Participatory Messaging in the UCLA Psychiatry Partial Hospitalization and Intensive Outpatient Programs

The Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) in the
Neuropsychatric Hospital at UCLA provide psychiatric services for adults and children with
acute mental illness. These include voluntary programs that support individuals in their
recovery with the goal to assist patients in achieving the highest level of independence.
Most programs operate Monday through Friday between four to eight hours a day. Recently, the
PHP and IOP programs have decided to start including mobile messaging as a part of care,
helping patients to feel supported even after they have left the hospital for the day.

The purpose of this study is to evaluate the feasibility and effectiveness of their ongoing
use of the Chorus Participatory Mobile Framework to support clinical care. Chorus is a
framework and web application that allows users to rapidly create a broad range of automated
text messaging (SMS), interactive voice (IVR), or mobile web applications using a simple and
accessible visual interface without requiring any server programming. There will be two
broad populations using Chorus: (1) programs (e.g. OCD Intensive Treatment Program) in which
all participants will receive participatory mobile messaging and (2) programs (e.g. Adult
Acute PHP) in which patients will be randomized to receive either participatory mobile
messaging or no mobile messaging. Across all programs, Kandace Whiting and Armen Arevian
will train PHP and IOP therapists starting with creating simple, basic, useful messaging
content in Chorus to support patients in achieving program goals. Examples of messages
include Cognitive Behavioral Therapy (CBT), symptom management, and stress management cues
to patients in the Obsessive Compulsive Disorder Clinic, patients in the Adult Eating
Disorder Clinic, and parents from The Achievement, Behavior, Cognition (ABC) Child Programs.

All participating patients receiving participatory mobile messaging will work with program
staff one-on-one to tailor SMS and IVR content and design based on their own preferences. By
being able to personalize the messaging, the Chorus Participatory Mobile Framework meets the
capacities and preferences of the users rather than a "one-size" approach requiring
adaptation of the users to the technology. Both therapists and patients will be invited to
up to bi-weekly, in-person workshops specific to their program to provide feedback and
input. The goal of these workshops is to further develop and refine the novel mobile
interventions based on stakeholder input. The Chorus Participatory Framework will be used
during the workshops to develop and test the application in real-time. Workshops will be
audio and/or video recorded to document the process.

Inclusion Criteria:

- Patients (over the age of 18) or parents of patients who are minors (between the ages
of 6 and 17)

- Enrolled in PHP or IOP programs at Resnick Neuropsychiatric Hospital

- Agree to participate (minors will be required to have parental consent)

- Patient participants will need to be English speaking because text and IVR messages
and workshops will be conducted in English.

- Patient must have cellular phone that can receive text messages

- All PHP and IOP staff are eligible and will be invited to participate in workshops
and complete surveys.

Exclusion Criteria:

- Declines consent or is unwilling to participate in the study

- Does not speak English. Language other than English is an exclusion given resources
and capacity of the study

- Patients without a cellular phone that can receive text messages

- Not receiving texts or IVR messages from their program is an exclusion given that it
is the intervention we are evaluating

- Patients under the age of 6.