Symposium 32: The Evidence Based Behavioral Medicine and Child and Family Health SIG presents: Exploring contextual factors when integrating technology within clinic settings

Symposium Title Exploring contextual factors when integrating technology within clinic settings.

Chair: Alyssa Button, PhD

Co-Presenters: Alyssa Button, PhD; Sabrina Ford, PhD; Margaret Emerson, APRN, PMHNP-BC

Discussant: Margaret Emerson, APRN, PMHNP-BS

Introduction: With 95% of households in the US having access to the internet and 90% having access to a smartphone, the integration of technology in all areas of life including healthcare is increasing. Telehealth literature suggests that it can be beneficial; however, research is needed to identify ways to improve communication, equitable access, and education of both patients and providers about telehealth. The goal of this symposium is to describe a variety of contextual factors that impact the implementation and uptake of technology within different clinic settings including perspectives from patients, providers, researchers, and clinics.

Methods: The first presenter will describe practicing mental health clinician focus group results regarding the adaptation and incorporation of GamerFit, a theory and evidence-based eHealth mobile app that utilizes telehealth coaching, exergaming challenges, and on-demand exercise videos, into ongoing treatment for youth with psychiatric disorders. The second presenter will discuss clinicians’ perceived benefit of telehealth and related intended use in healthcare systems. The third presenter will describe lessons learned from two different pilot studies integrating mental health mobile apps in three different integrated primary care clinics.

Results: Clinics and practitioners can feasibly employ telehealth interventions in a variety of settings to support physical and mental health outcomes among diverse populations as an accessible and acceptable adjunct to standard care.

Conclusion: The integration of technology into clinic settings presents both opportunities and challenges. While technology can extend care beyond face-to-face visits and address barriers to access, their implementation requires comprehensive strategies to ensure buy-in from healthcare providers and patients.

 
Title: Clinician Considerations for Incorporating Physical Activity and Sleep Prescriptions into Practice Using eHealth for Youth with Comorbid Psychiatric Disorders

Authors: Alyssa M. Button1, PhD, James Slavet2, PhD, *Amanda E. Staiano1, MPP, PhD, & *April B. Bowling3, ScD *Multiple Principal Investigators
1Pennington Biomedical Research Center
2Marblehead Family Therapy and Wellness
3Merrimack College

Background: Physical activity (PA) and sleep prescriptions are indicated for the treatment of psychiatric disorders among youth. However, there is limited clinical adoption of these practices. This study collected feedback from practicing clinicians on adopting GamerFit, an app-based intervention that incorporates exergames, step and sleep tracking, and online health coaching to promote PA and sleep, as a tool within treatment plans for youth with comorbid psychiatric disorders.

Methods: Mental health clinicians participated in two online focus groups. A semi-structured interview was used to gather information on perceptions of the importance of PA and sleep, considerations for using GamerFit with clients, and approaches for incorporating GamerFit into standard care. Qualitative analysis included hierarchical thematic coding system of isolated quotes, with the structure, frequency, and interrelationships of coded quotes used for analysis. The process included inductive and deductive analysis.

Results: All clinicians (8/8) endorsed PA and sleep prescriptions as important interventions, and most perceived eHealth approaches positively (7/8). Clinicians were optimistic about the feasibility of using GamerFit. The exergame and health coaching aspects of GamerFit were perceived favorably, as was the perceived transferability of using this intervention in residential, school, and home settings. Clinicians desired to access app data in electronic health systems to incorporate in therapeutic sessions and recommended use in residential settings with home continuation after discharge. Clinicians expressed concern regarding the implementation of GamerFit with families with low technology literacy. They also suggested increased variety of exergame and app features to increase adolescents’ engagement. Clinicians perceived GamerFit as a feasible and acceptable clinical approach to PA and sleep prescriptions for youth with psychiatric disorders.

Funding: National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, R21HD106465


Title: Integrating Telemedicine into Medical Training: Assessing Factors Influencing Adoption in Clinical Settings

Authors: Bree Holtz, PhD,1 Kelly Hirko, PhD,2 Naadiyahtu Iddrisu, MA,1 & Sabrina Ford, PhD2
1College of Communication Arts & Sciences, Michigan State University (MSU)
2College of Human Medicine, MSU

Introduction: Telemedicine is increasingly essential in modern healthcare, yet medical education programs lack structured telehealth raining, leaving future physicians I’ll-equipped for virtual patient interactions. This study applies the Unified Theory of Acceptance and Use of Technology (UTAUT) framework to examine factors influencing medical students’ adoption of telehealth in clinical practice.

Methods: A cross-sectional survey of 98 medical students from a Midwestern university assessed key UTAUT constructs: Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC). The survey included a 5-point Likert scale and open-ended questions, with data analyzed using multiple linear regression and thematic analysis.

Results: Multiple linear regression analysis found that PE was the strongest predictor of Behavioral Intention (BI) to use telemedicine (B = 0.771, p < 0.001), indicating that students who perceived telemedicine as beneficial were more likely to adopt it. However, EE (B = -0.040, p = 0.671), SI (B = 0.144, p = 0.240), and FC (B = -0.006, p = 0.952) were not significant predictors. Thematic analysis of qualitative responses reinforced the importance of telemedicine’s perceived utility, with students citing its relevance in improving patient access and future clinical workflows.

