Characterizing Use of a Multicomponent Digital Intervention to Predict Treatment Outcomes in First-Episode Psychosis: Cluster Analysis.
clustering
digital health
digital intervention
log data
psychotic disorders
social networking
usage metrics
youth mental health
Journal
JMIR mental health
ISSN: 2368-7959
Titre abrégé: JMIR Ment Health
Pays: Canada
ID NLM: 101658926
Informations de publication
Date de publication:
07 Apr 2022
07 Apr 2022
Historique:
received:
31
03
2021
accepted:
10
01
2022
revised:
18
06
2021
entrez:
7
4
2022
pubmed:
8
4
2022
medline:
8
4
2022
Statut:
epublish
Résumé
Multicomponent digital interventions offer the potential for tailored and flexible interventions that aim to address high attrition rates and increase engagement, an area of concern in digital mental health. However, increased flexibility in use makes it difficult to determine which components lead to improved treatment outcomes. This study aims to identify user profiles on Horyzons, an 18-month digital relapse prevention intervention for first-episode psychosis that incorporates therapeutic content and social networking, along with clinical, vocational, and peer support, and to examine the predictive value of these user profiles for treatment outcomes. A secondary objective is to compare each user profile with young people receiving treatment as usual (TAU). Participants comprised 82 young people (aged 16-27 years) with access to Horyzons and 84 receiving TAU, recovering from first-episode psychosis. In addition, 6-month use data from the therapy and social networking components of Horyzons were used as features for K-means clustering for joint trajectories to identify user profiles. Social functioning, psychotic symptoms, depression, and anxiety were assessed at baseline and 6-month follow-up. General linear mixed models were used to examine the predictive value of user profiles for treatment outcomes and between each user profile with TAU. A total of 3 user profiles were identified based on the following system use metrics: low use, maintained use of social components, and maintained use of both therapy and social components. The maintained therapy and social group showed improvements in social functioning (F Continued engagement with both therapy and social components might be key in achieving long-term recovery. Maintained social use and low use outcomes were broadly comparable with TAU, emphasizing the importance of maintaining engagement for improved treatment outcomes. Although the social network may be a key ingredient to increase sustained engagement, as users engaged with this more consistently, it should be leveraged as a tool to engage young people with therapeutic content to bring about social and clinical benefits.
Sections du résumé
BACKGROUND
BACKGROUND
Multicomponent digital interventions offer the potential for tailored and flexible interventions that aim to address high attrition rates and increase engagement, an area of concern in digital mental health. However, increased flexibility in use makes it difficult to determine which components lead to improved treatment outcomes.
OBJECTIVE
OBJECTIVE
This study aims to identify user profiles on Horyzons, an 18-month digital relapse prevention intervention for first-episode psychosis that incorporates therapeutic content and social networking, along with clinical, vocational, and peer support, and to examine the predictive value of these user profiles for treatment outcomes. A secondary objective is to compare each user profile with young people receiving treatment as usual (TAU).
METHODS
METHODS
Participants comprised 82 young people (aged 16-27 years) with access to Horyzons and 84 receiving TAU, recovering from first-episode psychosis. In addition, 6-month use data from the therapy and social networking components of Horyzons were used as features for K-means clustering for joint trajectories to identify user profiles. Social functioning, psychotic symptoms, depression, and anxiety were assessed at baseline and 6-month follow-up. General linear mixed models were used to examine the predictive value of user profiles for treatment outcomes and between each user profile with TAU.
RESULTS
RESULTS
A total of 3 user profiles were identified based on the following system use metrics: low use, maintained use of social components, and maintained use of both therapy and social components. The maintained therapy and social group showed improvements in social functioning (F
CONCLUSIONS
CONCLUSIONS
Continued engagement with both therapy and social components might be key in achieving long-term recovery. Maintained social use and low use outcomes were broadly comparable with TAU, emphasizing the importance of maintaining engagement for improved treatment outcomes. Although the social network may be a key ingredient to increase sustained engagement, as users engaged with this more consistently, it should be leveraged as a tool to engage young people with therapeutic content to bring about social and clinical benefits.
Identifiants
pubmed: 35389351
pii: v9i4e29211
doi: 10.2196/29211
pmc: PMC9030973
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e29211Informations de copyright
©Shaunagh O'Sullivan, Lianne Schmaal, Simon D'Alfonso, Yara Jo Toenders, Lee Valentine, Carla McEnery, Sarah Bendall, Barnaby Nelson, John F Gleeson, Mario Alvarez-Jimenez. Originally published in JMIR Mental Health (https://mental.jmir.org), 07.04.2022.
