Symposia
Telehealth/m-Health
Snezana Urosevic, Ph.D. (she/her/hers)
Clinician Investigator Team Program Manager
Minneapolis VA Health Care System
Minneapolis, Minnesota
John J. Curtin, Ph.D.
Professor
Department of Psychology, University of Wisconsin - Madison
Madison, Wisconsin
Tasha Nienow, Ph.D.
Staff Psychologist, Clinician-Investigator
Minneapolis VAMC
Minneapolis, Minnesota
David Bond, MD, PhD (he/him/his)
Associate Professor
John Hopkins University
Baltimore, Maryland
Kasey Stack, B.S. (she/her/hers)
Project Coordinator
Minneapolis VA Health Care System
Minneapolis, Minnesota
Helen Frieman, B.A. (she/her/hers)
Project Coordinator
Minneapolis VA Health Care System
Minneapolis, Minnesota
Eric Kuhn, Ph.D. (he/him/his)
Clinical Psychologist | Associate Professor
National Center for PTSD
Menlo Park, California
John Ferguson, Ph.D.
Associate Professor
University of Minnesota
Minneapolis, Minnesota
Adriana Hughes, Ph.D. (she/her/hers)
Staff Neuropsychologist
Minneapolis VAMC
Minneapolis, Minnesota
Background: People with bipolar disorders (BD) are at a high risk for poor psychosocial functioning, such as erratic employment and relationship difficulties. Veterans with BD have similar poor outcomes with high rates of unemployment, incarceration, and deaths by suicide. Mood tracking is an effective tool for early detection and prevention of BD episodes, which in turn can improve patients’ overall functioning. Still, patients’ lack of insight during acute BD states can lead to unreliable detection of early symptoms. Digital phenotyping approaches that rely on passive monitoring in real-time could provide low-patient burden and reliable assessments of functioning in BD. The present study examined feasibility and acceptability of smartphone GPS-tracking as a tool for detecting changes in social engagement in Veterans with BD.
Methods: During three-month follow-up, 30 Veterans with BD provided continuous tracking of their smartphones’ GPS using FollowMee app and, using two other apps, daily self-report ratings of mood and voice diaries about their activities. At a baseline assessment, participants provided location context information for frequently visited places (e.g., a type of place, typical activities engaged in). Biweekly interviews assessed social engagement using Patient-Reported Outcome Measurement Information System (PROMIS) Satisfaction with Participation in Social Roles and Ability to Engage in Social Roles and Activities scales, as well as symptoms using Your Mania Rating Scale and Modified Hamilton Depression Rating Scale. Veterans provided feedback about their experiences and perceived utility of methods in Exit Interviews.
Results: Retention rate was high with 26 participants completing the study. Three-month follow-up was sufficient to observe BD episodes (81% of participants) and periods of poor social engagement (92% of participants). Participants on average provided GPS data on 98% of study days. Location context GPS-based measures of time spent at work, home, or completing daily chores, tracked self-report PROMIS measures of social engagement. In Exit Interviews, participants indicated high acceptability of GPS-tracking method.
Conclusions: Location context-enriched GPS measures provide meaningful indicators of real-world ability to engage with communities and social networks in patients with BD. These passive and unobtrusive methods are feasible and acceptable to Veterans with BD. Future larger studies are needed to build reliable algorithms using this type of GPS-data for clinical use in BD.