are gaining popularity. Research examining mobile phone‒based mHealth programs for people with psychosis has shown that these approaches are feasible, acceptable, and clinically promising. However, most mHealth initiatives involving people with schizophrenia have spanned periods ranging from a few days to several weeks and have typically involved participants who were clinically stable. Objective: Our aim was to evaluate the viability of extended mHealth interventions for people with schizophrenia-spectrum disorders following hospital discharge. Specifically, we set out to examine the following: (1) Can individuals be engaged with a mobile phone intervention program during this high-risk period?, (2) Are age, gender, racial background, or hospitalization history associated with their engagement or persistence in using a mobile phone intervention over time?, and (3) Does engagement differ by characteristics of the mHealth intervention itself (ie, pre-programmed vs on-demand functions)? Methods: We examined mHealth intervention use and demographic and clinical predictors of engagement in 342 individuals with schizophrenia-spectrum disorders who were given the FOCUS mobile phone intervention as part of a technology-assisted relapse prevention program during the 6-month high-risk period following hospitalization. Results: On average, participants engaged with FOCUS for 82% of the weeks they had the mobile phone. People who used FOCUS more often continued using it over longer periods: 44% used the intervention over 5-6 months, on average 4.3 days a week. Gender, race, age, and number of past psychiatric hospitalizations were associated with engagement. Females used FOCUS on average 0.4 more days a week than males. White participants engaged on average 0.7 days more a week than African-Americans and responded to prompts on 0.7 days more a week than Hispanic participants. Younger participants (age 18-29) had 0.4 fewer days of on-demand use a week than individuals who were 30-45 years old and 0.5 fewer days a week than older participants (age 46-60). Participants with fewer past hospitalizations (1-6) engaged on average 0.2 more days a week than those with seven or more. mHealth program functions were associated with engagement. Participants responded to prompts more often than they self-initiated on-demand tools, but both FOCUS functions were used regularly. Both types of intervention use declined over time (on-demand use had a steeper decline). Although mHealth use declined, the majority of individuals used both on-demand and system-prompted functions regularly throughout their participation. Therefore, neither function is extraneous. Conclusions: The findings demonstrated that individuals with schizophrenia-spectrum disorders can actively engage with a clinically supported mobile phone intervention for up to 6 months following hospital discharge. mHealth may be useful in reaching a clinical population that is typically difficult to engage during high-risk periods.
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Ben-Zeev et al found that participants who engaged with their schizophrenia self-management app for 5 to 6 months had a higher frequency of interactions and engaged 4.3 days per week on average.
“Ben-Zeev et al found that participants who engaged with their schizophrenia self-management app for a period of 5 to 6 months also had a higher frequency of interactions and engaged 4.3 days per week on average [37].”
From A Library of Analytic Indicators to Evaluate Effective Engagement with Consumer mHealth Apps for Chronic Conditions: Scoping Review (2019) · cites this paper as [37]
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- Authors
- Ben-Zeev, D., Scherer, E. A., Gottlieb, J. D., Rotondi, A. J., Brunette, M. F., Achtyes, E. D., Mueser, K. T., Gingerich, S., Brenner, C. J., Begale, M., Mohr, D. C., Schooler, N., Marcy, P., Robinson, D. G., & Kane, J. M.
- Affiliations
- Dartmouth College (US)
- Boston University (US)
- University of Pittsburgh (US)
- Michigan State University (US)
- Northwestern University (US)
- Northwell Health (US)
- ORCID
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2016-07-27
- Volume
- 3
- Issue
- 3
- Pages
- e34
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC4999306
- OpenAlex
- W2496523590
- Cited by
- 137
- References
- 25
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 11 · 2023: 19 · 2022: 11 · 2021: 15 · 2020: 12 · 2019: 13 · 2018: 24 · 2017: 11 · 2016: 1
- FWCI
- 25.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- mobile health, schizophrenia, psychosis, patient engagement, mobile phone intervention, relapse prevention, hospital discharge, high-risk periods, predictors of engagement, demographic differences, age and gender differences, racial differences, intervention persistence, technology-assisted care, digital mental health tools
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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