Références
Child Psychiatry Hum Dev. 2017 Aug;48(4):554-571
pubmed: 27619221
J Abnorm Psychol. 1971 Aug;78(1):107-26
pubmed: 4938262
Schizophr Res. 2013 Apr;145(1-3):82-7
pubmed: 23410709
Acta Psychiatr Scand. 2000 Apr;101(4):323-9
pubmed: 10782554
J Clin Endocrinol Metab. 2019 Dec 1;104(12):6003-6016
pubmed: 31290977
Curr Opin Psychiatry. 2014 May;27(3):167-72
pubmed: 24662959
IEEE Trans Pattern Anal Mach Intell. 1979 Feb;1(2):224-7
pubmed: 21868852
Lancet Psychiatry. 2018 Jan;5(1):41-50
pubmed: 29242000
Schizophr Res. 2019 Jul;209:234-244
pubmed: 30826261
Schizophr Res. 2009 Feb;107(2-3):173-8
pubmed: 18945593
Psychiatr Rehabil J. 2010 Spring;33(4):278-87
pubmed: 20374986
J Med Internet Res. 2019 Sep 25;21(9):e14567
pubmed: 31573916
Schizophr Res. 2012 Aug;139(1-3):116-28
pubmed: 22658527
Br J Psychiatry. 2017 Jul;211(1):37-44
pubmed: 28385705
Schizophr Res. 2014 Jun;156(1):96-106
pubmed: 24746468
Schizophr Res. 2013 Jan;143(1):143-9
pubmed: 23146146
Psychiatr Serv. 2010 Nov;61(11):1099-105
pubmed: 21041348
Front Psychol. 2017 Jun 02;8:796
pubmed: 28626431
Schizophr Res. 2007 Jan;89(1-3):129-39
pubmed: 17095194
Psychiatry Res. 2015 Aug 30;228(3):803-7
pubmed: 26089018
Psychiatr Serv. 2019 Sep 1;70(9):801-807
pubmed: 31109262
World Psychiatry. 2021 Jun;20(2):233-243
pubmed: 34002511
Front Psychiatry. 2019 Apr 17;10:210
pubmed: 31057434
BMJ. 2017 Jan 12;356:i6681
pubmed: 28082379
J Med Internet Res. 2019 Nov 28;21(11):e14728
pubmed: 31778115
Clin Psychol Rev. 2010 Nov;30(7):849-64
pubmed: 20363063
Schizophr Res. 2011 Feb;125(2-3):236-46
pubmed: 21081266
Schizophr Bull. 1987;13(2):261-76
pubmed: 3616518
Br J Psychiatry. 2010 May;196(5):372-6
pubmed: 20435962
Psychol Med. 2012 Mar;42(3):595-606
pubmed: 21854682
Schizophr Bull. 2012 May;38(3):414-25
pubmed: 22080492
J Med Internet Res. 2018 Sep 27;20(9):e10035
pubmed: 30262449
Cyberpsychol Behav Soc Netw. 2019 Aug;22(8):535-542
pubmed: 31361508
J Med Internet Res. 2018 Jun 06;20(6):e199
pubmed: 29875089
J Med Internet Res. 2020 Aug 13;22(8):e17155
pubmed: 32788151
CNS Drugs. 2016 May;30(5):357-68
pubmed: 27106296
Schizophr Res. 2019 Feb;204:65-71
pubmed: 30126816
J Med Internet Res. 2019 Jul 22;21(7):e12869
pubmed: 31333198
J Abnorm Child Psychol. 2017 Nov;45(8):1621-1633
pubmed: 28120251
BMJ Open. 2019 Feb 19;9(2):e024104
pubmed: 30782893
BMC Psychol. 2018 Jul 17;6(1):32
pubmed: 30016999
Schizophr Bull. 2018 Aug 20;44(5):1070-1080
pubmed: 29566206
Br J Psychiatry Suppl. 1993 Dec;(22):39-44
pubmed: 8110442
Soc Psychiatry Psychiatr Epidemiol. 2016 Jan;51(1):1-13
pubmed: 26498752
Br J Psychiatry. 2019 May;214(5):269-272
pubmed: 30739613
Psychother Psychosom. 2015;84(3):177-82
pubmed: 25832111
Acta Psychiatr Scand. 2007 Feb;115(2):126-31
pubmed: 17244176
Early Interv Psychiatry. 2017 Feb;11(1):23-36
pubmed: 25585960
J Affect Disord. 2017 Aug 15;218:15-22
pubmed: 28456072
Am Psychol. 2000 Jan;55(1):68-78
pubmed: 11392867
Psychiatry Res. 2014 May 30;216(3):412-7
pubmed: 24613006
World Psychiatry. 2017 Oct;16(3):278-286
pubmed: 28941098
Schizophr Res. 2018 Dec;202:369-377
pubmed: 30031616
Front Psychiatry. 2017 May 03;8:72
pubmed: 28515699
J Med Internet Res. 2016 May 31;18(5):e121
pubmed: 27245693
Comput Methods Programs Biomed. 2013 Jan;109(1):104-11
pubmed: 23127283
Arch Gen Psychiatry. 2005 Sep;62(9):975-83
pubmed: 16143729
Acta Psychiatr Scand. 2020 Jun;141(6):541-552
pubmed: 31746462
Schizophr Bull. 1996;22(2):305-26
pubmed: 8782288
Br J Psychiatry. 2014 Aug;205(2):88-94
pubmed: 25252316