@文章{info:doi/ 10.2192 /29201，作者="Ben-Zeev, Dror和Chander, Ayesha和Tauscher, Justin和Buck, Benjamin和Nepal, Subigya和Campbell, Andrew和Doron, Guy"，标题="对严重精神疾病患者的智能手机干预:CORE的完全远程随机对照试验"，期刊="J Med Internet Res"，年="2021"，月="11"，日="12"，卷="23"，数="11"，页="e29201"，关键词="移动健康;精神分裂症;双相情感障碍;抑郁症;背景:患有严重精神疾病(SMI)的人有严重的精神健康需求未得到满足。开发和测试能够减轻重度精神分裂症患者痛苦的数字干预措施是公共卫生的一个优先事项。目的:本研究的目的是对CORE进行完全远程随机候选对照试验。CORE是一种智能手机干预，包括日常练习，旨在促进在多个领域的功能障碍信念的重新评估。方法:通过网络使用谷歌和Facebook广告招募个体。登记的参与者被随机分为主动干预组和等待对照组。参与者在基线(T1)、30天(T2)和60天(T3)的评估点完成贝克抑郁量表-第二版(BDI-II)、广泛性焦虑障碍-7 (GAD-7)、汉密尔顿精神分裂症声音计划、格林偏执思维量表、恢复评估量表(RAS)、罗森伯格自尊量表(RSES)、友谊量表和希恩残疾量表(SDS)。 Participants in the active group used CORE from T1 to T2, and participants in the waitlist group used CORE from T2 to T3. Both groups completed usability and accessibility measures after they concluded their intervention periods. Results: Overall, 315 individuals from 45 states participated in this study. The sample comprised individuals with self-reported bipolar disorder (111/315, 35.2{\%}), major depressive disorder (136/315, 43.2{\%}), and schizophrenia or schizoaffective disorder (68/315, 21.6{\%}) who displayed moderate to severe symptoms and disability levels at baseline. Participants rated CORE as highly usable and acceptable. Intent-to-treat analyses showed significant treatment{\texttimes}time interactions for the BDI-II (F1,313=13.38; P<.001), GAD-7 (F1,313=5.87; P=.01), RAS (F1,313=23.42; P<.001), RSES (F1,313=19.28; P<.001), and SDS (F1,313=10.73; P=.001). Large effects were observed for the BDI-II (d=0.58), RAS (d=0.61), and RSES (d=0.64); a moderate effect size was observed for the SDS (d=0.44), and a small effect size was observed for the GAD-7 (d=0.20). Similar changes in outcome measures were later observed in the waitlist control group participants following crossover after they received CORE (T2 to T3). Approximately 41.5{\%} (64/154) of participants in the active group and 60.2{\%} (97/161) of participants in the waitlist group were retained at T2, and 33.1{\%} (51/154) of participants in the active group and 40.3{\%} (65/161) of participants in the waitlist group were retained at T3. Conclusions: We successfully recruited, screened, randomized, treated, and assessed a geographically dispersed sample of participants with SMI entirely via the web, demonstrating that fully remote clinical trials are feasible in this population; however, study retention remains challenging. CORE showed promise as a usable, acceptable, and effective tool for reducing the severity of psychiatric symptoms and disability while improving recovery and self-esteem. Rapid adoption and real-world dissemination of evidence-based mobile health interventions such as CORE are needed if we are to shorten the science-to-service gap and address the significant unmet mental health needs of people with SMI during the COVID-19 pandemic and beyond. Trial Registration: ClinicalTrials.gov NCT04068467; https://clinicaltrials.gov/ct2/show/NCT04068467 ", issn="1438-8871", doi="10.2196/29201", url="//www.mybigtv.com/2021/11/e29201", url="https://doi.org/10.2196/29201", url="http://www.ncbi.nlm.nih.gov/pubmed/34766913" }