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Table 3 Study characteristics

From: Transitions from biomedical to recovery-oriented practices in mental health: a scoping review to explore the role of Internet-based interventions

Study Aim Methods and outcome measures Main findings
CommonGround [53] To describe challenges in decisions about medications and the CommonGround program Reflections and descriptions based on lived experience and research. Program being piloted. Promising as support for shared decision-making, decisional conflict and optimizing activities that give life meaning and purpose in recovery.
CommonGround [54] To describe a 12-month pilot for shared decision-making in psychopharmacology consultation Observational record for each use of the software from two case management teams for a total of 189 clients. Focus groups with case managers (n = 14) medical staff (n = 4), clients (n = 16) and peer-specialist staff (n = 3). The software was used 662 times varying from one to ten times for each client. Only ten clients refused to use it at some point. The intervention helped practitioners focus on client concerns, enriched dialogue and understanding, made the consultations more effective and empowered client involvement in decision-making.
CommonGround [81] To describe CommonGround, new role for peers and early adopters, patterns of use and lessons learned Use of CommonGround database and observation of 8 sites already offering the tool to a total of 4783 users.
Log files of use by clients, peers, administrators, therapists, and case managers.
Technology and peer support can enhance shared decision-making even during brief (15-min) psychiatric medication consultations.
CommonGround [49] Examine the impact of a decision support center and computerized tool on adherence to psychotropic medication Multivariate linear regression models were used to examine if tool users (n = 122) had higher rates of 180-day medication adherence than non-users (n = 1000) based on administrative pharmacy claims data. Relatively good adherence for psychotropic medications at baseline. Intervention had no detectable impact on adherence rates.
CommonGround [82] To describe the use of self-management strategies, especially a strategy called “Personal Medicine” and how it correlates with wellness and symptom improvement Pretest-posttest single-group design. A retrospective study of responses from CommonGround health reports generated from 12 clinics and service users (N = 5584). A self-developed questionnaire. Health functioning improved with time. Self-management reduced medication side-effects, increased user satisfaction with medication, and fostered recovery.
CommonGround [83] Examine the impact of CommonGround on the consumer–doctor interaction in medication consults Pretest-posttest control group design for four months (N = 98).
Measure of Patient-Centered Communication (MPCC) and Patient Perception of Patient-Centeredness (PPPC).
No significant effect at baseline. Improved scores after four to six months suggest need for longer intervention and better fidelity.
Horyzons [84] To describe the rationale and potential of moderated online social therapy and examine the acceptability, safety and initial clinical benefits of system A six-week trial using an uncontrolled single-group design for participants with first episode psychosis (N = 20) participating at least four weeks.
Descriptive statistics of log files of use. A questionnaire and semi-structured interviews.
Structured Clinical Interview for DSM-IV (SCID patient version), Brief Psychiatric Rating Scale (BPRS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Beck Anxiety Inventory (BAI).
No drop-outs; 70% used the system > three weeks, 95% used social networking, and 60% completed > three modules. The majority of participants reported feeling safe, empowered and more socially connected; 70% considered it a useful post-treatment option. Depressive symptoms were significantly reduced at follow-up.
Horyzons [85] To assess the safety of Horyzons Semi structured interviews with participants and simple descriptive statistics from online posts and interviews.
Structured Clinical Interview for DSM-IV (SCID patient version) and Brief Psychiatric Rating Scale (BPRS).
No clinical or security problems were noted. Users felt safe using Horyzons.
Horyzons [65] To determine design guidelines for increasing engagement in mental health applications Complex health intervention framework in stages: theory, design, exploratory trial, and implementation. Themes identified for use in guidelines: 1) belonging and security, 2) better understanding of condition, 3) engendering positive thoughts, being accountable and focusing on strengths, and 4) appealing and engaging presentation.
Mieli.Neta [86] To evaluate usability, quality, functionality, content and benefits of Mieli.Net Explorative descriptive multiphase study among nurses (N = 76), using a questionnaire (The Quality Criteria of Public Online Services) and descriptive statistics, and additionally written feedback and content analysis. The evaluation showed good portal functionality, relevant content and benefits for users.
Mieli.Neta [52] Identify barriers and facilitators in implementation of Mieli.Net Questionnaire after one year use of portal among nurses (N = 89). Two thematic open-ended questions analyzed by using content analysis. Issues emerged in four categories: organization resources, nurses’ individualities, patient-related factors, and portal-related factors. Barriers: lack of computers, time and/or training; nurses’ negative attitudes. Facilitators: easy access to technical resources and Internet; time and motivation among staff.
