3 - (SYM 61) Empowering Early Psychosis Caregivers to Facilitate Help-seeking with Self-guided Mhealth: The Bolster Project

A long duration of untreated illness is robustly linked with poorer outcomes for young adults with early psychosis (EP). Caregivers, who are often the most critical facilitator of help-seeking for young adults with EP (Anderson et al., 2013) face their own unique barriers and challenges in supporting help-seeking. Many lack accurate information about psychosis and commonly report feeling highly distressed, isolated, and unable to help (Jansen et al., 2015). While family interventions are well-suited to address these difficulties, caregivers must first facilitate their loved one’s help-seeking to receive it. While previous interventions have demonstrated digital tools capable of extending family interventions for psychosis, few interventions are self-guided, and none to our knowledge are designed specifically for this critical help-seeking period (Onwumere et al., 2018). Our team developed Bolster, a self-guided mHealth intervention designed for EP caregivers whose loved ones are not engaged in services. Twenty-one caregivers were remotely recruited to complete qualitative interviews and usability test a preliminary app prototype. Test sessions were analyzed to determine (1) primary unmet needs, (2) prioritized app features, and (3) strengths and weaknesses of the prototype. Unmet needs included guidance in communication (N = 18, 86% of caregivers), support for caregiver coping (N = 11, 52%), actionable help-seeking guidance (N = 11, 52%), and general information on psychosis (N = 11, 52%). Usability ratings (i.e. 1 to 10 usefulness scale) provided to Bolster were high (overall score; Mean = 8.26, SD = 1.46) with highest ratings given to intervention features related to interactive communication coaching (Mean = 8.90, SD = 0.89). Caregivers noted that Bolster was easy to use, encouraging, and informative, but suggested that subsequent versions add additional depth of information and personalization. Our team developed design solutions to address areas for improvement and completed development of the beta version of Bolster in February 2023. In addition to introducing this innovative tool to support this underserved population, study results provide insights into how digital mental health tools ought to be designed to better support EP caregivers. Later this year our team will launch a randomized controlled trial later this year to determine whether Bolster (compared to existing online resources) can improve caregiving skills and improve family communication while reducing caregiver distress and time to initiation of services.