title: CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia.
abstract: OBJECTIVE
  This paper describes CBT-I Coach, a patient-facing smartphone app designed to enhance cognitive behavioral therapy for insomnia (CBT-I). It presents findings of two surveys of U.S. Department of Veterans Affairs (VA) CBT-I trained clinicians regarding their perceptions of CBT-I Coach before it was released (n = 138) and use of it two years after it was released (n = 176).
  
  
  METHODS
  VA-trained CBT-I clinicians completed web-based surveys before and two years after CBT-I Coach was publicly released.
  
  
  RESULTS
  Prior to CBT-I Coach release, clinicians reported that it was moderately to very likely that the app could improve care and a majority (87.0%) intended to use it if it were available. Intention to use the app was predicted by smartphone ownership (β = 0.116, p < 0.05) and perceptions of relative advantage to existing CBT-I practices (β = 0.286, p < 0.01), compatibility with their own needs and values (β = 0.307, p < 0.01), and expectations about the complexity of the app (β = 0.245, p < 0.05). Two years after CBT-I Coach became available, 59.9% of participants reported using it with patients and had favorable impressions of its impact on homework adherence and outcomes.
  
  
  CONCLUSIONS
  Findings suggest that before release, CBT-I Coach was perceived to have potential to enhance CBT-I and address common adherence issues and clinicians would use it. These results are reinforced by findings two years after it was released suggesting robust uptake and favorable perceptions of its value.
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.|Stanford University, Stanford, CA.
authors.forename: Eric
authors.initials: E
authors.lastname: Kuhn
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.|Stanford University, Stanford, CA.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Weiss
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Taylor
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Hoffman
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Ramsey
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Manber
authors.affiliation: Philadelphia VA Medical Center, Philadelphia, PA.|University of Pennsylvania, Philadelphia, PA.
authors.forename: Philip
authors.initials: P
authors.lastname: Gehrman
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.
authors.forename: Jill J
authors.initials: JJ
authors.lastname: Crowley
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA.|Stanford University, Stanford, CA.
authors.forename: Josef I
authors.initials: JI
authors.lastname: Ruzek
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: Mickey
authors.initials: M
authors.lastname: Trockel
mesh_terms: D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology / Q000628:therapy*; D000068997:Smartphone; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data
keywords: Cognitive behavioral therapy for insomnia; Diffusion of Innovations; mobile apps; sleep problems