Conclusions: Findings suggest that while students recognize telemedicine’s potential, institutional support, and structured training are crucial for successful adoption. Integrating telemedicine education into medical curricula can enhance digital health competencies and prepare future physicians for evolving clinical environments. Expanding telehealth training across institutions and assessing long-term competency development will be key to optimizing telemedicine’s role in patient care.
 
Title: Lessons learned from integrating mental mobile health apps into integrated primary care settings

Presenter: Margaret Emerson, APRN, PMHNP-BC

Introduction: Mental health apps offer an innovative approach to meeting the rising demand for psychiatric services, especially in underserved populations. Despite the availability of numerous mental health apps, their use in integrated primary care (IPC) settings, particularly for patients with depression and trauma, remains under-researched. This paper aims to describe the lessons learned from two pilot studies integrating MindLAMP and BBN apps into IPC environments.

Methods: The two pilot studies were conducted in three Midwestern IPC clinics, selected based on their provision of integrated care and service to predominantly underserved populations. MindLAMP focused on depression, while BBN targeted trauma symptoms. Behavioral Health Providers (BHPs) were trained to facilitate app use and support patients. Data were collected through surveys, interviews, and app usage metrics.

Results: Both studies faced challenges in patient recruitment and app integration. The MindLAMP study saw moderate improvements in depression symptoms among participants, while the BBN study showed mixed results in anxiety and PTSD symptoms. However, both studies revealed systemic barriers to the successful adoption of mHealth apps in IPC settings, including time constraints, inconsistent patient follow-up, and limited clinic support structures. Lessons learned will be discussed around recruitment as well as clinic buy-in and clinic flow.

Chair - Alyssa Button PhD  Student
Virginia Commonwealth University

Co-Author - Alyssa Button PhD  Student
Virginia Commonwealth University

Co-Presenter - Sabrina Ford PhD  Student
Michigan State University Institute for Health Policy

Co-Presenter - Margaret Emerson APRN, PMHNP-BC  Student
University of Nebraska Medical Center

Discussant - Margaret Emerson APRN, PMHNP-BS  Student
University of Nebraska Medical Center

Co-Author - Sandra Williams MD, PhD  Student
National Institute of Arthritis and Musculoskeletal and Skin Disease

Co-Author - Amanda Staiano MPP, PhD  Student
Pennington Biomedical Research Center

Co-Author - April Bowling MA, ScD  Student
Merrimack College

Co-Author - James Slavet PhD  Student
Marblehead Family Therapy and Wellness

Symposium Title Exploring contextual factors when integrating technology within clinic settings.

Chair: Alyssa Button, PhD

Co-Presenters: Alyssa Button, PhD; Sabrina Ford, PhD; Margaret Emerson, APRN, PMHNP-BC

Discussant: Margaret Emerson, APRN, PMHNP-BS

Introduction: With 95% of households in the US having access to the internet and 90% having access to a smartphone, the integration of technology in all areas of life including healthcare is increasing. Telehealth literature suggests that it can be beneficial; however, research is needed to identify ways to improve communication, equitable access, and education of both patients and providers about telehealth. The goal of this symposium is to describe a variety of contextual factors that impact the implementation and uptake of technology within different clinic settings including perspectives from patients, providers, researchers, and clinics.

Methods: The first presenter will describe practicing mental health clinician focus group results regarding the adaptation and incorporation of GamerFit, a theory and evidence-based eHealth mobile app that utilizes telehealth coaching, exergaming challenges, and on-demand exercise videos, into ongoing treatment for youth with psychiatric disorders. The second presenter will discuss clinicians’ perceived benefit of telehealth and related intended use in healthcare systems. The third presenter will describe lessons learned from two different pilot studies integrating mental health mobile apps in three different integrated primary care clinics.

Results: Clinics and practitioners can feasibly employ telehealth interventions in a variety of settings to support physical and mental health outcomes among diverse populations as an accessible and acceptable adjunct to standard care.

Conclusion: The integration of technology into clinic settings presents both opportunities and challenges. While technology can extend care beyond face-to-face visits and address barriers to access, their implementation requires comprehensive strategies to ensure buy-in from healthcare providers and patients.



 
Title: Clinician Considerations for Incorporating Physical Activity and Sleep Prescriptions into Practice Using eHealth for Youth with Comorbid Psychiatric Disorders

Authors: Alyssa M. Button1, PhD, James Slavet2, PhD, *Amanda E. Staiano1, MPP, PhD, & *April B. Bowling3, ScD *Multiple Principal Investigators
1Pennington Biomedical Research Center
2Marblehead Family Therapy and Wellness
3Merrimack College

Background: Physical activity (PA) and sleep prescriptions are indicated for the treatment of psychiatric disorders among youth. However, there is limited clinical adoption of these practices. This study collected feedback from practicing clinicians on adopting GamerFit, an app-based intervention that incorporates exergames, step and sleep tracking, and online health coaching to promote PA and sleep, as a tool within treatment plans for youth with comorbid psychiatric disorders.

