TY - JOUR
T1 - Using Innovation-Corps (I-Corps™) Methods to Adapt a Mobile Health (mHealth) Obesity Treatment for Community Mental Health Settings
AU - Haddad, Rita
AU - Badke D'Andrea, Carolina
AU - Ricchio, Amanda
AU - Evanoff, Bradley
AU - Morrato, Elaine H.
AU - Parks, Joseph
AU - Newcomer, John W.
AU - Nicol, Ginger E.
N1 - Funding Information:
BE has received funding from the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). EM has received grant support from the National Institutes of Health (NIH) and the CDC and has consulted for the U.S. Food and Drug Administration (FDA) and Eli Lilly and Company. JP has participated in Advisory panels or consulted with Merck, Boehringer-Ingelheim, Lundbeck, Otsuka, and Janssen. JN has participated in advisory panels or consulted with Merck, Boehringer-Ingelheim, Lundbeck, Otsuka, and Janssen; has received grant support from the NIH and the Substance Abuse and Mental Health Services Administration (SAMHSA); has served as a consultant for Alkermes, Inc., Intra-cellular Therapies, Inc., Sunovion and Merck; and served on a Data Safety Monitoring Board for Amgen. GN has received grant support from the NIH, the Barnes Jewish Hospital Foundation, the McDonnell Center for Systems Neuroscience, and Usona Institute (drug only), and has served as a consultant for Alkermes, Inc., Otsuka and Sunovion. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Funding Information:
Each CMHC and Clubhouse ecosystem is unique, meaning health promotion programs must be tailored both to the clinical population and treatment setting in order to be successful (). Thus, multi-level stakeholder engagement is critical for adapting or developing programs before they are implemented (, ). Innovation Corps (I-Corps™) methodology, co-created by the National Science Foundation (NSF) () and adopted by the National Institutes of Health (NIH), () uses the design-based Lean Launchpad approach, popularized for tech startups for the academic research audience to facilitate customer-centered design and promote more successful commercialization of technology and engineering innovation into real-world settings and markets (, ). The emphasis of the I-Corps method is on immediate and iterative collection of stakeholder feedback via “customer discovery” interviews to identify and validate a “value proposition” for key consumers (). From this, major “gains,” “pains” and “jobs to be done” are identified, and used to revise assumptions and hypotheses, testing redesigned offerings and making further small adjustments (iterations) or more substantive ones (pivots) to improve outcomes.
Funding Information:
Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1TR002535, UL1TR003096, UL1TR001417, and the National Institute of Mental Health Grant Numbers MH112473 and MH118395. This work was also made possible by Public Health Cubed seed funding via the Washington University School of Medicine Institute for Public Health.
Funding Information:
The authors would like to thank everyone who participated in interviews for this project, including leadership, clinicians, staff, consumers, and their family members at BJC Behavioral Health, the Independence Center, Places for People, the Washington University School of Medicine Outpatient Child, and Adult Psychiatry Clinics in St. Louis Missouri, Fellowship House in Miami, FL, and the leadership at the Missouri Coalition for Behavioral Health and the National Council on Behavioral Health.
Publisher Copyright:
Copyright © 2022 Haddad, Badke D'Andrea, Ricchio, Evanoff, Morrato, Parks, Newcomer and Nicol.
PY - 2022/5/27
Y1 - 2022/5/27
N2 - Background: We employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings. Methods: We hypothesized “jobs to be done” in three broad stakeholder groups: “decision makers” (DM = state and community clinic administrators), “clinician consumers” (CC = case managers, peer supports, nurses, prescribers) and “service consumers” (SC = patients, peers and family members). Semistructured interviews (N = 29) were recorded and transcribed ver batim and coded based on pragmatic-variant grounded theory methods. Results: Four themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on implementation ownership, intersecting with professional development, suggesting the importance of training and supervision in scalability. Sub-themes in resources and intertia differed between CC and SC groups, suggesting illness severity and access to healthy food as major barriers to engagement, whereas the SC group identified the need for enhanced emotional support, in addition to pragmatic skills like menu planning and cooking, to promote health behavior change. Although SMS was percieved as a viable education and support tool, CC and DM groups had limited familiarity with use in clinical care delivery. Conclusions: Based on customer discovery, the characteristics of a minimum viable iOTA for implementation, scalability and sustainability include population- and context-specific adaptations to treatment content, interventionist training and delivery mechanism. Successful implementation of an SMS-based intervention will likely require micro-adaptations to fit specific clinical settings.
AB - Background: We employed Innovation Corps (I-Corps™) methods to adaptation of a mobile health (mHealth) short-message-system (SMS) -based interactive obesity treatment approach (iOTA) for adults with severe mentall illness receiving care in community settings. Methods: We hypothesized “jobs to be done” in three broad stakeholder groups: “decision makers” (DM = state and community clinic administrators), “clinician consumers” (CC = case managers, peer supports, nurses, prescribers) and “service consumers” (SC = patients, peers and family members). Semistructured interviews (N = 29) were recorded and transcribed ver batim and coded based on pragmatic-variant grounded theory methods. Results: Four themes emerged across groups: education, inertia, resources and ownership. Sub-themes in education and ownership differed between DM and CC groups on implementation ownership, intersecting with professional development, suggesting the importance of training and supervision in scalability. Sub-themes in resources and intertia differed between CC and SC groups, suggesting illness severity and access to healthy food as major barriers to engagement, whereas the SC group identified the need for enhanced emotional support, in addition to pragmatic skills like menu planning and cooking, to promote health behavior change. Although SMS was percieved as a viable education and support tool, CC and DM groups had limited familiarity with use in clinical care delivery. Conclusions: Based on customer discovery, the characteristics of a minimum viable iOTA for implementation, scalability and sustainability include population- and context-specific adaptations to treatment content, interventionist training and delivery mechanism. Successful implementation of an SMS-based intervention will likely require micro-adaptations to fit specific clinical settings.
KW - clinical and translational science
KW - health services
KW - implementation science
KW - innovation-corps
KW - mentally ill persons
KW - obesity
UR - http://www.scopus.com/inward/record.url?scp=85132589968&partnerID=8YFLogxK
U2 - 10.3389/fdgth.2022.835002
DO - 10.3389/fdgth.2022.835002
M3 - Article
C2 - 35721796
AN - SCOPUS:85132589968
SN - 2673-253X
VL - 4
JO - Frontiers in Digital Health
JF - Frontiers in Digital Health
M1 - 835002
ER -