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Start Over Author "Helen Whitehill" Topic schizophrenia
2 results on '"Helen Whitehill"'

1. Using EMPOWER in daily life: a qualitative investigation of implementation experiences

Author

Stephanie Allan, Sara Beedie, Hamish J. McLeod, John Farhall, John Gleeson, Simon Bradstreet, Emma Morton, Imogen Bell, Alison Wilson-Kay, Helen Whitehill, Claire Matrunola, David Thomson, Andrea Clark, and Andrew Gumley

Subjects
Schizophrenia, Implementation science, Mhealth, Psychiatry, RC435-571
Abstract

Abstract Background Digital self-management tools blended with clinical triage and peer support have the potential to improve access to early warning signs (EWS) based relapse prevention in schizophrenia care. However, the implementation of digital interventions in psychosis can be poor. Traditionally, research focused on understanding how people implement interventions has focused on the perspectives of mental health staff. Digital interventions are becoming more commonly used by patients within the context of daily life, which means there is a need to understand implementation from the perspectives of patients and carers. Methods Semi-structured one-on-one interviews with 16 patients who had access to the EMPOWER digital self-management intervention during their participation in a feasibility trial, six mental health staff members who supported the patients and were enrolled in the trial, and one carer participant. Interviews focused on understanding implementation, including barriers and facilitators. Data were coded using thematic analysis. Results The intervention was well implemented, and EMPOWER was typically perceived positively by patients, mental health staff and the carer we spoke to. However, some patients reported negative views and reported ideas for intervention improvement. Patients reported valuing that the app afforded them access to things like information or increased social contact from peer support workers that went above and beyond that offered in routine care. Patients seemed motivated to continue implementing EMPOWER in daily life when they perceived it was creating positive change to their wellbeing, but seemed less motivated if this did not occur. Mental health staff and carer views suggest they developed increased confidence patients could self-manage and valued using the fact that people they support were using the EMPOWER intervention to open up conversations about self-management and wellbeing. Conclusions The findings from this study suggest peer worker supported digital self-management like EMPOWER has the potential to be implemented. Further evaluations of these interventions are warranted, and conducting qualitative research on the feasibility gives insight into implementation barriers and facilitators, improving the likelihood of interventions being usable. In particular, the views of patients who demonstrated low usage levels would be valuable.

Published
2023
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2. Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-Being, Engagement, and Recovery: Protocol for a Feasibility Cluster Randomized Controlled Trial Harnessing Mobile Phone Technology Blended With Peer Support

Author

Andrea Clark, Emma Morton, Nicola McMeekin, Hamish J. McLeod, Shôn Lewis, Stephanie Allan, Imogen H. Bell, John Farhall, David J. Thomson, Frank Reilly, Simon Bradstreet, Andrew Thompson, Max Birchwood, Reeva Lederman, Alison Wilson-Kay, Lidia Engel, Graeme MacLennan, Andrew Gumley, Mario Alvarez-Jimenez, Andrew Briggs, Claire Matrunola, John Norrie, John Ainsworth, Alison R. Yung, John Gleeson, Matthias Schwannauer, Swaran P. Singh, Cathrine Mihalopoulos, Paul French, Matthew Machin, Christopher Williams, Sue M. Cotton, Suresh Sundram, Sandra Bucci, Emily Castagnini, Helen Whitehill, Lesley Smith, and Louise Beattie

Subjects
medicine.medical_treatment, Computer applications to medicine. Medical informatics, R858-859.7, Psychological intervention, BF, MHealth, Peer support, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Manchester Institute of Biotechnology, Intervention (counseling), Protocol, medicine, psychosis, mHealth, relapse, business.industry, General Medicine, ResearchInstitutes_Networks_Beacons/manchester_institute_of_biotechnology, medicine.disease, Digital health, Triage, R1, 3. Good health, 030227 psychiatry, schizophrenia, randomized controlled trial, Medicine, Medical emergency, business, 030217 neurology & neurosurgery, Crisis intervention, RC
Abstract

BackgroundRelapse in schizophrenia is a major cause of distress and disability and is predicted by changes in symptoms such as anxiety, depression, and suspiciousness (early warning signs [EWSs]). These can be used as the basis for timely interventions to prevent relapse. However, there is considerable uncertainty regarding the implementation of EWS interventions.ObjectiveThis study was designed to establish the feasibility of conducting a definitive cluster randomized controlled trial comparing Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) against treatment as usual (TAU). Our primary outcomes are establishing parameters of feasibility, acceptability, usability, safety, and outcome signals of a digital health intervention as an adjunct to usual care that is deliverable in the UK National Health Service and Australian community mental health service (CMHS) settings. We will assess the feasibility of candidate primary outcomes, candidate secondary outcomes, and candidate mechanisms for a definitive trial.MethodsWe will randomize CMHSs to EMPOWER or TAU. We aim to recruit up to 120 service user participants from 8 CMHSs and follow them for 12 months. Eligible service users will (1) be aged 16 years and above, (2) be in contact with local CMHSs, (3) have either been admitted to a psychiatric inpatient service or received crisis intervention at least once in the previous 2 years for a relapse, and (4) have an International Classification of Diseases-10 diagnosis of a schizophrenia-related disorder. Service users will also be invited to nominate a carer to participate. We will identify the feasibility of the main trial in terms of recruitment and retention to the study and the acceptability, usability, safety, and outcome signals of the EMPOWER intervention. EMPOWER is a mobile phone app that enables the monitoring of well-being and possible EWSs of relapse on a daily basis. An algorithm calculates changes in well-being based on participants’ own baseline to enable tailoring of well-being messaging and clinical triage of possible EWSs. Use of the app is blended with ongoing peer support.ResultsRecruitment to the trial began September 2018, and follow-up of participants was completed in July 2019. Data collection is continuing. The database was locked in July 2019, followed by analysis and disclosing of group allocation.ConclusionsThe knowledge gained from the study will inform the design of a definitive trial including finalizing the delivery of our digital health intervention, sample size estimation, methods to ensure successful identification, consent, randomization, and follow-up of participants, and the primary and secondary outcomes. The trial will also inform the final health economic model to be applied in the main trial.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 99559262; http://isrctn.com/ISRCTN99559262International Registered Report Identifier (IRRID)DERR1-10.2196/15058

Published
2020
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