Journal article
Veteran Experiences With an mHealth App to Support Measurement-Based Mental Health Care: Results From a Mixed Methods Evaluation
JMIR mental health, Vol.11, e54007
05/10/2024
DOI: 10.2196/54007
PMCID: PMC11127133
PMID: 38728684
Abstract
Mental health conditions are highly prevalent among US veterans. The Veterans Health Administration (VHA) is committed to enhancing mental health care through the integration of measurement-based care (MBC) practices, guided by its Collect-Share-Act model. Incorporating the use of remote mobile apps may further support the implementation of MBC for mental health care.
This study aims to evaluate veteran experiences with Mental Health Checkup (MHC), a VHA mobile app to support remote MBC for mental health.
Our mixed methods sequential explanatory evaluation encompassed mailed surveys with veterans who used MHC and follow-up semistructured interviews with a subset of survey respondents. We analyzed survey data using descriptive statistics. We then compared responses between veterans who indicated having used MHC for ≥3 versus <3 months using χ
tests. We analyzed interview data using thematic analysis.
We received 533 surveys (533/2631, for a 20% response rate) and completed 20 interviews. Findings from these data supported one another and highlighted 4 key themes. (1) The MHC app had positive impacts on care processes for veterans: a majority of MHC users overall, and a greater proportion who had used MHC for ≥3 months (versus <3 months), agreed or strongly agreed that using MHC helped them be more engaged in their health and health care (169/262, 65%), make decisions about their treatment (157/262, 60%), and set goals related to their health and health care (156/262, 60%). Similarly, interviewees described that visualizing progress through graphs of their assessment data over time motivated them to continue therapy and increased self-awareness. (2) A majority of respondents overall, and a greater proportion who had used MHC for ≥3 months (versus <3 months), agreed/strongly agreed that using MHC enhanced their communication (112/164, 68% versus 51/98, 52%; P=.009) and rapport (95/164, 58% versus 42/98, 43%; P=.02) with their VHA providers. Likewise, interviewees described how MHC helped focus therapy time and facilitated trust. (3) However, veterans also endorsed some challenges using MHC. Among respondents overall, these included difficulty understanding graphs of their assessment data (102/245, 42%), not receiving enough training on the app (73/259, 28%), and not being able to change responses to assessment questions (72/256, 28%). (4) Interviewees offered suggestions for improving the app (eg, facilitating ease of log-in, offering additional reminder features) and for increasing adoption (eg, marketing the app and its potential advantages for veterans receiving mental health care).
Although experiences with the MHC app varied, veterans were positive overall about its use. Veterans described associations between the use of MHC and engagement in their own care, self-management, and interactions with their VHA mental health providers. Findings support the potential of MHC as a technology capable of supporting the VHA's Collect-Share-Act model of MBC.
Details
- Title: Subtitle
- Veteran Experiences With an mHealth App to Support Measurement-Based Mental Health Care: Results From a Mixed Methods Evaluation
- Creators
- Robin T Higashi - VA New England Healthcare SystemBella Etingen - Veterans Health AdministrationEric Richardson - VA New England Healthcare SystemJennifer Palmer - VA New England Healthcare SystemMark S Zocchi - VA New England Healthcare SystemFelicia R Bixler - VA New England Healthcare SystemBridget Smith - Northwestern UniversityNicholas McMahon - VA New England Healthcare SystemKathleen L Frisbee - Veterans Health AdministrationJohn C Fortney - University of WashingtonCarolyn Turvey - University of IowaJennifer Evans - New York State Office of Mental HealthTimothy P Hogan - VA New England Healthcare System
- Resource Type
- Journal article
- Publication Details
- JMIR mental health, Vol.11, e54007
- DOI
- 10.2196/54007
- PMID
- 38728684
- PMCID
- PMC11127133
- eISSN
- 2368-7959
- Language
- English
- Date published
- 05/10/2024
- Academic Unit
- Psychiatry; Epidemiology
- Record Identifier
- 9984627149402771
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