Schizophrenia is associated with staggeringly high individual and societal costs. Antipsychotic medications are considered the primary intervention for long-term treatment of schizophrenia, but long-term treatment outcomes are often poor. A large body of research suggests illness-management strategies can support pharmacotherapies by reducing the severity and distress associated with persistent psychotic symptoms, improve social functioning at various stages of the illness, and enhance medication adherence. Unfortunately, these illness-management interventions are rarely available at mental health centers. Mobile technologies are ubiquitous and may be tremendously instrumental in increasing the accessibility and utilization of effective psychosocial interventions for schizophrenia. Mobile interventions have already been successfully developed and deployed to support the self-management of a number of chronic health conditions as well as several mental health conditions. The goal of the proposed project is to develop and pilot a mobile system for Self- Management of Schizophrenia (SOS) with the ultimate objective of creating a widely-available tool that can be deployed by users as needed, in their own environments. Individuals with schizophrenia will provide input on planned intervention content as well as the structure and style of the proposed system. Expert consultants will review and provide feedback to ensure content is grounded in effective evidence-based approaches and the technical complexity is appropriate for the target audience. Laboratory and field tests will be conducted to identify and resolve technical problems, and to determine acceptability and feasibility of the SOS system in real-world conditions. Following appropriate modifications, a randomized pilot trial of SOS compared to treatment as usual will be conducted with individuals with schizophrenia. All aspects of the intervention protocol will be examined, including functionality, recruitment and retention procedures, and preliminary effectiveness of the mobile intervention on outcomes, in preparation for a subsequent larger randomized controlled trial. The proposed project will introduce a model of treatment which offers illness-management strategies at any time and in any location, allowing for ongoing, as well as "on-demand" therapeutic support. If effective, the SOS system could improve individuals'ability to effectively manage their illness when they are not receiving psychosocial services, or enhance the potency of care when offered as adjunct to standard treatments. The long-term goals of the project are to create a validated application that can be easily downloaded onto a mobile phone and used by anyone, facilitating wide-scale and far-reaching implementation and dissemination of evidence-based tools.

Public Health Relevance

Mobile technologies are developing at a phenomenal rate and hold tremendous promise for transforming schizophrenia research and treatment. The goal of the proposed project is to develop and pilot a mobile system for Self-Management of Schizophrenia (SOS) that will use smartphone technology to deliver evidence- based illness-management strategies, at any time, and in any location. This approach will allow for ongoing, as well as on-demand therapeutic support, increasing the likelihood that illness-management skills are used regularly and integrated into one's daily routine. The proposed mobile intervention has the potential to reduce the high personal and societal costs associated with schizophrenia, and may also function as a novel delivery system of interventions for an array of additional targets in future extensions of this work.

Agency
National Institute of Health (NIH)
Type
Planning Grant (R34)
Project #
5R34MH100195-02
Application #
8679007
Study Section
(SERV)
Program Officer
Azrin, Susan
Project Start
Project End
Budget Start
Budget End
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Dartmouth College
Department
Psychiatry
Type
Schools of Medicine
DUNS #
City
Hanover
State
NH
Country
United States
Zip Code
03755
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Ben-Zeev, Dror; Brenner, Christopher J; Begale, Mark et al. (2014) Feasibility, acceptability, and preliminary efficacy of a smartphone intervention for schizophrenia. Schizophr Bull 40:1244-53
Ben-Zeev, Dror; Kaiser, Susan M; Krzos, Izabela (2014) Remote "hovering" with individuals with psychotic disorders and substance use: feasibility, engagement, and therapeutic alliance with a text-messaging mobile interventionist. J Dual Diagn 10:197-203