Co-Production of a Flexibly Delivered Relapse Prevention Tool to Support the Self-Management of Long-Term Mental Health Conditions: Co-Design and User Testing Study

Alyssa Milton; Ingrid Ozols A M; Tayla Cassidy; Dana Jordan; Ellie Brown; Urska Arnautovska; Jim Cook; Darren Phung; Brynmor Lloyd-Evans; Sonia Johnson; Ian Hickie; Nick Glozier

doi:10.2196/49110

Co-Production of a Flexibly Delivered Relapse Prevention Tool to Support the Self-Management of Long-Term Mental Health Conditions: Co-Design and User Testing Study

JMIR Form Res. 2024 Feb 23:8:e49110. doi: 10.2196/49110.

Authors

Alyssa Milton^{1

2

3}, Ingrid Ozols A M^{4

5}, Tayla Cassidy^{6

7}, Dana Jordan¹, Ellie Brown^{8

9}, Urska Arnautovska¹⁰, Jim Cook¹¹, Darren Phung¹¹, Brynmor Lloyd-Evans¹², Sonia Johnson¹², Ian Hickie², Nick Glozier^{1

3}

Affiliations

¹ Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
² Brain and Mind Centre, University of Sydney, Camperdown, Australia.
³ ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia.
⁴ mentalhealth@work (mh@work), Melbourne, Australia.
⁵ Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia.
⁶ One Door Mental Health, Sydney, Australia.
⁷ School of Social Work and Arts, Charles Sturt University, Canberra, Australia.
⁸ Orygen, Parkville, Australia.
⁹ Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
¹⁰ Faculty of Medicine, The University of Queensland, Woolloongabba, Australia.
¹¹ TechLab ICT, University of Sydney, Sydney, Australia.
¹² Division of Psychiatry, University College London, London, United Kingdom.

PMID: 38393768
PMCID: PMC10926903
DOI: 10.2196/49110

Abstract

Background: Supported self-management interventions, which assist individuals in actively understanding and managing their own health conditions, have a robust evidence base for chronic physical illnesses, such as diabetes, but have been underused for long-term mental health conditions.

Objective: This study aims to co-design and user test a mental health supported self-management intervention, My Personal Recovery Plan (MyPREP), that could be flexibly delivered via digital and traditional paper-based mediums.

Methods: This study adopted a participatory design, user testing, and rapid prototyping methodologies, guided by 2 frameworks: the 2021 Medical Research Council framework for complex interventions and an Australian co-production framework. Participants were aged ≥18 years, self-identified as having a lived experience of using mental health services or working in a peer support role, and possessed English proficiency. The co-design and user testing processes involved a first round with 6 participants, focusing on adapting a self-management resource used in a large-scale randomized controlled trial in the United Kingdom, followed by a second round with 4 new participants for user testing the co-designed digital version. A final round for gathering qualitative feedback from 6 peer support workers was conducted. Data analysis involved transcription, coding, and thematic interpretation as well as the calculation of usability scores using the System Usability Scale.

Results: The key themes identified during the co-design and user testing sessions were related to (1) the need for self-management tools to be flexible and well-integrated into mental health services, (2) the importance of language and how language preferences vary among individuals, (3) the need for self-management interventions to have the option of being supported when delivered in services, and (4) the potential of digitization to allow for a greater customization of self-management tools and the development of features based on individuals' unique preferences and needs. The MyPREP paper version received a total usability score of 71, indicating C+ or good usability, whereas the digital version received a total usability score of 85.63, indicating A or excellent usability.

Conclusions: There are international calls for mental health services to promote a culture of self-management, with supported self-management interventions being routinely offered. The resulting co-designed prototype of the Australian version of the self-management intervention MyPREP provides an avenue for supporting self-management in practice in a flexible manner. Involving end users, such as consumers and peer workers, from the beginning is vital to address their need for personalized and customized interventions and their choice in how interventions are delivered. Further implementation-effectiveness piloting of MyPREP in real-world mental health service settings is a critical next step.

Keywords: blended interventions; digital health tools; mobile phone; peer support; self-care; self-management; serious mental illness.

©Alyssa Milton, Ingrid Ozols A M, Tayla Cassidy, Dana Jordan, Ellie Brown, Urska Arnautovska, Jim Cook, Darren Phung, Brynmor Lloyd-Evans, Sonia Johnson, Ian Hickie, Nick Glozier. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.02.2024.