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Comparing a clinician-assisted and app-supported behavioral activation intervention to promote brain health and well-being in frontline care

Published online by Cambridge University Press:  24 August 2020

Keri-Leigh Cassidy ,
Michael Vallis ,
David Conn ,
Ariane S. Massie ,
Claire Checkland ,
Daria Parsons ,
Julie Spence Mitchell  and
Kiran Rabheru
Keri-Leigh Cassidy*
Affiliation:
Department of Psychiatry, Dalhousie University, Halifax, Canada
Michael Vallis
Affiliation:
Department of Psychiatry, Dalhousie University, Halifax, Canada
David Conn
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Coalition for Seniors’ Mental Health, Toronto, Canada
Ariane S. Massie
Affiliation:
Coalition for Seniors’ Mental Health, Toronto, Canada School of Kinesiology & Health Science, York University, Toronto, Canada
Claire Checkland
Affiliation:
Coalition for Seniors’ Mental Health, Toronto, Canada
Daria Parsons
Affiliation:
Coalition for Seniors’ Mental Health, Toronto, Canada
Julie Spence Mitchell
Affiliation:
Coalition for Seniors’ Mental Health, Toronto, Canada
Kiran Rabheru
Affiliation:
Coalition for Seniors’ Mental Health, Toronto, Canada Department of Psychiatry, University of Ottawa, Ottawa, Canada
*
Correspondence should be addressed to: Keri-Leigh Cassidy, Geriatric Psychiatry Department, 6th floor Abbie Lane Building, 5909 Veterans’ Memorial Lane, Halifax, Nova ScotiaB3H 2E2, Canada. Phone: +1 902-472-2927; Fax: +1 902-473-5713. Email: [email protected].
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Abstract

Background:

Positive psychiatry offers an unique approach to promote brain health and well-being in aging populations. Minimal interventions through behavioral activation to promote wellness are increasingly available using self-guided apps, yet little is known about the effectiveness of app technology or the difference between clinician-supported behavioral activation versus self-guided app methodologies.

Objectives:

Investigate the difference in users and outcomes between two methods of the Fountain of Health (FoH) positive psychiatry intervention for behavioral activation to promote brain health and well-being: (1) clinician-assisted and (2) independent app use for behavioral self-management.

Design and setting:

As part of a larger knowledge translation intervention in positive psychiatry, two specific methods of a behavioral activation intervention were retrospectively compared.

Participants:

Two subsets of patients were compared; 254 clinician-assisted patients; 333 independent app users.

Intervention:

A minimal positive psychiatry intervention in frontline care using the FoH health and behavior change clinical tools

Measurements:

Main outcomes were changes in psychological (health and resilience, well-being scores) and behavioral indices (goal attainment, items of goal SMART-ness). User profiles (age, sex and completion rates) were also compared.

Results:

Clinician-assisted patients were more likely to be male, older, and have lower health and resilience scores at baseline. Clinician-assisted patients had notably higher completion rates (99.2% vs. 10.8%). Psychological outcomes (improved health and resilience, and well-being) were similar regardless of intervention method for those who completed the intervention. Behavioral outcomes revealed clinician-assisted patients set goals that better adhered to key goal-setting items.

Conclusions:

Clinician–patient relationships appear to be an important factor for intervention completion and behavioral outcomes, while further exploration of best practices for intervention completion using health apps in clinical practice is needed. A preliminary goal-setting methodology for effective behavioral activation, to promote brain health and wellness, is given.

Keywords

behavior and behavioral activationpositive psychiatryinternet-based interventiongoalsbrain health promotionwell-beingpreventive medicinehealthy aging
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 6: Issue Theme: Diverse Strategies for Improving Seniors’ Well-Being , June 2021 , pp. 615 - 625
Copyright
© International Psychogeriatric Association 2020

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