Build a better mouse: directly-observed issues in computer use for adults with SMI

Area of Science:

• Health Informatics
• Psychiatry
• Digital Health Equity

Background:

• Information technology (IT) in healthcare can improve access to treatment, especially for underserved populations.
• Individuals with serious mental illness (SMI) may not benefit equally from IT advances due to disparities in computer ownership and digital literacy.
• Previous research on computer skills and attitudes in adults with SMI relied heavily on self-reported data.

Purpose of the Study:

• To assess the computer ownership, skills, and attitudes of adults with SMI and co-occurring cocaine use.
• To compare self-reported computer skills with objectively measured performance.
• To evaluate the impact of interacting with a health informational website on participants' attitudes and self-efficacy.

Main Methods:

• Interviews were conducted with 28 psychiatric outpatients with co-occurring cocaine use regarding computer use and opinions.
• Direct observation using task analysis and think-aloud methods was employed for 25 participants navigating a health informational website.
• Data collection focused on computer ownership, self-reported skills, observed performance, and attitudes towards technology.

Main Results:

• Participants reported low rates of computer ownership and use, coupled with negative attitudes toward computers.
• Objectively measured computer skills were lower than participants' self-reported abilities.
• Website navigation led to more positive attitudes and increased computer self-efficacy in some individuals.

Conclusions:

• Significant disparities exist in computer ownership and skills among adults with SMI, hindering digital health access.
• Self-report measures may overestimate computer proficiency in this population.
• Interventions aimed at improving digital literacy and providing access are crucial for equitable digital health benefits for individuals with SMI.