PeerTECH: a randomized controlled trial of a peer-led mobile health intervention to improve medical and psychiatric self-management for persons with serious mental illness.
Academic Article
Overview
abstract
BACKGROUND: Certified peer support specialists (CPSs) can empower individuals with serious mental illness (SMI) to engage with mobile health interventions designed to improve medical and psychiatric self-management. This study pilot-tested PeerTECH, a digital, 12-session intervention adapted from Integrated Illness Management and Recovery and delivered by CPSs, to assess its feasibility, acceptability, and preliminary effectiveness in enhancing self-management among individuals with SMI compared to peer support as usual (PSAU). METHODS: A two-arm pilot randomized controlled trial was conducted with individuals diagnosed with SMI and at least one medical comorbidity. Participants were randomly assigned to either PeerTECH, a 12-week structured mobile health intervention delivered by CPSs, or PSAU (peer support without mobile technology). Outcome measures related to medical and psychiatric self-management were assessed at baseline and 12 weeks. Data was analysed using linear mixed-effects regression models to compare outcomes between groups. Feasibility and acceptability were evaluated by participant retention rates, intervention adherence, and participant-reported satisfaction. RESULTS: The study demonstrated that the randomized control trial design was feasible and acceptable, with 72.73% of approached patients consenting to participate. PeerTECH delivery was engaging, with 90% of participants initiating the intervention, approximately 80% completing it, and participants engaging in text exchanges on 70% of possible days, averaging 10 text exchanges. The intervention was found to be acceptable, with 100% of participants reporting satisfaction, and safe, with no adverse events. Statistically significant improvements were observed in PeerTECH compared to PSAU in physical health outcomes, as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 Physical Health scores (P=0.023). Clinically meaningful improvements in the Integrated Management and Recovery Scale and PROMIS-derived utility scores (EuroQol 5-Dimension Scale, Health Utilities Index) were also observed. CONCLUSIONS: The Peer-Led Mobile Health Intervention demonstrated feasibility and effectiveness in enhancing self-management among individuals with SMI and chronic comorbidities. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (NCT04481737).
