TY -的盟Ben-Zeev Dror盟——Chander阿伊莎盟——陶谢尔,贾斯汀盟——巴克,本杰明AU -尼泊尔,Subigya AU -坎贝尔,Andrew AU - Doron家伙PY - 2021 DA - 2021/11/12 TI -智能手机患有严重精神疾病的干预:完全远程随机对照试验的核心乔- J地中海互联网Res SP - e29201六世- 23 - 11 KW -移动健康KW -精神分裂症KW双相情感障碍KW -抑郁KW -手机AB -背景:患有严重精神疾病(SMI)的人有严重的精神卫生需求未得到满足。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)。活动组T1 ~ T2使用CORE，等待组T2 ~ T3使用CORE。两组人在结束干预期后都完成了可用性和可访问性测试。结果:共有来自45个州的315名个体参与了这项研究。 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×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 SN - 1438-8871 UR - //www.mybigtv.com/2021/11/e29201 UR - https://doi.org/10.2196/29201 UR - http://www.ncbi.nlm.nih.gov/pubmed/34766913 DO - 10.2196/29201 ID - info:doi/10.2196/29201 ER -