Methods: Mental health clinicians participated in two online focus groups. A semi-structured interview was used to gather information on perceptions of the importance of PA and sleep, considerations for using GamerFit with clients, and approaches for incorporating GamerFit into standard care. Qualitative analysis included hierarchical thematic coding system of isolated quotes, with the structure, frequency, and interrelationships of coded quotes used for analysis. The process included inductive and deductive analysis.

Results: All clinicians (8/8) endorsed PA and sleep prescriptions as important interventions, and most perceived eHealth approaches positively (7/8). Clinicians were optimistic about the feasibility of using GamerFit. The exergame and health coaching aspects of GamerFit were perceived favorably, as was the perceived transferability of using this intervention in residential, school, and home settings. Clinicians desired to access app data in electronic health systems to incorporate in therapeutic sessions and recommended use in residential settings with home continuation after discharge. Clinicians expressed concern regarding the implementation of GamerFit with families with low technology literacy. They also suggested increased variety of exergame and app features to increase adolescents’ engagement. Clinicians perceived GamerFit as a feasible and acceptable clinical approach to PA and sleep prescriptions for youth with psychiatric disorders.

Funding: National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, R21HD106465



Title: Integrating Telemedicine into Medical Training: Assessing Factors Influencing Adoption in Clinical Settings

Authors: Bree Holtz, PhD,1 Kelly Hirko, PhD,2 Naadiyahtu Iddrisu, MA,1 & Sabrina Ford, PhD2
1College of Communication Arts & Sciences, Michigan State University (MSU)
2College of Human Medicine, MSU

Introduction: Telemedicine is increasingly essential in modern healthcare, yet medical education programs lack structured telehealth raining, leaving future physicians I’ll-equipped for virtual patient interactions. This study applies the Unified Theory of Acceptance and Use of Technology (UTAUT) framework to examine factors influencing medical students’ adoption of telehealth in clinical practice.

Methods: A cross-sectional survey of 98 medical students from a Midwestern university assessed key UTAUT constructs: Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC). The survey included a 5-point Likert scale and open-ended questions, with data analyzed using multiple linear regression and thematic analysis.

Results: Multiple linear regression analysis found that PE was the strongest predictor of Behavioral Intention (BI) to use telemedicine (B = 0.771, p < 0.001), indicating that students who perceived telemedicine as beneficial were more likely to adopt it. However, EE (B = -0.040, p = 0.671), SI (B = 0.144, p = 0.240), and FC (B = -0.006, p = 0.952) were not significant predictors. Thematic analysis of qualitative responses reinforced the importance of telemedicine’s perceived utility, with students citing its relevance in improving patient access and future clinical workflows.

Conclusions: Findings suggest that while students recognize telemedicine’s potential, institutional support, and structured training are crucial for successful adoption. Integrating telemedicine education into medical curricula can enhance digital health competencies and prepare future physicians for evolving clinical environments. Expanding telehealth training across institutions and assessing long-term competency development will be key to optimizing telemedicine’s role in patient care.
 
Title: Lessons learned from integrating mental mobile health apps into integrated primary care settings
Presenter: Margaret Emerson, APRN, PMHNP-BC

Introduction: Mental health apps offer an innovative approach to meeting the rising demand for psychiatric services, especially in underserved populations. Despite the availability of numerous mental health apps, their use in integrated primary care (IPC) settings, particularly for patients with depression and trauma, remains under-researched. This paper aims to describe the lessons learned from two pilot studies integrating MindLAMP and BBN apps into IPC environments.

Methods: The two pilot studies were conducted in three Midwestern IPC clinics, selected based on their provision of integrated care and service to predominantly underserved populations. MindLAMP focused on depression, while BBN targeted trauma symptoms. Behavioral Health Providers (BHPs) were trained to facilitate app use and support patients. Data were collected through surveys, interviews, and app usage metrics.

Results: Both studies faced challenges in patient recruitment and app integration. The MindLAMP study saw moderate improvements in depression symptoms among participants, while the BBN study showed mixed results in anxiety and PTSD symptoms. However, both studies revealed systemic barriers to the successful adoption of mHealth apps in IPC settings, including time constraints, inconsistent patient follow-up, and limited clinic support structures. Lessons learned will be discussed around recruitment as well as clinic buy-in and clinic flow.

Chair - Alyssa Button, PhD,
Virginia Commonwealth University

Co-Presenter - Alyssa Button, PhD,
Virginia Commonwealth University

Co-Presenter - Sabrina Ford, PhD, PhD,
Michigan State University Institute for Health Policy

Co-Presenter - Margaret Emerson, APRN, PMHNP-BS,
University of Nebraska Medical Center

Discussant - Margaret Emerson, APRN, PMNHP-BS,
University of Nebraska Medical Center

Co-Author - Amanda Staiano, MPP, PhD,
Pennington Biomedical Research Center

Co-Author - April Bowling, MA, ScD,
Merrimack College

Co-Author - James Slavet, PhD,
Marblehead Family Therapy and Wellness