Engaging With a Web-Based Psychosocial Intervention for Psychosis: Qualitative Study of User Experiences

JMIR Ment Health. 2020 Jun 19;7(6):e16730. doi: 10.2196/16730.

Abstract

Background: Web-based interventions are increasingly being used for individuals with serious mental illness, including psychosis, and preliminary evidence suggests clinical benefits. To achieve such benefits, individuals must have some level of engagement with the intervention. Currently, little is known about what influences engagement with web-based interventions for individuals with psychotic disorders.

Objective: This study aimed to explore users' perspectives on what influenced engagement with a web-based intervention for psychosis.

Methods: A qualitative design was employed using semistructured telephone interviews. Participants were 17 adults with psychosis who had participated in a trial examining engagement with a self-guided, web-based intervention promoting personal recovery and self-management of mental health.

Results: We identified 2 overarching themes: challenges to using the website and factors supporting persistence. Both of the main themes included several subthemes related to both user-related factors (eg, mental health, personal circumstances, approach to using the website) and users' experience of the intervention (eg, having experienced similar content previously or finding the material confronting).

Conclusions: Individuals with psychosis experienced several challenges to ongoing engagement with a web-based intervention. Adjunctive emails present an important design feature to maintain interest and motivation to engage with the intervention. However, fluctuations in mental health and psychosocial difficulties are a significant challenge. Design and implementation considerations include flexible interventions with tailoring opportunities to accommodate changeable circumstances and individual preferences.

Keywords: eHealth; engagement; internet intervention; mobile phone; psychosis; qualitative research.