Adapting a Psychosocial Intervention for Smartphone Delivery to Middle-Aged and Older Adults with Serious Mental Illness.
OBJECTIVE
To describe the process of adapting an integrated medical and psychiatric self-management intervention to a smartphone application for middle-aged and older adults with serious mental illness using an adaptive systems engineering framework and user-centered design.


METHODS
First, we determined the technical abilities and needs of middle-aged and older adults with serious mental illnesses using smartphones. Then, we developed smartphone content through principles of user-centered design and modified an existing smartphone platform. Finally, we conducted a usability test using "think aloud" and verbal probing.


RESULTS
We adapted a psychosocial self-management intervention to a smartphone application and tested its usability. Ten participants (mean age: 55.3 years, SD: 6.2 years) with serious mental illness and comorbid chronic health conditions reported a high level of usability and satisfaction with the smartphone application.


CONCLUSIONS
Middle-aged and older adults with serious mental illness and limited technical abilities were able to participate in a process involving user-centered design and adaptation of a self-management intervention to be delivered by a smartphone. High usability ratings suggest that middle-aged and older adults with serious mental illness have the potential to use tailored smartphone interventions. Future research is indicated to establish effectiveness and to determine the type and intensity of clinical support needed to successfully implement smartphone applications as a component of community-based services for older adults with psychiatric and medical conditions.
Dartmouth Centers for Health and Aging, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH. Electronic address: Karen.L.Fortuna@Dartmouth.edu.
Karen L
KL
Fortuna
Dartmouth Centers for Health and Aging, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH.
Matthew C
MC
Lohman
Dartmouth Centers for Health and Aging, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH.
Lydia E
LE
Gill
Dartmouth Centers for Health and Aging, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH.
Martha L
ML
Bruce
Dartmouth Centers for Health and Aging, Lebanon, NH; CDC Health Promotion Research Center at Dartmouth, Lebanon, NH; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH.
Stephen J
SJ
Bartels
D000368:Aged; D001714:Bipolar Disorder / Q000628:therapy; D003865:Major Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008491:Medical Informatics Applications; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D063731:Mobile Applications; D017060:Patient Satisfaction; D011613:Psychotherapy / Q000379:methods*; D011618:Psychotic Disorders / Q000628:therapy; D012559:Schizophrenia / Q000628:therapy; D000073278:Self-Management; D000068997:Smartphone; D017216:Telemedicine
Psychosocial intervention; mobile health technology; older adults; self-management