Hardy, Amy;
Ward, Thomas;
Emsley, Richard;
Greenwood, Kathryn;
Freeman, Daniel;
Fowler, David;
Kuipers, Elizabeth;
... Garety, Philippa; + view all
(2022)
Bridging the Digital Divide in Psychological Therapies: Observational Study of Engagement With the SlowMo Mobile App for Paranoia in Psychosis.
JMIR Human Factors
, 9
(3)
, Article e29725. 10.2196/29725.
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Abstract
BACKGROUND: Marginalized groups are more likely to experience problems with technology-related access, motivation, and skills. This is known as the "digital divide." Technology-related exclusion is a potential barrier to the equitable implementation of digital health. SlowMo therapy was developed with an inclusive, human-centered design to optimize accessibility and bridge the "digital divide." SlowMo is an effective, blended digital psychological therapy for paranoia in psychosis. OBJECTIVE: This study explores the "digital divide" and mobile app engagement in the SlowMo randomized controlled trial. METHODS: Digital literacy was assessed at baseline, and a multidimensional assessment of engagement (ie, adherence [via system analytics and self-report] and self-reported user experience) was conducted at 12 weeks after therapy. Engagement was investigated in relation to demographics (ie, gender, age, ethnicity, and paranoia severity). RESULTS: Digital literacy data demonstrated that technology use and confidence were lower in Black people and older people (n=168). The engagement findings indicated that 80.7% (96/119) of therapy completers met the a priori analytics adherence criteria. However, analytics adherence did not differ by demographics. High rates of user experience were reported overall (overall score: mean 75%, SD 17.1%; n=82). No differences in user experience were found for ethnicity, age, or paranoia severity, although self-reported app use, enjoyment, and usefulness were higher in women than in men. CONCLUSIONS: This study identified technology-related inequalities related to age and ethnicity, which did not influence engagement with SlowMo, suggesting that the therapy design bridged the "digital divide." Intervention design may moderate the influence of individual differences on engagement. We recommend the adoption of inclusive, human-centered design to reduce the impact of the "digital divide" on therapy outcomes. TRIAL REGISTRATION: ISRCTN Registry ISRCTN32448671; https://www.isrctn.com/ISRCTN32448671.
| Type: | Article |
|---|---|
| Title: | Bridging the Digital Divide in Psychological Therapies: Observational Study of Engagement With the SlowMo Mobile App for Paranoia in Psychosis |
| Location: | Canada |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.2196/29725 |
| Publisher version: | https://doi.org/10.2196/29725 |
| Language: | English |
| Additional information: | ©Amy Hardy, Thomas Ward, Richard Emsley, Kathryn Greenwood, Daniel Freeman, David Fowler, Elizabeth Kuipers, Paul Bebbington, Philippa Garety. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 05.06.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on https://humanfactors.jmir.org, as well as this copyright and license information must be included. |
| Keywords: | adherence, apps, digital health, engagement, human-centered design, paranoia, psychosis, therapy, user experience |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10162226 |
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