Developing a Theory-Informed Smartphone App for Early Psychosis: Learning Points From a Multidisciplinary...

Area of Science:

• Digital mental health interventions
• Cognitive Behavior Therapy (CBT) for psychosis
• Stakeholder engagement in health technology

Background:

• Actissist is a smartphone application delivering cognitive behavior therapy (CBT) for early psychosis.
• Developed by a multidisciplinary team including academics, clinicians, individuals with lived experience, and software engineers.
• Successfully tested in proof-of-concept and randomized controlled trials for safety, acceptability, and feasibility.

Purpose of the Study:

• To describe the design and development process of the Actissist app.
• To outline how qualitative research and expert groups informed app development.
• To detail user feedback integration, successes, challenges, and recommendations for stakeholder involvement in digital health.

Main Methods:

• Expert reference groups and person-centered stakeholder involvement through focus groups and interviews informed initial app design.
• Iterative development involved user interviews and testing across two subsequent app versions.
• Multidisciplinary collaboration included individuals with lived experience, clinicians, academics, and computer scientists.

Main Results:

• Multidisciplinary collaboration enhanced app design and content, incorporating features like non-directive content, co-designed recovery videos, relaxation exercises, and goal-setting.
• Key features developed include psychoeducation materials and a "favorite" function for helpful content.
• Challenges included aligning stakeholder desires with technical feasibility, resource constraints, and managing power dynamics in collaboration.

Conclusions:

• Stakeholder involvement was fundamental to the successful design, development, and delivery of Actissist.
• Collaborative processes generated unique perspectives and ideas beyond the research team's initial scope.
• The study provides valuable learning points and recommendations for involving stakeholders in digital health interventions.