Sofie Ragnhild Aminoff’s research while affiliated with Oslo University Hospital and other places

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Publications (3)


Figure 3. A workflow with iTandem. After setting initial goals, the service user logs data, which are assessed during sessions. After monitoring sleep for 4 weeks, the service user and the clinician choose to change modules as they want to focus more on activities and medication.
A Mobile Health Intervention to Support Collaborative Decision-Making in Mental Health Care: Development and Usability
  • Article
  • Full-text available

January 2025

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35 Reads

JMIR Formative Research

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Mari Skoge

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Sofie Ragnhild Aminoff

Background Shared decision-making between clinicians and service users is crucial in mental health care. One significant barrier to achieving this goal is the lack of user-centered services. Integrating digital tools into mental health services holds promise for addressing some of these challenges. However, the implementation of digital tools, such as mobile apps, remains limited, and attrition rates for mental health apps are typically high. Design thinking can support the development of tools tailored to the needs of service users and clinicians. Objective This study aims to develop and beta test a digital tool designed for individuals with severe mental disorders or substance use disorders to facilitate shared decision-making on treatment goals and strategies within mental health services. Methods We used a user-centered design approach to develop iTandem, an app facilitating collaborative treatment between service users and clinicians. Through qualitative interviews and workshops, we engaged 6 service users with severe mental disorders or substance use disorders, 6 clinicians, and 1 relative to identify and design relevant app modules. A beta test of iTandem was conducted to refine the app and plan for a pilot trial in a clinical setting. After 6 weeks of app use, 5 clinicians and 4 service users were interviewed to provide feedback on the concept, implementation, and technical issues. Safety and ethical considerations were thoroughly discussed and addressed. Results To avoid overload for the service users, we applied a pragmatic take on module content and size. Thus, iTandem includes the following 8 modules, primarily based on the needs of service users and clinicians: Sleep (sleep diary), Medication (intake and side effects), Recovery (measures, including well-being and personal recovery, and exercises, including good things and personal strengths), Mood (mood diary and report of daily feelings), Psychosis (level of positive symptoms and their consequences and level of negative symptoms), Activity (goal setting and progress), Substance use (weekly use, potential triggers or strategies used to abstain), and Feedback on therapy (of individual sessions and overall rating of the past week). For the beta testing, service users and clinicians collaborated in choosing 2-3 modules in iTandem to work with during treatment sessions. The testing showed that the app was well received by service users, and that facilitation for implementation is crucial. Conclusions iTandem and similar apps have the potential to enhance treatment outcomes by facilitating shared decision-making and tailoring treatment to the needs of service users. However, successful implementation requires thorough testing, iterative development, and evaluations of both utility and treatment effects. There is a critical need to focus on how technology integrates into clinical settings—from development to implementation—and to conduct further research on early health technology assessments to guide these processes.

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Promoting Shared Decision-Making in Treatment for Psychotic Disorders with the iTandem Mobile App: A Feasibility and Acceptability Study (Preprint)

November 2024

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22 Reads

BACKGROUND Strengthening shared decision-making in mental healthcare may improve quality of services and treatment outcomes, but its implementation in services for severe mental disorders is currently lacking. OBJECTIVE This study aims to explore the feasibility and acceptability of the mobile app iTandem as a digital tool promoting shared decision-making in treatment for psychotic disorders. In addition, the study aims to investigate mechanisms that enable the intended effect of the app. iTandem is a mobile app developed as a therapy supplement that facilitates patient involvement in decisions regarding treatment goals and focus areas. It is designed for personalized use and contains eight optional modules: sleep, medication, recovery, mood, psychosis, activity, substance use, and feedback concerning therapy. METHODS Patients undergoing assessment or treatment for psychotic disorders and their clinicians were recruited to the study. The patients and the clinicians jointly used iTandem as part of the standard treatment in a six week-trial. Using a mixed methods design, feasibility and acceptability measures were assessed with descriptive statistics based on app usage data and pre- and post-intervention questionnaires, in addition to a reflexive thematic analysis of post-intervention interviews. RESULTS Nine patients and eight clinicians completed the trial. The participants evaluated iTandem as a user-friendly and acceptable tool, but there were considerable variations in how the app was integrated in treatment and in perceptions of its clinical value. The thematic analysis suggests that iTandem promoted shared decision-making by supporting cognition and shifting the patient role. It also identified scaffolding structures, an analogy of personalised support, as a precondition for the overall feasibility and acceptability of the intervention. CONCLUSIONS iTandem generally functioned as a feasible and acceptable digital promoter of shared decision-making in treatment for patients with psychotic disorders. Our findings suggest that non-clinical aspects, such as support structures, digital habits and personal styles of relating to others are important in evaluations of patients’ aptness for digitalised treatment. Future research should explore these general parameters further, as opposed to grouping potential users based on diagnoses and symptom severity.


A Mobile Health Intervention to Support Collaborative Decision-Making in Mental Health Care: Development and Usability (Preprint)

February 2024

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1 Read

BACKGROUND Shared decision-making between clinicians and service users is crucial in mental health care. One significant barrier to achieving this goal is the lack of user-centered services. Integrating digital tools into mental health services holds promise for addressing some of these challenges. However, the implementation of digital tools, such as mobile apps, remains limited, and attrition rates for mental health apps are typically high. Design thinking can support the development of tools tailored to the needs of service users and clinicians. OBJECTIVE This study aims to develop and beta test a digital tool designed for individuals with severe mental disorders or substance use disorders to facilitate shared decision-making on treatment goals and strategies within mental health services. METHODS We used a user-centered design approach to develop iTandem, an app facilitating collaborative treatment between service users and clinicians. Through qualitative interviews and workshops, we engaged 6 service users with severe mental disorders or substance use disorders, 6 clinicians, and 1 relative to identify and design relevant app modules. A beta test of iTandem was conducted to refine the app and plan for a pilot trial in a clinical setting. After 6 weeks of app use, 5 clinicians and 4 service users were interviewed to provide feedback on the concept, implementation, and technical issues. Safety and ethical considerations were thoroughly discussed and addressed. RESULTS To avoid overload for the service users, we applied a pragmatic take on module content and size. Thus, iTandem includes the following 8 modules, primarily based on the needs of service users and clinicians: Sleep (sleep diary), Medication (intake and side effects), Recovery (measures, including well-being and personal recovery, and exercises, including good things and personal strengths), Mood (mood diary and report of daily feelings), Psychosis (level of positive symptoms and their consequences and level of negative symptoms), Activity (goal setting and progress), Substance use (weekly use, potential triggers or strategies used to abstain), and Feedback on therapy (of individual sessions and overall rating of the past week). For the beta testing, service users and clinicians collaborated in choosing 2-3 modules in iTandem to work with during treatment sessions. The testing showed that the app was well received by service users, and that facilitation for implementation is crucial. CONCLUSIONS iTandem and similar apps have the potential to enhance treatment outcomes by facilitating shared decision-making and tailoring treatment to the needs of service users. However, successful implementation requires thorough testing, iterative development, and evaluations of both utility and treatment effects. There is a critical need to focus on how technology integrates into clinical settings—from development to implementation—and to conduct further research on early health technology assessments to guide these processes.