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A Smartphone-Based Self-management Intervention for Individuals With Bipolar Disorder (LiveWell): Protocol
Evan H Goulding1, Cynthia A Dopke1, Tania Michaels2
1Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
JMIR Formative Research
|December 24, 2021
Summary
This study details an expert system for LiveWell, a smartphone app that adaptively delivers content to help manage bipolar disorder. It enhances self-management and provider communication for better mental health care.
Area of Science:
- Digital Mental Health
- Clinical Psychology
- Health Informatics
Background:
- Bipolar disorder significantly impacts morbidity and mortality, with psychotherapy improving outcomes but facing access limitations.
- Smartphone interventions offer scalable solutions for self-management and provider communication in bipolar disorder care.
- Detailed reporting of adaptive intervention components is crucial for replication and improvement of digital mental health tools.
Purpose of the Study:
- To provide a detailed description of the expert system powering LiveWell, a smartphone-based self-management intervention for bipolar disorder.
- To support the improvement and dissemination of technology-based mental health interventions through transparent reporting of adaptive system components.
Main Methods:
- Integrated empirically supported psychotherapies, behavior change theories, and chronic disease self-management models.
- Incorporated user-centered design and psychiatrist feedback to guide expert system development.
- Defined daily and weekly decision points for content adaptation based on self-reported medication adherence, sleep, routine, and wellness.
Main Results:
- Developed decision rules and a clinical status state machine using self-reported data to tailor content and provider alerts.
- Adaptive content focuses on sleep, medication adherence, symptom management, support, and routine, addressing underlying behavioral determinants.
- Shifted content to symptom management and provider engagement when early warning signs or acute states were detected.
Conclusions:
- Adaptive mental health technologies show promise for enhancing self-management in complex conditions like bipolar disorder.
- Detailed reporting of adaptive intervention components is essential for advancing the field and improving patient outcomes.
- The LiveWell system demonstrates a method for adapting interventions to fluctuating clinical statuses and multiple self-management behaviors.
