Acceptability of mHealth augmentation of Collaborative Care: A mixed methods pilot study

Objective: To assess the feasibility and acceptability of a mobile health platform supporting Collaborative Care. Method: Collaborative Care patients (n = 17) used a smartphone app to transmit PHQ-9 and GAD-7 scores and sensor data to a dashboard used by one care manager. Patients completed usability and satisfaction surveys and qualitative interviews at 4 weeks and the care manager completed a qualitative interview. Mobile metadata on app usage was obtained. Results: All patients used the app for 4 weeks, but only 35% (n = 6) sustained use at 8 weeks. Prior to discontinuing use, 88% (n = 15) completed all PHQ-9 and GAD-7 measures, with lower response rates for daily measures. Four themes emerged from interviews: understanding the purpose; care manager's role in supporting use; benefits of daily monitoring; and privacy/security concerns. Two themes were user-specific: patients' desire for personalization; and care manager burden. Conclusions: The feasibility and acceptability of the mobile platform is supported by the high early response rate, however attrition was steep. Our qualitative findings revealed nuanced participant experiences and uncovered some concerns about mobile health. To encourage retention, attention may need to be directed toward promoting patient understanding and provider engagement, and offering personalized patient experiences.