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dc.contributor.authorLarkin, Celine
dc.contributor.authorDjamasbi, Soussan
dc.contributor.authorBoudreaux, Edwin D
dc.contributor.authorVarzgani, Fatima
dc.contributor.authorGarner, Roscoe
dc.contributor.authorSiddique, Mariam
dc.contributor.authorPietro, John
dc.contributor.authorTulu, Bengisu
dc.date.accessioned2023-03-22T19:33:37Z
dc.date.available2023-03-22T19:33:37Z
dc.date.issued2023-01-27
dc.identifier.citationLarkin C, Djamasbi S, Boudreaux ED, Varzgani F, Garner R, Siddique M, Pietro J, Tulu B. ReachCare Mobile Apps for Patients Experiencing Suicidality in the Emergency Department: Development and Usability Testing Using Mixed Methods. JMIR Form Res. 2023 Jan 27;7:e41422. doi: 10.2196/41422. PMID: 36705961; PMCID: PMC9919536.en_US
dc.identifier.eissn2561-326X
dc.identifier.doi10.2196/41422en_US
dc.identifier.pmid36705961
dc.identifier.urihttp://hdl.handle.net/20.500.14038/51866
dc.description.abstractBackground: Many individuals with suicide risk present to acute care settings such as emergency departments (EDs). However, staffing and time constraints mean that many EDs are not well equipped to deliver evidence-based interventions for patients experiencing suicidality. An existing intervention initiated in the ED for patients with suicide risk (Emergency Department Safety Assessment and Follow-up Evaluation [ED-SAFE]) has been found to be effective but faces trenchant barriers for widespread adoption. Objective: On the basis of the ED-SAFE intervention, we aimed to develop 2 apps for patients with suicide risk: a web app guiding patients through safety planning in the ED (ED app) and a smartphone app providing patients components of the ED-SAFE program on their phones after discharge (patient app). We then tested the usability of these apps with patients presenting to the ED with suicide risk. Methods: Using a user-centered design framework, we first developed user personas to explore the needs and characteristics of patients who are at risk for suicide using inputs from clinicians (n=3) and suicidologists (n=4). Next, we validated these personas during interviews with individuals with lived experience of suicidality (n=6) and used them to inform our application designs. We field-tested the apps with ED patients presenting with suicide risk (n=14) in 2 iterative cycles to assess their usability and engagement using a mixed methods approach. We also rated the quality and fidelity of the safety plans created. Results: We developed 2 interoperable and complementary apps. The first is a web app designed for use on a tablet device during ED admission that guides the patient by creating a safety plan using a chatbot-style interface. The second is a smartphone app for use after discharge and allows the patient to view, edit, and share their completed safety plan; access self-care education, helplines, and behavioral health referrals; and track follow-up appointments with the study clinician. The initial prototype usability testing (n=9) demonstrated satisfactory scores (ED app System Usability Scale [SUS], mean 78.6/100, SD 24.1; User Engagement Scale, mean 3.74/5, SD 0.72; patient app SUS, mean 81.7/100, SD 20.1). After refining the apps based on participant feedback, the second cycle testing (n=5) showed improvement (ED app SUS, mean 90.5/100, SD 9.9; User Engagement Scale, mean 4.07/5, SD 0.36; patient app SUS, mean 97.0/100, SD 1.9). The quality ratings for completed safety plans were satisfactory (Safety Planning Intervention Scoring Algorithm-Brief, mean 27.4, SD 3.4). Conclusions: By adopting a user-centered approach and creating personas to guide development, we were able to create apps for ED patients with suicide risk and obtain satisfactory usability, engagement, and quality scores. Developing digital health tools based on user-centered design principles that deliver evidence-based intervention components may help overcome trenchant implementation barriers in challenging health care settings.en_US
dc.language.isoenen_US
dc.relation.ispartofJMIR Formative Researchen_US
dc.relation.urlhttps://doi.org/10.2196/41422en_US
dc.rights©Celine Larkin, Soussan Djamasbi, Edwin D Boudreaux, Fatima Varzgani, Roscoe Garner, Mariam Siddique, John Pietro, Bengisu Tulu. Originally published in JMIR Formative Research (https://formative.jmir.org), 27.01.2023. 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 JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be includeden_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectemergency departmenten_US
dc.subjectengagementen_US
dc.subjectmobile appen_US
dc.subjectmobile phoneen_US
dc.subjectsuicideen_US
dc.subjectusabilityen_US
dc.titleReachCare Mobile Apps for Patients Experiencing Suicidality in the Emergency Department: Development and Usability Testing Using Mixed Methodsen_US
dc.typeJournal Articleen_US
dc.source.journaltitleJMIR formative research
dc.source.volume7
dc.source.beginpagee41422
dc.source.endpage
dc.source.countryCanada
dc.identifier.journalJMIR formative research
refterms.dateFOA2023-03-22T19:33:37Z
dc.contributor.departmentEmergency Medicineen_US


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©Celine Larkin, Soussan Djamasbi, Edwin D Boudreaux, Fatima Varzgani, Roscoe Garner, Mariam Siddique, John Pietro,
Bengisu Tulu. Originally published in JMIR Formative Research (https://formative.jmir.org), 27.01.2023. 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 JMIR
Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on
https://formative.jmir.org, as well as this copyright and license information must be included
Except where otherwise noted, this item's license is described as ©Celine Larkin, Soussan Djamasbi, Edwin D Boudreaux, Fatima Varzgani, Roscoe Garner, Mariam Siddique, John Pietro, Bengisu Tulu. Originally published in JMIR Formative Research (https://formative.jmir.org), 27.01.2023. 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 JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included