Use of Ecological Momentary Assessment Through a Passive Smartphone-Based App (eB2) by Patients With Schizophrenia: Acceptability Study

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Abstract

Background

Ecological momentary assessment (EMA) tools appear to be useful interventions for collecting real-time data on patients’ behavior and functioning. However, concerns have been voiced regarding the acceptability of EMA among patients with schizophrenia and the factors influencing EMA acceptability.

Objective

The aim of this study was to investigate the acceptability of a passive smartphone-based EMA app, evidence-based behavior (eB2), among patients with schizophrenia spectrum disorders and the putative variables underlying their acceptance.

Methods

The participants in this study were from an ongoing randomized controlled trial (RCT) of metacognitive training, consisting of outpatients with schizophrenia spectrum disorders (F20-29 of 10th revision of the International Statistical Classification of Diseases and Related Health Problems), aged 18-64 years, none of whom received any financial compensation. Those who consented to installation of the eB2 app (users) were compared with those who did not (nonusers) in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight, and metacognitive variables. A multivariable binary logistic regression tested the influence of the above (independent) variables on “being user versus nonuser” (acceptability), which was the main outcome measure.

Results

Out of the 77 RCT participants, 24 (31%) consented to installing eB2, which remained installed till the end of the study (median follow-up 14.50 weeks) in 14 participants (70%). Users were younger and had a higher education level, better premorbid adjustment, better executive function (according to the Trail Making Test), and higher cognitive insight levels (measured with the Beck Cognitive Insight Scale) than nonusers (univariate analyses) although only age (OR 0.93, 95% CI 0.86-0.99; P=.048) and early adolescence premorbid adjustment (OR 0.75, 95% CI 0.61-0.93; P=.01) survived the multivariable regression model, thus predicting eB2 acceptability.

Conclusions

Acceptability of a passive smartphone-based EMA app among participants with schizophrenia spectrum disorders in this RCT where no participant received financial compensation was, as expected, relatively low, and linked with being young and good premorbid adjustment. Further research should examine how to increase EMA acceptability in patients with schizophrenia spectrum disorders, in particular, older participants and those with poor premorbid adjustment.

Trial Registration

ClinicalTrials.gov NCT04104347; https://clinicaltrials.gov/ct2/show/NCT04104347

Related collections

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Author and article information

Contributors

Javier-David Lopez-Morinigo:

ORCID: https://orcid.org/0000-0002-4264-2664

Departamento de Psiquiatria, IIS-Fundación Jiménez DíazAvenida de los Reyes CatólicosMadrid, 28040Spain34 627277126javierd.lopez@uam.es

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: July 2021

Publication date (Electronic): 26 July 2021

Volume: 23

Issue: 7

Electronic Location Identifier: e26548

Affiliations

[1 ] Departamento de Psiquiatria, IIS-Fundación Jiménez Díaz Madrid Spain

[2 ] Departamento de Psiquiatria, Universidad Autónoma de Madrid Madrid Spain

[3 ] Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Madrid Spain

[4 ] Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense Madrid Spain

[5 ] Departamento de Psiquiatria, Hospital Universitario Rey Juan Carlos Móstoles, Madrid Spain

[6 ] Departamento de Teoría de Señal y de la Comunicación, Universidad Carlos III Madrid Spain

[7 ] Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM) Madrid Spain

[8 ] Evidence-Based Behavior Leganés, Madrid Spain

[9 ] Institute of Mental Health, University College London London United Kingdom

[10 ] Universidad Católica del Maule Talca Chile

[11 ] Departamento de Psiquiatría, Hospital Universitario Central de Villalba Madrid Spain

[12 ] Departamento de Psiquiatría, Hospital Universitario Infanta Elena Valdemoro, Madrid Spain

[13 ] Université de Nîmes Nimes France

Author notes

Corresponding Author: Javier-David Lopez-Morinigo javierd.lopez@ 123456uam.es

Author information

Javier-David Lopez-Morinigo https://orcid.org/0000-0002-4264-2664

María Luisa Barrigón https://orcid.org/0000-0002-2497-6353

Alejandro Porras-Segovia https://orcid.org/0000-0003-2019-9099

Verónica González Ruiz-Ruano https://orcid.org/0000-0002-8346-3259

Adela Sánchez Escribano Martínez https://orcid.org/0000-0002-2113-752X

Paula Jhoana Escobedo-Aedo https://orcid.org/0000-0003-2579-7370

Sergio Sánchez Alonso https://orcid.org/0000-0002-5495-3144

Laura Mata Iturralde https://orcid.org/0000-0001-6847-1229

Laura Muñoz Lorenzo https://orcid.org/0000-0003-0855-5812

Antonio Artés-Rodríguez https://orcid.org/0000-0001-6540-7109

Anthony S David https://orcid.org/0000-0003-0967-774X

Enrique Baca-García https://orcid.org/0000-0002-6963-6555

Article

Publisher ID: v23i7e26548

DOI: 10.2196/26548

PMC ID: 8367186

PubMed ID: 34309576

SO-VID: c58ce6f1-d90a-4ddf-9831-f70b0e825be6

Copyright © ©Javier-David Lopez-Morinigo, María Luisa Barrigón, Alejandro Porras-Segovia, Verónica González Ruiz-Ruano, Adela Sánchez Escribano Martínez, Paula Jhoana Escobedo-Aedo, Sergio Sánchez Alonso, Laura Mata Iturralde, Laura Muñoz Lorenzo, Antonio Artés-Rodríguez, Anthony S David, Enrique Baca-García. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 26.07.2021.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 16 December 2020

Date revision requested : 14 January 2021

Date revision received : 10 February 2021

Date accepted : 13 May 2021

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