A Novel Method for Evaluating Mobile Apps (App Rating Inventory): Development Study.

BACKGROUND: Selecting and integrating health-related apps into patient care is impeded by the absence of objective guidelines for identifying high-quality apps from the many thousands now available. OBJECTIVE: This study aimed to evaluate the App Rating Inventory, which was developed by the Defense Health Agency's Connected Health branch, to support clinical decisions regarding app selection and evaluate medical and behavioral apps. METHODS: To enhance the tool's performance, eliminate item redundancy, reduce scoring system subjectivity, and ensure a broad application of App Rating Inventory-derived results, inventory development included 3 rounds of validation testing and 2 trial periods conducted over a 6-month interval. The development focused on content validity testing, dimensionality (ie, whether the tool's criteria performed as operationalized), factor and commonality analysis, and interrater reliability (reliability scores improved from 0.62 to 0.95 over the course of development). RESULTS: The development phase culminated in a review of 248 apps for a total of 6944 data points and a final 28-item, 3-category app rating system. The App Rating Inventory produces scores for the following three categories: evidence (6 items), content (11 items), and customizability (11 items). The final (fourth) metric is the total score, which constitutes the sum of the 3 categories. All 28 items are weighted equally; no item is considered more (or less) important than any other item. As the scoring system is binary (either the app contains the feature or it does not), the ratings' results are not dependent on a rater's nuanced assessments. CONCLUSIONS: Using predetermined search criteria, app ratings begin with an environmental scan of the App Store and Google Play. This first step in market research funnels hundreds of apps in a given disease category down to a manageable top 10 apps that are, thereafter, rated using the App Rating Inventory. The category and final scores derived from the rating system inform the clinician about whether an app is evidence informed and easy to use. Although a rating allows a clinician to make focused decisions about app selection in a context where thousands of apps are available, clinicians must weigh the following factors before integrating apps into a treatment plan: clinical presentation, patient engagement and preferences, available resources, and technology expertise.

Competencies Needed for Behavioral Health Professionals to Integrate Digital Health Technologies into Clinical Care: a Rapid Review.

This rapid review examines literature on training and competencies for behavioral health professionals to integrate digital health technologies into clinical practice. While the evidence for digital health is growing, research evidence supports its use in behavioral healthcare. Despite this, behavioral health professionals have been slow to integrate technologies into care for various reasons. The aim of this review is to inform behavioral health professionals on competencies needed to support the adoption of digital health technologies. PubMed and Google Scholar were searched for articles from 2010 through 2020. Search terms associated with digital health technologies, behavioral health professionals, and competencies, skills, training, and best practices yielded 1972 articles. Twenty-three articles met inclusion criteria indicating foundational core competencies and data was extracted and organized based on profession and technology platform in order to detect similarities and differences. The findings were used to generate an interdisciplinary approach for the clinical integration of digital health. Recommendations are presented for foundational digital health competencies applicable across behavioral health disciplines, rather than technology- or discipline-specific training. The universal digital health inter-professional competencies identified include: (a) privacy, security, and patient safety; (b) digital health technical skills; (c) ethical and legal considerations; (d) clinical skills; (e) art of therapy and digital health; and (f) administrative tasks. Research is needed to understand if the development of professional digital health competencies helps to improve patients' behavioral health.

An Applied Test of Knowledge Translation Methods Using a Mobile Health Solution.

INTRODUCTION: The study's objectives were to improve providers' knowledge of mobile health core competencies; increase providers' knowledge and clinical use of the Virtual Hope Box (VHB) mobile app as an evidence-based treatment tool; and test elements of a structured knowledge translation paradigm. MATERIALS AND METHODS: knowledge translation best practices were integrated into a training workshop with the goal to increase provider adoption of the VHB. Providers were trained at three sites and provided feedback before the training, post-training, and at 3, 6, and 12 months following the training. RESULTS: Pretraining, <22% of respondents indicated that they had used the VHB in clinical practice; post-training, 89% of respondents reported their intent to use the VHB. At 3 and 6 months, 82% of evaluation respondents indicated actual use of the VHB. CONCLUSIONS: Using a public-facing technology, this study successfully integrated knowledge translation methods within an existing provider training program. Implementation planning should be deliberate and consider a target site's capacity for new ideas and potential adoption barriers. Lessons learned have implications for future efforts to bridge the gap between research and practice in improving the quality and impact of clinical care.

Review of mobile health technology for military mental health.

Mental health problems pose challenges for military veterans, returning service members, and military family members including spouses and children. Challenges to meeting mental health needs include improving access to care and improving quality of care. Mobile Health, or "mHealth," can help meet these needs in the garrison and civilian environments. mHealth brings unique capabilities to health care provision through the use of mobile device technologies. This report identifies high-priority mHealth technology development considerations in two categories. First, priority considerations specific to mental health care provision include safety, privacy, evidence-based practice, efficacy studies, and temperament. Second, priority considerations broadly applicable to mHealth include security, outcomes, ease of use, carrier compliance, hardware, provider perspectives, data volume, population, regulation, command policy, and reimbursement. Strategic planning for the advancement of these priority considerations should be coordinated with stated Department of Defense capability needs to maximize likelihood of adoption. This report also summarizes three leading, military programs focused on mHealth projects in mental health, The Telemedicine and Advanced Technology Research Center, The Military Operational Medicine Research Program, United States Army Medical Research and Materiel Command, and The National Center for Telehealth and Technology.

Bringing Internet-based education and intervention into mental health practice: afterdeployment.org.

BACKGROUND: Internet-facilitated interventions may offer numerous advantages in reaching the large numbers of military service men and women exposed to traumatic events. The Internet is now a primary source of health-related information for consumers and research has shown the effectiveness of web-based interventions in addressing a range of mental health problems. OBJECTIVE: Clinicians can learn how to bring Internet education and intervention into routine care, to help clients better understand mental health issues and learn skills for self-management of problems. METHOD: The Afterdeployment.org (AD) Internet site can be used by health care professionals serving U.S. military personnel returning from Iraq and Afghanistan, and their families. The site currently addresses 18 key domains of functioning, including post-traumatic stress, sleep, anger, alcohol and drugs, and military sexual trauma. It provides an extensive amount of client and family education that is suitable for immediate use by clients and providers, as well as the kinds of interactive workshop content and self-assessment tools that have been shown to be helpful in other treatment contexts. RESULTS: AD CAN BE UTILIZED IN CLINICAL PRACTICE IN A VARIETY OF WAYS: as an adjunct to treatment for PTSD, to supplement existing treatments for a range of post-deployment problems, or as the primary focus of treatment for a client. CONCLUSIONS: AD represents a kind of service that is likely to become increasingly available in coming years and that is important for mental health providers to actively explore as a tool for extending their reach, improving their efficiency, and improving quality of care.