Mieli.Neta [50] To describe the design and development process of Mieli.Net Mixed methods design in four phases: needs analysis (survey for administrative personnel (n = 36) and patients (n = 316), interviews with patients (n = 51) and relatives (n = 50) and overview of the literature); development of information areas (relevant literature and feedback from multidisciplinary team and end-users); development of a prototype (information source from 10 focus groups meetings and existing computer-based support systems; and evaluation by clients (n = 21), nursing students (n = 20) and nurses (n = 35). Five informational areas were identified: illness, treatment, well-being, daily activities, and patient’s rights. Based on this, changes were made in the structure and new applications were added. The service was found to be promising. User involvement in development is important.
Mieli.Neta [87] To describe nurses’ experiences of information technology-based standardized patient education Nurses completed a questionnaire about their experiences (n = 56), analyzed by content analysis. The intervention brought the patient and the nurses closer to each other and helped nurses to provide individual support for their patients. The education was time-consuming.
Mieli.Neta [88] To determine the effectiveness of a needs-based computerized patient education program on patients’ experience of being deprived of their liberty during hospitalization RCT with three groups: an intervention group with needs based computerized patient education (n = 100), a patient education group with conventional education (n = 106), and a control group with standard care (n = 105).
Primary outcome measure patients’ self-reported deprivation of liberty developed for the study, and additionally the PSS-Fin (patient satisfaction scale, Finnish adaptation).
Technology-based education was not found to be superior to other approaches.
Mieli.Neta [89] To compare user groups’ evaluation of usability Descriptive design, a small-scale usability study with service users (n = 21), nursing students (n = 21) and registered nurses (n = 35). A self-developed questionnaire about the content, structure and visual appearance of the website. Service users were positive to intervention tools, but require support. Content, structure and appearance rated as good.
ReConnectb [55] To describe the design and development process Community-based participatory research design with particular focus on implications of service user involvement, conducted in two communities by a practice-research-team, involving work-shops with stakeholders and an iterative design process. The intervention invites a proactive approach from providers. Service users must be involved at all levels of project development to promote person-centeredness.
Wegweis [51] To investigate the usability of web-based support for routine outcome monitoring (ROM) A usability study consisting of three types of evaluation; heuristic, qualitative and quantitative with service users (n = 15) and ICT experts (n = 4). Usability testing grouped into usability topics, verbal reports and observations.
Questionnaires .
The prototype has promise for improving ROM practice. Study confirms earlier findings that people with psychotic disorders are not incapable of using web-based systems independently.
Wegweis [64] To present, evaluate and explain the shared decision support module in Wegweis An ontology-based approach for selecting and ranking information for service users with schizophrenia based on their routine assessment results.
The Manchester short assessment of quality of life (MANSA).
Wegweis pioneers automated interpretation of assessment of results for service users with schizophrenia. Tool interpretations corresponded well with those of clinicians. Service users considered most of the automatically generated advice relevant. The tool is deemed feasible.
Wegweis [56] To investigate the intervention in naturalistic setting An open-label, 2-group, parallel RCT with patients with psychosis (N = 250) recruited from two outpatient teams, and process evaluation with open interviews with patients (n = 15), observation of discussions, and a questionnaire among clinicians.
Primary outcome: Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Secondary outcome: Client Satisfaction Questionnaire (CSQ).
Inconclusive results on service users’ satisfaction and involvement in decision-making. Poor provider adherence to the protocol may explain the lack of effect. Improved training of clinicians and adaptation of the intervention to the organization is recommended in future studies.
Your Schizophrenia Care [90] To test the hypothesis that patients assigned to the intervention would be more verbally active and that mental health providers would be more patient-centered in the visit RCT with patients who have schizophrenia (N = 50). The visits were recorded and analyzed using the Roter Interaction Analysis System. Different variables related to communication (e.g., number of statements, patient-centeredness ratio and type of questions asked and information given) and affective tone during visits was measured. Visits by patients in the intervention group were longer and had greater patient contribution to the dialogue than visit by the control group. Clinicians asked more questions about treatment and the condition than in the control group.
  1. aMieli.Net is called Mental.Net in English
  2. bReConnect was previously called PsyConnect