126P
Barriers, Attitudes, and Capacity for Mobile Technology Adoption in a Community ACT Provider
Mobile communications technology (i.e. smart phones and computer tablets) has potential to revolutionize mental health treatment, particularly for Assertive Community Treatment (ACT) teams. However, little work has been done to assess technological readiness of the mental health workforce and to identify barriers that could affect implementation of new technologically based interventions. The purpose of this study was to explore clinicians’ attitudes about technology, beliefs about clients’ attitudes toward technology, and agency capacity to integrate technology in the workflow of a community-based ACT team.
Methods:
Structured qualitative interviews were conducted with a convenience sample of seven clinicians (majority female; a nurse, a substance abuse counselor, three social workers, a vocational counselor, and a housing specialist between the ages of 30-64) at an ACT program located in Baltimore. This ACT program serves approximately 100 clients with serious and persistent mental illness, typically from low socioeconomic backgrounds. Interviewers were the principal investigator, social work faculty researcher, and doctoral social work student. Respondents answered questions related to their attitudes about mobile technologies, thoughts about clients’ attitudes about mobile technologies, and clinical barriers to using mobile technologies.
Two research team members used a constant comparison approach to code interviews. All interviews were coded using NVivo version 10. The two coders then compared codes and identified key domains.
Results:
Three essential domains were identified: clinicians’ attitudes towards using mobile technology, clinicians’ concerns about consumers’ capacity in using mobile technology, and agency necessities related to implementing mobile technology in clinical settings. Results indicated that clinicians expressed an interest in using technology at work. In particular, clinicians identified potential for technology to save time and increase clinical capacity by facilitating access to information and community resources. Two clinicians above the age of 50 expressed concerns related to comfort in using new technology.
Overall, clinicians were optimistic about clients’ ability and interest in using mobile technology but raised several concerns about client capacity. In particular, clinicians suggested that psychiatric symptoms and intellectual disabilities would limit consumers’ independence when using technology. Several clinicians identified substance abuse as a risk for selling technology. Furthermore, client resource barriers would limit consumers’ access to technology. Clinicians raised concerns about client confidentiality, safety using expensive devices in their neighborhood, and general lack of internet access as barriers to client acceptance of internet-based mobile technologies. Clinicians identified several agency necessities for quality implementation of technology including proper training on use of technology, specifically issues of privacy, patient confidentiality, and for older workforce members who may not be comfortable using new technologies. Clinicians also identified access to technology and shared data resources as key limitations of existing agency capacity.
Conclusions and Implications:
Findings suggest that mobile technology can play a valuable role in community-based treatment programs such as ACT teams. Responses indicate that clinicians would like to engage with their clients more through technology and are interested in participating in training in order to do so. However, researchers seeking to develop mobile technological interventions should take client and agency resource issues into account.