检查用于推进精神分裂症疾病自我管理和提供者参与的数字健康方法

App4独立（A4i）

实验：A4i Intervention App4Independence (A4i) 该研究干预是数字健康平台 A4i。 A4i 在个人自己的手机上运行，​​无论是否有数据。

具体的 A4i 功能包括：

• 通过个性化提示、活动安排以及与一系列资源的连接来解决社交孤立和认知挑战。
• 通过循证内容促进疾病自我管理。
• 一个点对点参与平台，促进用户（匿名和主持）之间的策略/技巧共享。
• 每日健康和目标实现情况检查。
• 带有示波器型指示器的环境声音探测器可以帮助有幻听的人将幻听与真实声音区分开来。
• 被动收集手机使用数据作为睡眠指标。
• 提供商仪表板。 对照和实验条件参与者都将接受标准门诊护理 (TAU)。

• A4i

Medication adherence will be measured using the 4-item Brief Adherence Rating Scale with responses obtained by both providers and participants to assess medication adherence. There are two indicators, both are pre-post changes, "days not taken" and "days taken less", and both are not scored as a percentage.

The change scores for taking medication less (days taken less) and medication not taken (days not taken) were calculated as the difference from their 6 month score minus their baseline score. An value of "better" was assigned when the change score is > 0, value of "no change" was assigned when the change score is = 0, and a value of "worse" value was assigned when the change score is < 0.

The Heinrichs-Carpenter Quality of Life Scale, has 21 items, is well validated for schizophrenia, and captures sense of purpose, motivation, emotional and social interaction, role functioning, and engagement in regular activities. Higher values are better. Range 0-126.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Schizophrenia-specific symptomatology will be assessed with the Positive and Negative Syndrome Scale. Lower values are better. Range 30-210.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Global Appraisal of Individual Needs- Short Screener (GAIN-SS) - Instrument used for screening possible internalizing or externalizing psychiatric disorders, substance use disorders, or crime and violence problems. Lower values are better. Range 0-20.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

The 5-item, 6-point likert scale Medical Outcomes Study general adherence scale to capture broader adherence to treatment recommendations (again triangulated with provider responses). Higher values are better. Range 5-26.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Provider-Patient Clinical Alliance will be assessed with Scale to Assess the Therapeutic Relationship - Patient to measure patient perspective of provider-patient relationship. This 12-item measure employing a 5-point likert scale has been used extensively in studies of outpatient care for severe mental illness. This measure supports patient and provider versions. Higher values are better. Range 0-48.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Service Use History measure to assess past month service use history of patient participant.

Number of visits due to physical health issues (in the past 6 months) included the sum of: family doctor, ER, walk-in clinic, and other services for the patient participant Number of visits due to mental health issues (in the past 6 months) included the sum of: sum of family doctor, outpatient, psychologist, social worker, community service for the patient participant There is no limit on the scale range since it is based on the number of visits to various services in the past 6 months.