Psychiatr Rehabil J

ObjectiveTheoretical models offer valuable insights for designing effective and sustainable behavioral health interventions, yet the application of theory for informing digital technology interventions for people with mental illness has received limited attention. We offer a perspective on the importance of applying behavior theories and models to developing digital technology interventions for addressing mental and physical health concerns among people with mental illness.MethodsIn this commentary, we summarize prominent theories of human behavior, highlight key theoretical constructs, and identify opportunities to inform digital health interventions for people with mental illness. We consider limitations with existing theories and models, and examine recent theoretical advances that can specifically guide development of digital technology interventionsResultsEstablished behavioral frameworks including Health Belief Model, Theory of Planned Behavior, Transtheoretical Model, and Social Cognitive Theory consist of important and overlapping constructs that can inform digital health interventions for people with mental illness. As digital technologies continue to evolve and enable longitudinal data collection, real-time behavior monitoring, and adaptive features tailored to users\u2019 changing needs over time, there are new opportunities to broaden our understanding of health behaviors and mechanisms of behavior change. Recent advances include dynamic models of behavior, Persuasive System Design, the Behavioral Intervention Technology model, and behavioral models for Just-In-Time Adaptive Interventions.Conclusions and Implications for PracticeBehavior theories offer advantages for guiding use of digital technologies. Future research must explore how theoretical models can effectively advance efforts to develop, evaluate, and disseminate digital health interventions targeting individuals with mental illness.P30 DA029926/DA/NIDA NIH HHS/United StatesU48 DP005018/DP/NCCDPHP CDC HHS/United StatesHealth Promotion Research Center/Center for Technology and Behavioral Health/2018-09-01T00:00:00Z28182469PMC5550360vault:2389

Activity Theory Analysis of Heart Failure Self-Care

The management of chronic health conditions such as heart failure is a complex process emerging from the activity of a network of individuals and artifacts. This article presents an Activity Theory-based secondary analysis of data from a geriatric heart failure management study. Twenty-one patients' interviews and clinic visit observations were analyzed to uncover eight configurations of roles and activities involving patients, clinicians, and others in the sociotechnical network. For each configuration or activity pattern, we identify points of tension and propose guidelines for developing interventions for future computer-supported healthcare systems

Exploring the Perceived Barriers and Benefits of Physical Activity Among Wounded, Injured, and/or Sick Military Veterans

Wounded, injured, and/or sick (WIS) military veterans face significant physical and psychosocial challenges following discharge from service. Physical activity can have many positive effects on the holistic wellbeing of such individuals. However, little knowledge exists regarding the perceived barriers and benefits of physical activity within this population, creating challenges surrounding physical activity promotion. Therefore, this study was designed to identify key barriers and benefits among this population, so that informed approaches to encourage participation in physical activity can be developed. A questionnaire related to the perceived barriers and benefits of physical activity was completed by 105 WIS British military veterans. Participants were predominantly male, physically active, served in the British Army, and described their injury as frequently impacting their daily living. Factor analysis revealed that poor mental health, negative beliefs about physical activity, and low beliefs about physical capability were prominent barriers represented in the data. However, only veterans’ beliefs about their physical capability were related to physical activity levels and differed between active and insufficiently active participants. Beliefs identified as benefits of physical activity that correlated with physical activity levels were improved mental and physical health, a sense of purpose, and increased physical fitness. Subsequently, barriers and benefits were categorized using the Behaviour Change Wheel, a behavior change framework, that indicated intervention functions of education, incentivization, and persuasion might be effective methods of increasing physical activity behavior among WIS veterans. Ultimately, this will lead to greater engagement with physical activity and improved health and wellbeing within this population

Design for Mobile Mental Health:An Exploratory Review

A large number of mobile mental health apps are available to the public but current knowledge about requirements of designing such solutions is scarce, especially from sociotechnical and user centred points of view. Due to the significant role of mobile apps in the mental health service models, identifying the design requirements of mobile mental health solutions is crucial. Some of those requirements have been addressed individually in the literature, but there are few research studies that show a comprehensive picture of this domain. This exploratory review aims to facilitate such holistic understanding. The main search keywords of the review were identified in a cross-disciplinary requirements workshop. The search was started by finding some core references in the healthcare databases. A wider range of references then has been explored using a snowball method. Findings showed that there is a good understanding of individual design requirements in current literature but there are few examples of implementing a combination of different design requirements in real world products. The design processes specifically developed for mobile mental health apps are also rare. Most studies on operational mobile mental health apps address major mental health issues while prevention and wellbeing areas are underdeveloped. In conclusion, the main recommendations for designing future mobile mental health solutions include: moving towards sociotechnical and open design strategies, understanding and creating shared value, recognizing all dimensions of efficacy, bridging design and medical research and development, and considering an ecosystem perspective

Barriers and facilitators of young people’s engagement with webchat counselling: A qualitative analysis informed by the Behaviour Change Wheel

Young people's engagement with online counselling remains an endemic obstacle faced by mental health services. This study utilises the Behaviour Change Wheel (BCW) framework to systematically explore the barriers and facilitators of young people's behavioural engagement with online webchat counselling. The current study defines behavioural engagement as any observable or active contribution by the young person in the webchat sessions, such as written verbalisation and self-expression. Semi-structured interviews with counsellors (n = 8) and open-ended questionnaire data from 43 young people (aged 18–25 years) were gathered and then coded. Nine core themes were identified including communication difficulties, the safety of the webchat environment, absence of face-to-face communication, ambiguity in messages or pauses, reaching goals, optimism about outcomes, pre-existing anxieties, mood or well-being and wanting/not wanting to attend. Using the BCW framework, these themes were mapped to broad intervention functions and behaviour change techniques (BCTs) to provide suggestions to optimise young people's engagement with online counselling. These include the application of persuasive design features, the use of social strategies, increased counsellor training and greater personalisation of the online therapeutic approach. Future research can determine the effectiveness of these proposed strategies and BCTs to enrich the emerging engagement strategy field and the wider digital and mental health behaviour change literature

A Reflection on Virtual Reality Design for Psychological, Cognitive & Behavioral Interventions: Design Needs, Opportunities & Challenges

Despite the substantial research interest in using Virtual Reality (VR) in healthcare in general and in Psychological, Cognitive, and Behavioral (PC&B) interventions in specific, as well as emerging research supporting the efficacy of VR in healthcare, the design process of translating therapies into VR to meet the needs of critical stakeholders such as users and clinicians is rarely addressed. In this paper, we aim to shed light onto the design needs, opportunities and challenges in designing efficient and effective PC&B-VR interventions. Through analyzing the co-design processes of four user-centered PC&B-VR interventions, we examined how therapies were adapted into VR to meet stakeholders’ requirements, explored design elements for meaningful experiences, and investigated how the understanding of healthcare contexts contribute to the VR intervention design. This paper presents the HCI research community with design opportunities and challenges as well as future directions for PC&B-VR intervention design