Symposia
Technology
Alexandra L. Silverman, M.A.
Doctoral Student
University of Virginia
CHARLOTTESVILLE, Virginia
Jennifer Boggs, PhD, MSW
Post Doctoral Research Fellow
Kaiser Permanente Colorado – Institute for Health Research
Aurora, CO
Jeremy W. Eberle, M.A.
Graduate Student
University of Virginia
Charlottesville, Virginia
Megan Baldwin, B.S.
Project Manager
Kaiser Permanente Colorado
Aurora, Colorado
Henry Behan, MA
Project Coordinator
University of Virginia
Charlottesville, VA
Anna Baglione, M.S.
Graduate Student
University of Virginia
Charlottesville, Virginia
Valerie Paolino, PhD
Research Staff
Kaiser Permanente Colorado
Aurora, Colorado
Angel F. Vela de la Garza Evia, B.S.
Graduate Student
University of Virginia
Charlottesville, Virginia
Medhi Boukhechba, Ph.D.
Assistant Professor
University of Virginia
Charlottesville, Virginia
Laura Barnes, PhD
Associate Professor
University of Virginia
Charlottesville, VA
Bethany Teachman, Ph.D.
Professor
University of Virginia
Charlottesville, Virginia
Digital mental health interventions (DMHIs) can be embedded in existing healthcare systems, where people most frequently receive mental health services, and used in place of in-person services (particularly in low resource settings), or as a treatment adjunct. However, when DMHIs are moved from randomized controlled trials to real-world healthcare settings, rates of uptake and engagement are low (Fleming et al., 2018). The purpose of this mixed methods pilot trial was to examine the feasibility and acceptability of offering a web-based cognitive bias modification for interpretation intervention (called MindTrails) to patients with anxiety in a large healthcare system as part of usual care.
In Phase 1 of the trial, qualitative interviews were conducted with key stakeholders in a large healthcare system, including healthcare administrators (n = 6), patients (n = 6), and clinicians (n = 6). Stakeholders were asked questions regarding their overall impressions of MindTrails, anticipated obstacles for delivering MindTrails in this setting and suggestions for overcoming these barriers, and ways to increase the DMHI’s appeal. Interviews were led by research personnel in the healthcare system and key themes were identified. Impressions of the DMHI were positive overall, though some stakeholders found aspects of the DMHI to be confusing. Clinicians and administrators noted lack of access to technology, lack of technological literacy, and patient preferences for traditional in-person services as anticipated obstacles to implementing the DMHI. Suggestions to enhance engagement included providing incentives for session completion, offering additional guidance from a coach, and having healthcare providers follow up with patients about their DMHI use.
In Phase 2 of the trial, a database of electronic health records was used to identify 1,600 anxious patients and invite them to participate in MindTrails. Patients could then enroll in MindTrails and complete five once-weekly sessions of the DMHI. We will discuss the feasibility and acceptability of implementing MindTrails in this setting, including rates of clicks to visit the DMHI website (19.4%), enrollment (6.7%), and starting the first session (4.2%), in addition to the preliminary effectiveness of MindTrails in this setting (changes in anxiety and interpretation bias over time). Implications for future larger-scale implementations of DMHIs in healthcare settings will be discussed.