背景:支持自我管理干预措施,帮助个人积极了解和管理自己的健康状况,对慢性身体疾病有强有力的证据基础,比如糖尿病,但对于长期的精神健康状况却没有得到充分利用。
目的:本研究旨在共同设计和用户测试一种心理健康支持的自我管理干预措施,我的个人恢复计划(MyPREP)这可以通过数字和传统的纸质媒体灵活地交付。
方法:本研究采用参与式设计,用户测试,和快速成型方法,以2个框架为指导:2021年医学研究委员会复杂干预措施框架和澳大利亚联合制作框架。参与者年龄≥18岁,自我认定具有使用精神卫生服务或在同伴支持角色中工作的生活经验,并拥有英语水平。共同设计和用户测试过程涉及第一轮,有6名参与者,专注于适应在英国的大规模随机对照试验中使用的自我管理资源,接下来是第二轮,有4名新参与者,供用户测试共同设计的数字版本。进行了最后一轮收集来自6名同行支持工作者的定性反馈。数据分析涉及转录,编码,和主题解释以及使用系统可用性量表计算可用性得分。
结果:在共同设计和用户测试会议期间确定的关键主题与(1)需要自我管理工具灵活并很好地集成到心理健康服务中,(2)语言的重要性以及语言偏好在个体之间的差异,(3)需要自我管理干预措施,以便在提供服务时可以选择得到支持,(4)数字化的潜力,以允许更大的自定义自我管理工具和基于个人的独特偏好和需求的功能开发。MyPREP论文版本的可用性总分为71,表明C或良好的可用性,而数字版本的可用性总分为85.63,表明A或出色的可用性。
结论:国际上呼吁提供精神卫生服务,以促进自我管理文化,常规提供支持的自我管理干预措施。由此产生的澳大利亚版本的自我管理干预MyPREP的共同设计原型为以灵活的方式在实践中支持自我管理提供了途径。涉及最终用户,比如消费者和同龄人,从一开始,对于满足他们对个性化和定制干预措施的需求以及他们如何提供干预措施的选择至关重要。在现实世界的精神卫生服务环境中进一步实施MyPREP的有效性试点是关键的下一步。
BACKGROUND: Supported self-management interventions, which assist individuals in actively understanding and managing their own health conditions, have a robust evidence base for chronic physical illnesses, such as diabetes, but have been underused for long-term mental health conditions.
OBJECTIVE: This study aims to co-design and user test a mental health supported self-management intervention, My Personal Recovery Plan (MyPREP), that could be flexibly delivered via digital and traditional paper-based mediums.
METHODS: This study adopted a participatory design, user testing, and rapid prototyping methodologies, guided by 2 frameworks: the 2021 Medical Research Council framework for complex interventions and an Australian co-production framework. Participants were aged ≥18 years, self-identified as having a lived experience of using mental health services or working in a peer support role, and possessed English proficiency. The co-design and user testing processes involved a first round with 6 participants, focusing on adapting a self-management resource used in a large-scale randomized controlled trial in the United Kingdom, followed by a second round with 4 new participants for user testing the co-designed digital version. A final round for gathering qualitative feedback from 6 peer support workers was conducted. Data analysis involved transcription, coding, and thematic interpretation as well as the calculation of usability scores using the System Usability Scale.
RESULTS: The key themes identified during the co-design and user testing sessions were related to (1) the need for self-management tools to be flexible and well-integrated into mental health services, (2) the importance of language and how language preferences vary among individuals, (3) the need for self-management interventions to have the option of being supported when delivered in services, and (4) the potential of digitization to allow for a greater customization of self-management tools and the development of features based on individuals\' unique preferences and needs. The MyPREP paper version received a total usability score of 71, indicating C+ or good usability, whereas the digital version received a total usability score of 85.63, indicating A or excellent usability.
CONCLUSIONS: There are international calls for mental health services to promote a culture of self-management, with supported self-management interventions being routinely offered. The resulting co-designed prototype of the Australian version of the self-management intervention MyPREP provides an avenue for supporting self-management in practice in a flexible manner. Involving end users, such as consumers and peer workers, from the beginning is vital to address their need for personalized and customized interventions and their choice in how interventions are delivered. Further implementation-effectiveness piloting of MyPREP in real-world mental health service settings is a critical next step.